It’s not yet mission accomplished on the Centre’s Poshan Abhiyaan

Context: Findings of recently released National Family Health Survey -5 (NFHS-5) presents a bleak picture of nutritional achievements of the Poshan Abhiyan, launched three years ago.

Significance of Poshan Abhiyan: aims to improve the nutritional status of children and adolescent girls, as well as pregnant and lactating mothers.

• Focus on improving five indicators—prevalence of low birth weight, stunting, underweight and anaemia among children and women

Nutritional status of children and women: findings of NFHS-5

• Stunting: improved most, with 69/342 districts experiencing a decline of more than 6 percentage points (the Poshan Abhiyaan target) as compared with NFHS-4.
• Child underweight: only 42/342 districts meet the target.
• Anaemia: not only showed minimal improvement across districts, but it also reversed in 81 % (278/342 for children) and 74 % (254/342 for adolescent girls/women) of the districts.
  • The reversal was greater than 9 percentage points in 186/342 (children) and 139/342 (adolescent girls and women) districts.

Way forward:

• Learning from both success and failures: Within the same state, there are districts that experienced improvement as well as a reversal, especially with regards to stunting and underweight findings.
  • Such learning can focus on both the distinct components of the Poshan Abhiyaan programme, as well as how synergistically they were implemented.
• Learning from prioritized districts: Prioritizing certain districts over others is inevitable in any policy formulation and implementation. Learning from this can be utilized to tweak modification in prioritizing.
  • Indicator-specific prioritization: as there is a difference between anthropometric-based nutritional measures of stunting/underweight from the more direct measures of dietary deficiency.
• Focus on within-district variation, in particular between villages: as villages are a setting for social engagement and the unit where public policies and programmes come to fruition.
• Rigorous assessment of Poshan Abhiyaan, including an exploration of any changes and course corrections that may be necessary.

Conclusion: Reversals experienced by a majority of districts on nutrition indicators suggest that India needs to make food security a centrepiece of its overall development agenda.