Public Health Nutrition Policies Need Novelty

Syllabus :GS2/Health

In News

• The recent evaluation published in The Lancet assesses the global progress toward the World Health Assembly’s Global Nutrition Targets (GNTs).

Global Nutrition Targets (GNTs)

• It is set by the World Health Assembly to track the impact of public health policies on maternal and child malnutrition.
• Key targets: Reduce stunting by 40% in children under 5, reduce anemia by 50% in women of reproductive age, and prevent childhood overweight.

• Recent Evaluation (The Lancet): Analysis of global progress from 2012-2021, with projections up to 2050.
  • Slow and insufficient progress in most countries.
  • By 2030, few countries (excluding India) are expected to meet the stunting target, and no country is expected to meet targets for low birthweight, anaemia, or childhood overweight.

Challenges to Progress:

• Anaemia in India: Prevalence static for 20 years, despite efforts focused on iron deficiency.
  • Recent studies reveal that iron deficiency accounts for only a third of anaemia, while unknown causes make up another third.

• A study showed increased anaemia when school meals were stopped, but not due to iron deficiency, suggesting the need for a diverse diet.
• Measurement Issues: Different methods for measuring anaemia (venous vs. capillary blood) yield varying results, raising concerns about the accuracy of data.
  • Diagnostic cut-offs for anaemia and stunting may not be universally applicable, and more accurate metrics are needed.
• Stunting: Stunting is most prevalent in the first two years of life. Overfeeding after age 2 may lead to being overweight instead of addressing stunting.
  • In India, stunting increases from 7-8% at birth to nearly 40% by two years of age.
  • Early prevention (within the first two years) is key to addressing stunting.
• Dietary Concerns for Stunting: Poor children in India consume much less fat than needed (7 grams per day vs. the required 30-40 grams).
  • New POSHAN guidelines now include oil in feeding rations for children under 3, which is a positive step.
• Childhood Overweight: Overweight is increasing globally, but it’s still lower than undernutrition rates.
  • However, “metabolic overnutrition” (risk of non-communicable diseases) affects around 50% of Indian children aged 5-19, including those who are stunted or underweight.
  • Overnutrition should be an important policy focus, alongside undernutrition.

Related Initiatives in  India  

• India has multiple national and local initiatives aimed at combating hunger and malnutrition, focusing on vulnerable populations like low-income families, children, and the elderly.
• National Food Security Act (NFSA)  Provides subsidized food grains to 75% of the rural population and 50% of the urban population, covering 81 crore beneficiaries, including 16 crore women.
• Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY) launched to support the poor during COVID-19, extended until 2029, providing free food grains to 81.35 crore beneficiaries.
• PM POSHAN (POshan SHAkti Nirman) Scheme aimed at improving children’s nutritional status in schools, with a budget of ₹130,794.90 crore for 2021-2026, targeting hunger and school attendance.
• Antyodaya Anna Yojana (AAY) focuses on food security for the most vulnerable, supporting over 8.92 crore individuals, including over 2 crore women.
• Fortified rice, enhanced with vitamins and minerals, has been distributed through the Public Distribution System (PDS), totaling 406 lakh metric tonnes by March 2024.
• The government manages price volatility through the Price Stabilization Fund (PSF) and buffers for commodities like onions, ensuring affordability for low-income groups.
• In 2023, the government launched Bharat Dal and subsidized grains like Bharat Atta and Bharat Rice through NAFED, NCCF, and Kendriya Bhandar to maintain affordability.

Suggestions and the Way Forward:

• India’s food security initiatives focus on increasing agricultural productivity, improving distribution systems, and ensuring affordable food.
  • These efforts, along with nutritional support and sustainable practices, are crucial for long-term food security.
• India needs to fill gaps in the nutritional composition of daily diets, focusing on sustainable and nutrient-dense foods.
  •  Incorporating climate-smart crops like millets into daily diets could prevent nutritional deficiencies and diet-related non-communicable diseases (NCDs). 
• Additionally, India must strengthen its data management, improve food distribution accountability, enhance resource management, invest in nutrition education

Source: TH