Pandemic and Malnutrition

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    The Parliamentary panel asked the Ministry of Women and Child Development (MoWCD) to conduct a survey on the impact of the pandemic on anganwadi services and malnutrition levels among children.

     

    About

    • The Parliamentary Standing Committee on Education, Women, Children, Youth and Sports fixating on the need for data to understand “how anganwadi services were delivered on the ground during the pandemic, and to assess the impact of COVID-19 on stunting and wasting levels”.
    • Recently, the government has launched an app called Poshan Tracker to monitor delivery of services at 14 lakh anganwadis, but here also the data is beginning to be uploaded only from June 1.
    • The Ministry also made a presentation on children orphaned during COVID-19 and apprised the panel of various measures being taken to help them, including 
      • funds for family and institutional care, 
      • revising norms for child care institutions as well as 
      • maintaining monthly reports on foster care for such children. 
    • The secondary impacts of the COVID-19 crisis are aggravating the challenges faced by many families, especially in terms of access to affordable and nutritious food. This could reverse some of the recent gains in reducing malnutrition.

     

    Malnutrition

    • Malnutrition, in all its forms, includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related noncommunicable diseases.
    • The term malnutrition addresses 3 broad groups of conditions:
      • Undernutrition, which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age);
      • Micronutrient-related malnutrition, which includes micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess; and
      • Overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers).

     

    India’s Malnutrition Profile

    • There are about 189.2 million undernourished people in India; a majority of whom are women and children.
    • According to government figures from the year 2015-2016, 22.9% of women in the 15-29 age group are underweight, as compared to 20.2% of men in the same age group. 
    • Further, according to The State of Food Security and Nutrition in the World 2020 report, in 2016, nearly 51.4 percent of women of reproductive age in India were suffering from anemia.
    • Almost 50% of women are facing severe undernutrition and Anaemia.
    • In fact, around 60 million children, which is roughly about half, of all children in India are underweight, 
      • about 45 per cent are stunted, 
      • 21 percent are wasted, 
      • 57 percent are vitamin A deficient, and 
      • 75 percent are anemic.
    • Malnutrition has thus become the major contributor to the under-five mortality rate in India.
    • These statistics indicate that undernutrition in India is a gendered problem. 
      • The root cause for these male-female differentials can be found in native socio-cultural norms and mindsets. Such norms, rooted in patriarchy, would suggest that distribution of resources—including food—should be done in a hierarchical manner, with male members of the family typically at the top of the ladder.
    • Malnutrition and the widespread prevalence of stunting, wasting, and nutritional deficiencies among women and children are well-recognised elements of India’s profile in the Global Hunger Index.
    • The prevalence of malnutrition in India has notably declined over the last decade, and the Comprehensive National Nutrition Survey 2016-18 revealed that major challenges remain. 

     

    Initiatives by GoI to Address Malnutrition and Food Security

    • The initiatives covered under the National Food Security (NFS) Act, 2013:
      • Targeted Public Distribution System (TPDS), 
      • the Mid-Day meals (MDM) and 
      • The Integrated Child Development Services (ICDS).
    • POSHAN Abhiyaan (2018), an ambitious, multi-sectoral programme with the vision to attain a malnutrition-free India by 2022.
      • An example of the success of POSHAN Abhiyaan is the increase in the coverage of iron folate supplementation for adolescent girls under the Anaemia Mukt Bharat Campaign, which reduced the prevalence of anaemia from 20 percent to 39 percent in two years.
    • Pradhan Mantri Matru Vandana Yojana
      • Centrally sponsored Scheme
      • Started in 2017
      • Rs.6,000 is transferred directly to the bank accounts of pregnant women and Lactating Mothers for availing better facilities for their delivery to compensate for wage loss
      • Eligible for First Child of the family
      • Implementation of the scheme is closely monitored by the central and state governments through the Pradhan Mantri Matru Vandana Yojana – Common Application Software (PMMVY-CAS).
    • Anemia Mukt Bharat Abhiyaan: 
      • Launched in 2018, 
      • The mission aims at accelerating the annual rate of decline of anaemia from one to three percentage points.

