Mains Practice Questions

Approach

• In the introduction part give the present status of the malnutrition in India.
• Examine the reasons behind persistence of malnutrition in India
• Enumerate some of steps taken by government.
• Give a way forward to make the present policies more effective.

Introduction

• Status of malnutrition: India is home to over 40 million stunted and 17 million wasted children (under-five years). Despite a marked trend of improvement in a variety of anthropometric measures of nutrition over the last 10 years, child under-nutrition rates persist as among the highest in the world
• Also by 2025, India will have over 17 million obese children and stand second among 184 countries.

Body

The reasons behind persistence of malnutrition in India –

• Poverty: Low income constrains households’ ability to feed children food with a high and balanced micro-nutrient content as such food items, i.e. animal products, fruits and vegetables are invariably more expensive than staple grains.
• Female illiteracy: Illiterate mothers are in a disadvantaged position to acquire and apply knowledge about appropriate health-care and feeding practices. Uneducated women are likely to be less able to care well for themselves in terms of nutrition and health.
• Inefficient and ineffective implementation of, and huge leakage in, government’s schemes meant to overcome hunger and malnutrition.
• Low level of awareness about ‘dos and don’ts’ of balanced food, health and hygiene as well as about accessing entitlements and rights under the government’s schemes/resources and services compounds the problem.
• Centralisation of governance, resources, decision-making, and development action as well as concentration of productive assets, resources and wealth in a few hands further aggravates the problem.
• Lack of disaggregated data of district level and below up to Gram Panchayat level comes in the way of focused measures and efficient and effective monitoring, mapping and surveillance system.
• Lack of adequate political and social will is yet another cause

Some of steps taken by government –

• National Nutrition Mission (NNM):
• It has introduced a central nodal agency with extensive financial resources to coordinate various central and state government schemes and imbue them with additional financial resources.
• The total outlay for the nutrition mission has been set at over Rs. 9,000 crore for a period of three years.
• The core strategy of the mission is to create decentralized governance system with flexibility given to states, districts and local level with robust monitoring, accountability and incentive frameworks that will encourage local solutions.
• The programme, through well-defined targets, strives to reduce the level of stunting, under-nutrition, anemia and low birth weight babies. More than 10 crore people are likely to be benefitted by this programme.
• National Health Policy 2017: Improve health status through concerted policy action in all sectors and expand preventive, promotive, curative, palliative and rehabilitative services provided through the public health sector with focus on quality.
• National Food Security Act 2013: It specially mentions the need for nutritional security. An Act to provide for food and nutritional security in human life cycle approach, by ensuring access to adequate quantity of quality food at affordable prices to people to live a life with dignity and for matters connected therewith or incidental thereto.
• The Integrated Child Development Services (ICDS) and Mid-day meal scheme: It was aimed at providing food supplements to children from poor and marginalized sections to bridge the gap between requirement and actual dietary intake. Another component of ICDS programme was weighing children for early detection of growth faltering and under-nutrition and initiating appropriate management of under-nourished children.

Way forward

Some of the approaches that should be focus of all the policies and programmes:

• Decentralized Approach to Tackling Nutrition
• Strengthen and restructure ICDS, and leverage PDS
• Extend coverage of food fortification of staples
• Target multiple contributing factors, for example, WASH (Water, Sanitation and Hygiene)
• Align agricultural policy with national nutritional objectives
• Boost private sector engagement in nutrition interventions