Putting food at the centre of India’s nutrition agenda

Context: Reducing the burden of child undernutrition needs a policy goal with a focus on providing affordable access to quality food items.

Child undernutrition:

• Diet-related undernutrition:
  • The percentage of children (aged 6-­23 months) who do not meet the minimum dietary adequacy is 83.9% (a decline of 2% from NFHS-4) - National Family Health Survey (NFHS) – 5.
  • While there are some variations, in every State, more than 75% of the children do not receive the minimum adequate diet.
  • Analysis based on NFHS­4 has shown that consumption of protein-rich food, as well as fruit and vegetables, were substantially low.
• Prevalence of anaemia:
  • Anaemia prevalence among children increased from 51.8% to 60.2%.
  • In the majority of the States, two out of three children have possible iron­ deficiency.
• Government Schemes: The Prime Minister’s Overarching Scheme for Holistic Nutrition (POSHAN) Abhiyaan and, the Anemia Mukt Bharat or AMB, Strategy was launched in 2018 with efforts to improve-
  • Iron and Folic Acid (IFA) supplementation,
  • Behaviour change and anaemia ­related care and
  • Treatment across six target groups including pregnant women, lactating mothers, and children
• Challenges:
  • Skewed Measures: which are focussed on Child’s anthropometry:
    • In Child’s anthropometry: Children are defined as stunted, underweight or wasted if their standardised height-­for-­age, weight-­for-­age or weight-­for-­height, respectively, is more than two standard deviations below the World Health Or­ganization (WHO) Child Growth Standards median.
    • A recent NFHS-4 based study found that 36.3% of children who experienced a dietary failure do not show anthropometric failure.
    • A child’s anthropometric status is a consequence of several complex factors, including inter-generational, which current policies and interventions cannot alter in the short term.

Way forward:

• Comprehensive approach: A classification of nutritional status using a combined typology based on children who experience dietary failure and anthropometric failure.
  • Food and diet have intrinsic importance, regardless of their impact on a child’s anthropometry.
  • Policy goal should be to provide affordable (economic and physical) access to quality food items, particularly for lower socioeconomic populations groups.
• Conduct a dedicated nationally representative survey: on the dietary intake and nutritional status of children and adults.
  • By leveraging and combining aspects of the NFHS, the National Nutrition Monitoring Bureau and the National Sample Surveys that collected data on detailed household-level consumption and expenditure on various food items.

Conclusion: The nutrition agenda needs to be considered from “food as a right” perspective. This may serve well as India tries to realise the Sustainable Development Goals (SDGs 2 and 3) related to zero hunger and good health and well-being.