Malnutrition

Context

Key points

• Poor nutrition among pregnant women affects the nutritional status of the child and has a greater chance to affect future generations.
• Undernourished children are at risk of under-performing in studies and have limited job prospects.
• This vicious cycle restrains the development of the country, whose workforce is affected mentally and physically and has reduced work capacity.

Marginal improvement 

• There has been some progress in tackling malnutrition among children and women over the past decade, but the improvement has been modest at best.
• This is despite declining rates of poverty, increased self-sufficiency in food production and the implementation of a range of government programmes.
• Children in several states are more undernourished now than they were five years ago.

Stunting, wasting, anaemia

• While there was some reduction in stunting rates (35.5 Per cent from 38.4 per cent in NFHS-4).
• 13 states and Union Territories increased children since NFHS-4; this includes Gujarat, Maharashtra, West Bengal and Kerala (Stunting is defined as low height for age).
• Malnutrition trends across NFHS Surveys show that westing, the most visible and life-threatening form of malnutrition, has either risen or has remained stagnant over the years ( Wasting is defined as low weight-for-height).
• India also has the highest prevalence of anaemia in the world.
• Anaemia is defined as the condition in which the number of red blood cells or the haemoglobin concentration within them is lower than normal.

• The NFHS-5 survey indicates that more than 57 per cent of women (15-49 years) and over 67 per cent of Children (6-59 Months) suffer from anaemia.
• Assam is among the low- performing states, with a huge burden of anaemic cases 66.4 per cent of women and 68.4 per cent of children are affected.
• It is imperative to introspect about these problems and remain persistent, pervasive and serious.
• It has major consequences in terms of human health and development.
• It reduces the work capacity of individuals, in turn impacting the economy and overall national growth.
• Developing countries lose up to 4.05 per cent in GDP per annum due to iron deficiency anaemia. 
• India loses up to 1.18 per cent of GDP annually.

Step up the financing

• There is a greater need to increase investment in women's and children's health and nutrition to ensure their sustainable development and improved quality of life.
• The government's focus has been on the consolidation of several programmes to improve outcomes, there is a need for the increased financial commitment.
• Saksham Anganwadi and the Prime Minister's Overarching Scheme for Holistic Nourishment (POSHAN) 2.0 programme have seen only a marginal increase in budgetary allocation this year.
• Additionally, 32 per cent of funds released under POSHAN Abhiyaan to States and Union Territories have not been utilised.

Monitor constituencies too

• India must adopt an outcome-oriented approach to nutrition programmes.
• Parliamentarians must begin monitoring needs and interventions in their constituencies and raise awareness of the issues, impact and solutions to address the challenges at the local level.
• There has to be direct engagement with nutritionally vulnerable groups (the elderly, pregnant women, those with special needs and young children) and contribute toward ensuring last-mile delivery of key nutrition services and interventions.
• This will ensure greater awareness on the one hand and proper planning and implementation of programmes at the grassroots level on the other.
• It can be replicated at the district and national levels.
• With basic education and general awareness, every individual is informed, takes initiative at the personal level and can become an agent of change. 
• Different studies highlight a strong link between a mother's education and improved access and compliance with nutrition interventions among children.
• The young population has a competitive advantage; nutrition and health are foundational to that outcome.

Other steps

• There should be a process to monitor and evaluate programmes and address systemic and on-the-ground challenges.
• The new or existing committee or the relevant standing committees meet and deliberate over effective policy decisions, monitor the implementation of schemes and review nutritional status across states.
• The country's response to malnutrition and its growing anaemia burden should be practical and innovative.
• This is critical to make an India that is malnutrition- free and anaemia free a reality and not just an aspiration.
• Everyone is a stakeholder and should contribute toward ending malnutrition and anaemia.