India Needs to Rethink its Nutrition Agenda

The Hindu     15th December 2020     Save    
QEP Pocket Notes

Context: The Ministry of Health and Family Welfare has released data fact sheets for 22 States and Union Territories (UTs) based on the findings of Phase I of the National Family Health Survey-5 (NFHS-5).

Findings of NFHS-5: State of nutrition in India

  • Findings: (in comparison to NFHS-4)
    • Prevalence of severe acute malnutrition: Increased in 16 states/UTs, only two big states (Karnataka and Kerala) have shown some marginal improvements.
    • Percentage of Underweight children (under five): increased in 16 out of 22 states.
    • Anaemia: increased among children and adult women in most States while declined only in four States/UTs (Lakshadweep, Andaman and Nicobar Islands, Dadra and Nagar Haveli and Daman and Diu, and Meghalaya).
    • Adult malnutrition (BMI of less than 18.5kg/m2): Increased in many states.
    • Overweight/obesity prevalence among children and adults: Most States/UTs saw an increase.
    • Childhood stunting: An indicator of chronic undernutrition and considered a sensitive indicator of overall well-being, increased in 13 of the 22 States/UTs.
      • There was a 10 percentage points (PP)decline in stunting among children under five (low height for age) between 2005-06 (NFHS-3) & 2015-16 (NFHS-4), from 48% to 38%, averaging 1PP a year.
      • The World Health Organization calls stunting “a marker of inequalities in human development”.
    • Positive trends: In determinants of malnutrition such as access to sanitation, clean cooking fuels and women’s status – a reduction in spousal violence and greater access of women to bank accounts.
  • Government’s efforts to contain malnutrition:
    • Social protection schemes and public programmes: such as the Mahatma Gandhi National Rural Employment Guarantee Scheme, the Public Distribution System, the Integrated Child Development Scheme (ICDS), and Mid-Day Meal Scheme.
    • Poshan Abhiyaan(2017): aimed at achieving 2PP reduction in childhood stunting per year.
  • Associated issues:
    • Underfunding and underutilization of funds: Only about 32.5% of the funds released for Poshan Abhiyaan from 2017-18 onwards had been utilised.
    • Slowdown in economic growth, stagnant rural wages and high levels of unemployment
    • Pandemic and lockdown-induced economic distress.
    • Inadequacy of diets in India both in terms of quality and quantity: ‘Hunger Watch’ survey shows high levels of food insecurity and decline in food consumption, especially among the poor.
      • Two-thirds of the respondents reported that the nutritional quality and quantity of their diets worsened in September-October compared to before the lockdown.

Way forward:

  • Direct interventions: such as supplementary nutrition (of good quality including eggs, fruits, etc.), growth monitoring, and behaviour change communication through the ICDS and school meals must be strengthened and given more resources.
  • Universal maternity entitlements and child care services: Enabling exclusive breastfeeding, appropriate infant and young child feeding as well as towards recognising women’s unpaid work burdens.
  • Linkages between agriculture and nutrition: Both through what foods are produced and available as well as what kinds of livelihoods are generated in farming sector.
  • Focus on basic determinants of malnutrition: like household food security, access to basic health services and equitable gender relations.

Conclusion: An employment-centred growth strategy which includes universal provision of basic services for education, health, food and social security is imperative to ensure nutritional security and sustainable development of India.

QEP Pocket Notes