Setting a proper diet plan

Highlights:

• India’s child malnourishment level is not only the highest in the world but varies considerably across States.

Facts:

• As per the National Family Health Survey-2016, the proportion of stunted (low height for age) children under five is significantly higher (38.4%) than global (22.9%) averages. The underweight (low weight for age) children rate (35.7%) is a lot higher than the global average (13.5%) too.
• India is home to over 53.3 million stunted, 49.6 million underweight and 29.2 million wasted (low weight for height) children under five.
• Major challenges
• Growing prosperity has hardly made any significant dent in chronic malnutrition of children.
• Faster economic growth has enormous benefits, but it is by no means sufficient and sustainable if millions of children remain undernourished, as it not only impacts early childhood health and imposes disease burden but also affects education, wages and productivity when they grow up, which will impact India’s growth.

Major Issues

Governance Side:

• One problem lies with the current thinking of growth-oriented development.  The low income and Empowered-Action-Group (EAG) States face major challenges to improve malnutrition, but, two EAG States, Chhattisgarh and Odisha, have performed better on this front compared to Gujarat and Maharashtra where per capita income is almost double.
• Odisha, which is a low income State, has a better network of Integrated Child Development Services (ICDS), public health facility/workforce per lakh population and educational attainment among women, which have translated into a better nutritional status when compared with Gujarat.
• Further, tribals, rural, poor and illiterate mothers’ children are badly off in so-called developed States of Haryana, Gujarat and Punjab.
• These groups are also affected in poorer States of U.P., Bihar, Jharkhand and Madhya Pradesh. Around two-thirds of stunted/underweight children are from 200 districts of both less developed and developed States.

Agriculture v. hunger

• Another prominent idea is the need to link agriculture and nutrition, as agriculture provides answers to most nutrition problems.
• Worryingly, malnutrition in some of its agriculturally-developed districts (Karnal, Panipat, Sonipat, Rohtak as well as in Gurugram) is even higher than the average of Odisha.
• To understand the contradiction between agrarian plenty and malnutrition, let us take the example of diversified food.
• With the increase in diversity in food intake, measured through Food Intake Index using 19 food items in all 640 districts, malnutrition (stunted/underweight) status declines.
• Only 12% of children are likely to be stunted and underweight in areas where diversity in food intake is high, while around 50% children are stunted if they consume less than three food items.
• The diversified food intake is very low in a majority of Indian districts; just 28% of children consumed over five items of the total 19 food items.
• The way forward
• An inclusive and holistic approach, including controlling/regulating food price, strengthening the public distribution system (PDS) and income support policies for making food cheaper are important steps.
• The ICDS was a high impact nutrition intervention, but its universal availability and quality are questionable due to poor functioning.
• The launch of the National Nutrition Mission as a strategy to fight maternal and child malnutrition is a welcome step towards achieving the targets of underweight and stunted children under five years from 35.7% to 20.7% and from 38.4% to 25% respectively by 2022.

The Hindu