Fixing India’s Malnutrition Problem

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