Fixing India’s Malnutrition Problem

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    In Context

    • Experts have suggested several approaches to address the problem of chronic malnutrition.

    Malnutrition

    • About:
      • It refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. 
      • It is a chronic problem and a longstanding challenge for the public administration of India.
    • The term malnutrition addresses 3 broad groups of conditions:
      • Undernutrition:
        • It includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age)
        • Together, the stunted and wasted children are considered to be underweight, indicating a lack of proper nutritional intake and inadequate care post-childbirth.
      • Micronutrient-related malnutrition
        • It includes micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess; and
      • Overweight: 
        • It includes obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers).

    Various reports on Malnutrition in India 

    • Global Hunger Index (GHI) 2022:
      • India ranked 107 out of 121 countries in the Global Hunger Index (GHI) 2022.
      • The GHI is an important indicator of nutrition, particularly among children, as it looks at stunting, wasting and mortality among children, and at calorific deficiency across the population. 
    • National Family Health Survey (NFHS-5):
      • India’s National Family Health Survey (NFHS-5) from 2019-21 reported that in children below the age of five years, 35.5% were stunted, 19.3% showed wasting, and 32.1% were underweight.
    • The State of Food Security and Nutrition in the World 2020 report:
      • Undernutrition in India is also a gendered problem. 
      • 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 percent of women are facing severe undernutrition and Anaemia.

    Measures Taken to Tackle Malnutrition

    • Poshan Abhiyan:
      • It is a multi-ministerial convergence mission with the vision to ensure the attainment of malnutrition free India by 2022.
      • The Ministry of Women and Child Development (MWCD) is implementing POSHAN Abhiyaan.
    • Prime Minister’s Overarching Scheme for Holistic Nutrition (POSHAN) 2.0 scheme: 
      • It now includes the Integrated Child Development Services (ICDS) scheme, which seeks to work with adolescent girls, pregnant women, nursing mothers and children below three.
    • Integrated Child Development Services:
      • It represents one of the world’s largest and unique programmes for early childhood care and development.
      • The beneficiaries under the Scheme are children in the age group of 0-6 years, pregnant women and lactating mothers
      • The Ministry of Women and Child Development is the implementing agency.
    • Mid-Day Meal Scheme:
      • The Mid-day Meal Scheme is a school meal programme in India designed to better the nutritional standing of school-age children
      • It covers all school students studying in Classes 1 to 8 of government schools, government-aided schools, special training centres, including madrasas supported under Samagra Shiksha Abhiyan.
    • National Food Security Mission:
      • It was launched in 2007-08 by the Ministry of Agriculture and Farmers’ Welfare as a Centrally Sponsored Scheme.
      • It focuses on the sustainable increase in the production of targeted crops through area expansion and productivity enhancement.
    • National Nutrition Mission:
      • It is the government’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers.
      • Aim: 
        • To reduce stunting and wasting by 2 percent per year (total 6 per cent until 2022) among children and anemia by 3 percent per year (total 9 per cent until 2022) among children, adolescent girls and pregnant women and lactating mothers.
      • The Ministry of Women and Child Development is the nodal ministry for implementation.

    Issues with addressing the problem of malnutrition

    • Inadequate funding & implementation:
      • Gaps remain in how the already existing centrally-sponsored schemes are funded and implemented.
      • The budgets being allocated are nowhere near the scale of the funds that are required to improve nutrition in the country.
    • Manpower constraints:
      • Over 50% Child Development Project Officer (CDPO) posts were vacant in Jharkhand, Assam, Uttar Pradesh, and Rajasthan, pointing to severe manpower constraints in successfully implementing the scheme of such importance. 
    • No routine in social audits:
      • Social audits that are meant to allow for community oversight of the quality of services provided in schools are not carried out routinely.
    • Issues with cash transfers:
      • Cash transfers seem to be a favoured solution for several social sector interventions in India today, and this includes the health and nutrition sectors.
      • But evidence of the impact of cash transfer on child nutrition in India is limited so far. 
      • The effect of cash transfers is also limited in a context where food prices are volatile and inflation depletes the value of cash. 
    • Social Factors:
      • Equally, there are social factors such as ‘son preference’, which sadly continues to be prevalent in India and can influence household-level decisions when responding to the nutrition needs of sons and daughters. 

    Suggestions & way ahead

    • Need of a comprehensive programme:
      • A comprehensive programme targeting adolescent girls is required if the intergenerational nature of malnutrition is to be tackled.
    • Cash transfers:
      • Cash transfers can also be used to incentivise behavioural change in terms of seeking greater institutional support. 
      • Food rations through PDS and special supplements for the target group of pregnant and lactating mothers, and infants and young children, are essential.
    • Fixing the pre-existing schemes:
      • Fixing the pre-existing schemes is the obvious answer to addressing India’s multi-dimensional nutrition challenge.
      • Getting the already existing schemes right requires greater involvement of local government and local community groups in the design and delivery of tailored nutrition interventions.
    • Keeping it a top priority:
      • The need of the hour is to make addressing child malnutrition the top priority of the government machinery, and all year around.

    Source: TH