Tackling malnutrition

(Mains GS 2 : Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources, poverty and hunger.)

Context:

• There are several concerns about the state of nutrition in the country, and the recently released fifth National Family Health Survey (NFHS-5) (2019-2021) offers an opportunity to look specifically  at nutrition related indicators.

Implications of malnutrition:

• Global evidence has established the serious implications of malnutrition on a child’s physical and brain  development; in turn, this has an adverse impact on cognitive development, and the overall productivity and economic development of a nation.
• According to the World Bank “A 1% loss in adult height due to childhood stunting is associated with a 1.4% loss in economic productivity.”
• It is estimated that undernourished children, as adults, have a reduced earning potential of at least 10 percent of their lifetime earnings, while every additional centimeter gain of adult height is associated with a 4.5-percent increase in wage rate.
• The adverse impact of undernutrition on brain structure and development cannot be corrected later in life and can lead to cognitive deficits and compromised learning abilities.

Negligible gain:

• The National Family Health Survey (NFHS)-5 shows negligible gains in nutritional outcomes among under-five children as the progress in reducing undernutrition, wasting and stunting is very less.
• The National Family Health Survey (NFHS)-5 shows that 35.5% of under-five children are stunted, 19.3% are wasted and childhood anemia has worsened from NFHS-4.
• Though institutional delivery has gone up, early initiation of breastfeeding is static.

Increased anemia:

• NFHS-5 shows that the incidence of anemia in young children has increased alarmingly; more than one in three children up to five years of age suffer from anemia.
• Under-five anemia was prevalent among 58.6 percent of children in 2015-16, 67.1 percent are now anemic.
• Also, the proportion of women (15-49 years of age) who are anaemic has grown — from 53.1 percent to 57 percent — during this five-year period.
• The percentage of pregnant women (15-49 years) who are anaemic has increased to 52.2 percent from 50.4 percent.
• The recently concluded National Family Health Survey or NFHS-5 had worrying markers of increased malnutrition, infant mortality and maternal health.

Infant care:

• After monitoring the successful initiation of breastfeeding in the hospital, anganwadi workers, ASHA workers and Auxiliary Nurse Midwives must continue to monitor exclusive breastfeeding till the infant is six months old.
• Then they must record the timely initiation of complementary feeding with soft gruel.
• We must also ensure that there is a take-home ration for under-three children through the regular supply of supplementary nutrition from the Integrated Child Development Services.

Rations supplied:

• It is important to monitor the Mahatma Gandhi National Rural Employment Guarantee Scheme workdays as well as the wages earned in areas where droughts frequently recur.
• We need to monitor the area of mass migration as these areas have a high prevalence of malnutrition.
• The regularity and quantity of dry rations supplied to anganwadi centers and schools for mid-day meals should be field monitored through live web-based centrally monitorable data on the movement of dry rations to anganwadis and schools.

Monitoring PDS:

• Real-time monitoring of the Public Distribution System (PDS) will go a long way in ensuring food at the family level. 
• Except in a few States where web-based portals are functioning, there is no monitoring of when PDS shops are open as well as the quantity and quality of dry rations supplied. 
• The PDS is focused on procuring wheat and rice through the Food Corporation of India to distribute to families; thus, PDS is a hunger-mitigation mechanism; it does not enable nutrition security. 

Conclusion:

• Both Poshan Abhiyan and the Pradhan Mantri Garib Kalyan Anna Yojana need to be monitored with the help of the community to ensure sustainable nutrition security.