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Direct Nutrition Interventions

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July 05, 2022

What is the issue?

It is disconcerting that even after 7 decades of Independence, India is afflicted by public health issues such as child malnutrition.

Why tackling public health issues is significant?

  • Mortality- Child malnutrition (35.5% stunted, 67.1% anaemic) attributes to 68.2% of under-five child mortality.
  • Learning and performance- Poor nutrition not only adversely impacts health and survival but also leads to diminished learning capacity, and poor school performance.
  • Risk of chronic diseases- In adulthood, it means reduced earnings and increased risks of chronic diseases such as diabetes, hypertension, and obesity.

What does NFHS-5 data reveal?

  • Progress- Data from the National Family Health Survey (NFHS)-5 2019-21 reveals a substantial improvement in a period of four to five years in several proxy indicators of women’s empowerment.
    • Antenatal service attendance (58.6 to 70.0%)
    • Women having their own saving bank accounts (63.0 to78.6%)
    • Women owning mobile phones that they themselves use (45.9 % to 54.0%)
    • Women married before 18 years of age (26.8 % to 23.3 %)
    • Women with 10 or more years of schooling (35.7% to 41.0%
    • Access to clean fuel for cooking (43.8 % to 68.6%)
  • Less effective- The country has not progressed well in terms of direct nutrition interventions.
    • Preconception nutrition, maternal nutrition, appropriate infant and child feeding remain to be effectively addressed.
    • Neither maternal nutrition care interventions nor infant and young child feeding practices have shown the desired improvement.
    • Despite a ban on sale of commercial milk for infant feeding, there has only been a marginal improvement in the practice of exclusive breastfeeding (EBF).
    • Child undernutrition in the first three months remains high.
    • NFHS-5 also confirms a gap in complementary feeding practices, i.e., complementing semi-solid feeding with continuation of breast milk from six months onwards.

What efforts were taken in this aspect?

  • POSHAN Abhiyaan- An aggressive push has been given to the National Nutrition Mission (NNM), rebranding it the Prime Minister’s Overarching Scheme for Holistic Nutrition, or POSHAN Abhiyaan.
  • It has the objective of reducing malnutrition in women, children and adolescent girls.
  • The Ministry of Women and Child (MWCD) is the nodal Ministry implementing the NNM to align different ministries to work in tandem on the window of opportunity of the first 1,000 days in life.
  • POSHAN 2.0- It places a special emphasis on selected high impact essential nutrition interventions, combined with nutrition-sensitive interventions, such as
    • Improving coverage of maternal-child health services,
    • Enhancing women empowerment,
    • Availability, and access to improved water, sanitation, and hygiene
    • Enhancing homestead food production for a diversified diet

What is the need of the hour?

  • Awareness- Creating awareness at the right time with the right tools and techniques regarding special care in the first 1,000 days deserves very high priority.
  • Revisiting POSHAN 2.0- There is a pressing need to revisit the system spearheading POSHAN 2.0 and overhaul it to remove any flaws in its implementation.
  • Revisiting ICDS- There is a need to revisit the nodal system for nutrition programme existing since 1975, the Integrated Child Development Scheme (ICDS) under the Ministry of Women and Child.
  • Alternate distribution mechanism- There is a need to explore alternative ways to distribute the ICDS supplied supplementary nutrition as Take- Home Ration packets through the Public Distribution (PDS) and free the anganwadi workers of the ICDS.
  • Integration of human resources- We need to systematically review the status, and develop and test a new system that would combine the human resource of ICDS and health from village to the district and State levels.

 

Reference

  1. https://www.thehindu.com/opinion/op-ed/india-needs-to-scale-up-direct-nutrition-interventions/article65600486.ece
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