India’s Progress in Tackling IMR, MMR and Malnutrition | 05 Dec 2022

Why in News?

The data presented by the Registrar General of India (RGI) presents a gain in momentum of the pace of decline in India’s maternal and infant mortality rates (MMR and IMR) post-2005.

• Unfortunately, nutrition is one key area that has remained oblivious to any major progress.

What Progress has been Made in Reducing MMRs and IMRs?

• Declining Trends:
  • According to a special bulletin released by the office of the RGI, India’s MMR was 97 during 2018-2020 compared to 301 during 2001-03.
  • The IMR has also been reduced to 27 (as of 2021) compared to 58 in 2005.
    • The Rural-Urban difference in this context has also been narrowed.
• Role of NHM and NRHM: As observed, for the last few years the National Rural Health Mission (NRHM) and the National Health Mission (NHM) has been a game changer for the country in terms of mortality reductions for infants and mothers.
  • The NRHM was launched in 2005 to provide accessible and affordable healthcare through a public system of primary health care.
  • NHM was launched by the government of India in 2013 subsuming the National Rural Health Mission (Launched in 2005) and the National Urban Health Mission (Launched in 2013).

What is the Scenario of Tackling Malnutrition?

• About:
  • Malnutrition is the condition that develops when the body is deprived of vitamins, minerals and other nutrients it needs to maintain healthy tissues and organ function.
  • Malnutrition occurs in people who are either undernourished or over nourished.
• Findings of NFHS 5:
  • The 5^th National Family Health Survey 2019-21 reports 35.5% of children under 5 are stunted, 19.3% are wasted, and 32.1% are underweight.
    • Meghalaya has the highest number of stunted children (46.5%), followed by Bihar (42.9%).
    • Maharashtra (25.6%) has the highest percentage of wasted children followed by Gujarat (25.1%).
  • Compared with NFHS-4, the prevalence of overweight or obesity has increased in most States/UTs in NFHS-5.
    • At the national level, it increased from 21% to 24% among women and 19% to 23% among men.
  • The incidence of anaemia in under-5 children (from 58.6 to 67%), women (53.1 to 57%) and men (22.7 to 25%) has worsened in all States of India.
• Inefficiency of Govt. Initiatives:
  • The POSHAN Abhiyaan, though innovative, is still not addressing the institutional decentralised public action challenge yet.
  • The initiatives for nutrition have remained compartmentalised and fragmented; the institutional role of local panchayats and communities with untied financial resources is still lagging.
• Other Issues:
  • The vicious cycle of poverty, undernutrition, diminished work capacity, low earnings and poverty.
  • Infections like malaria and measles precipitate acute malnutrition and aggravate the existing nutritional deficit.
  • Arbitrariness and inter-state-variation in determining a household's BPL status results in arbitrary identification of hunger.
  • Negligence towards micro-nutrient deficiency (hidden hunger) and inadequate knowledge among mothers regarding nutrition and breast-feeding.

What Should be the Reorganisation Principles for Nutrition Success?

• Vesting in grassroot level administration (Gram Panchayat, Gram Sabha and other community organisations), the responsibility of education, health, nutrition, skills and diversified livelihoods.
• Operationalising village-specific planning process with decentralised financial resources.
• Assessing (and accordingly increasing) (a) the need for additional caregivers with capacity development to ensure household visits and (b) the intensity of monitoring needed for outcomes in nutrition.
• Encouraging diversity of local food including millets, served hot.
• Intensifying behaviour change communication.
• Institutionalising monthly health days at every Anganwadi centre with community connection and parental involvement.
• Creating a platform for adolescent girls in every village for empowerment and for diversified livelihoods through skills.

Conclusion

Nutrition as a subject calls for a whole-of-government and whole-of-society approach. Technology can at best be a means and monitoring too has to become local. Panchayats and community organisations are the best way forward.

Source: IE