     

    Challenges

    • Income loss being faced by the population amid Covid 19
    • Supply chains are disrupted causing harm to farmers, specially the small and marginal ones.
    • Health systems and services are strained due to lack of infrastructure and also because of the fear in people’s minds that if they visit a Doctor, their chances of catching the virus will increase.
    • Malnutrition is on rise again as shown by recent trends.
    • Awareness about immunity boosters and nutrition rich diets is the need of the hour.
    • Health budget for nutrition and other aspects needs to increase if we wish to achieve the SDGs by 2030

     

    Suggestions

    • Nutrition actions: Maximise maternal, infant and young child nutrition actions. It is paramount to provide appropriate support for mothers to breastfeed, including those with COVID-19. 
    • Community-based services: Continue to provide critical community-based nutrition services using innovative/digital delivery systems for basic services such as promotion of breastfeeding, micronutrient supplementation, and basic primary health care including immunisations.
    • Partnership with agriculture: Needed to increase access to healthy and diverse food. Strengthening local supply chains for vegetables, fruit and other perishable foods that are subject to waste, especially in the context of lockdowns.
    • Strengthen food supply: To ensure smooth transportation of food supply, transportation costs should be reduced, and transporters incentivized while public buildings can be used as temporary storage facilities for increasing storage capacity. 
    • Special Attention: Focus needs to be on those who are most at risk of facing food shortages such as daily wage earners and returning migrant workers.
    • School feeding and nutrition: As schools are closed due to COVID-19, comprehensive guidance should be provided to school staff, parents and children on the importance of social distancing, consumption of safe and healthy diets, hygiene and physical activity for school-aged children. 
    • Establish nutrition surveillance: Regular collection and analysis of maternal and child nutrition data at state and district levels will assist in identifying areas where malnutrition is increasing. 
    • Communication Campaigns: Roll out national communication campaigns on COVID-19 Reiterating the need for social distancing while continuing to safely breastfeed infants, promoting handwashing, and emphasising the need for healthy diets, basic nutrition services such as vitamin A supplementation and immunisation.

     

    Conclusion

    • India has taken important steps and a few more concerted actions can get us closer to ensuring nutrition and food needs of the people are adequately met during these unprecedented times. 
    • By joining efforts, the Government, civil society, development partners, private sector, academia, the United Nations and other stakeholders can support the continued, safe and appropriate delivery of nutrition programmes.

     

    United Nations Decade of Action on Nutrition

    • On 1 April 2016, the United Nations (UN) General Assembly proclaimed 2016–2025 the United Nations Decade of Action on Nutrition. 
    • The Decade is an unprecedented opportunity for addressing all forms of malnutrition.
    • Led by WHO and the Food and Agriculture Organization of the United Nations (FAO), the UN Decade of Action on Nutrition calls for policy action across 6 key areas:
      • creating sustainable, resilient food systems for healthy diets;
      • providing social protection and nutrition-related education for all;
      • aligning health systems to nutrition needs, and providing universal coverage of essential nutrition interventions;
      • ensuring that trade and investment policies improve nutrition;
      • building safe and supportive environments for nutrition at all ages; and
      • strengthening and promoting nutrition governance and accountability, everywhere.

     

    5 D’s for Nutrition

    • As India puts all its efforts to deal with the crisis and revive the economy, in order to strengthen the health and nutrition landscape it must focus on the 5D’s: Dialogue, Decentralize, Digitalize, Data and Diversification.
    • Dialogue is essential to empower the frontline workers to help them deal with the current crisis, and after that, to bring all stakeholders together to foster effective convergence and generate awareness among the community about their rights, entitlements and roles.
    • Decentralizing responsibility and accountability is a must to enable local governance to provide customized solutions in a timely fashion.
    • Digital outreach is extremely necessary to ensure the masses receive the correct messages, particularly in these times of multiple communication channels and fake news.
    • Data must be the basis for taking strategic decisions, and comprehensive data visualization tools should be used to scale up and optimise resource utilization.
    • Diversified approaches are needed to involve multiple sectors, and make health and nutrition a focus of the non-health sector too.

    Sources: TH