Be Mains Ready

Approach

• Briefly mention some incidents of death due to malnutrition and some statistics related to obesity or constitutional obligation of the state to provide welfare support.
• Briefly explain the double burden.
• List the causes of the problem.
• Give a critical evaluation.
• Suggest some remedial measures.
• Mention some existing government schemes.
• Add any data or survey report for value addition.
• Provide a way forward for future course of action.

Introduction

• India beat US to have 2^nd highest number of obese children, on the other hand death of an 11 year old girl named Santosi because of starvation in Jharkhand highlights the grim reality of India’s nutritional status.
• The double burden of malnutrition is characterised by the coexistence of undernutrition along with overweight and obesity, or diet-related noncommunicable diseases, within individuals, households and populations, and across the lifecourse.

Body

Causes of Malnutrition

Critical Evaluation

• The National Nutrition Policy 1993, complemented by other policies such as the National Health Policy 2002, the National Policy for Children, 2013 provides a strong foundation for addressing the immediate and the underlying determinants of undernutrition through both direct and indirect interventions. However, implementation of these policies has remained a challenge.
• The National Food Security Act 2013 mandates food and nutrition entitlements for children, pregnant and breastfeeding mothers. However, it does not provide a universal protection to the population.
• Poshan Abhiyaan is India’s flagship programme to improve nutritional outcomes for children, adolescents, pregnant women and lactating mothers by leveraging technology, a targeted approach and convergence. Anganwadi centres are the focal points of delivery but lack basic amenities and face infrastructure issues.
• Under the Minimum Common Need Programme, the poor families were provided food grains at subsidized rate through distribution system. However, making only rice and wheat available through the subsidised PDS has adversely affected the consumption pattern of poor people.
• Mid-day meal scheme was launched by MHRD to provide nutritional support to school going children by providing meal carrying 300 calories and 8-12gm protein for 200 days. However, the scheme provides food only one time a day and the re-evaluation is not done frequently.
• Nutritional rehabilitation Centres, Village Health Sanitation & Nutrition Committee have been established in rural areas but the manpower is poorly skilled and resources for implementation are not enough.
• India also became one of 59 countries to impose a tax on sweetened beverages and the GST on soft drinks was increased from 32% to 40% in 2017. However, these measures need to be supplemented with an awareness generation campaign like Eat Right India Campaign to curb the consumption.
• Fortification of food by adding micronutrients to tackle hidden hunger is being promoted by FSSAI through government Schemes such as ICDS, PDS etc. However, the outreach of such measures is quite narrow.

Remedial Measures

• Ensure better coordination among various ministries
• Improve data collection on stunting and obesity
• Allow panchayats to have a bigger say in running welfare schemes
• Make welfare delivery mechanisms more accountable
• Diversify the Public Distribution System
• Revive and safeguard forests as sustainable sources of food
• Provide clinical counseling for overweight and obese children at primary care settings

The Global Hunger Index 2018 published jointly by Welthungerhilfe and Concern Worldwide has categorised India’s nutritional status as “serious” and ranked india at 103^th out of 119 countries.

Way Forward

This double burden of malnutrition needs to be addressed with an integrated action on malnutrition in all its forms. Addressing the double burden of malnutrition will be key in achieving the Sustainable Development Goals (in particular Goal 2 and Target 3.4) and the Commitments of the Rome Declaration on Nutrition, within the UN Decade of Action on Nutrition.