Context: A multipronged approach with community action, with a focus on women’s well-being, can fight malnutrition.
Programmes benefitting women: have raised incomes of women giving them more voices in the family.
- Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA): Increase women’s incomes with equal wages as men and direct payments to workers’ bank accounts.
- National Rural Livelihood Mission (NRLM): Improve women’s livelihood, social empowerment, and lives.
Silver linings in nutrition indicators: According to the National Family Health Survey (NFHS-5),
- Improvements in Child care: under-five mortality rates have fallen, and institutional births and child immunisation rates have increased.
- Improved access to drinking water and sanitation.
Concerns in nutrition: Child malnutrition is not improving due to a lack of direct nutrition interventions especially during pregnancy. (Need to go beyond behaviour change, regulation and monitoring)
Way forward: to deal with the menace of malnutrition.
- Provide hot cooked meals: for pregnant women, lactating mothers and young children with adequate protein, milk, and green leafy vegetables.
- E.g. Karnataka, Andhra Pradesh and Telangana have replaced take-home rations for mothers with daily hot cooked meals.
- Provide supplements to pregnant women: Frontline health workers should give pregnant women iron, folic acid and calcium tablets.
- Go for life cycle approach: Grassroot social empowerment programmes should address child marriage by promoting girl's education, improve the nutritional status of adolescent girls by using the mid-day meal programme.
- Effective use of Anganwadisystem: Childcare enables women to earn a livelihood.
- Encourage women's participation in Anganwadi: where health workers can provide them with appropriate services and counselling.
- Increase the working hours of Anganwadi: will help women go out to do paid work.
- Provide Anganwadi workers certificate courses: on nutrition and early childhood stimulation.
- Improve Anganwadi infrastructure: To cater to multiple meal requirements, Anganwadi kitchens need double-burner stoves, gas cylinders, pressure cookers and sufficient steel cooking vessels.
- Effective use of gram panchayat:
- Converge with Anganwadi : Anganwadi committee should be made as a subcommittee of gram panchayat to discuss on the issue of malnutrition and financial support (MGNREGA funds can be diverted).
- Panchayats can address the issue of exclusion and can ensure more convergence.
- Ensure full coverage of immunisation: among all children and mothers along with antenatal care, maternity benefits and nutrition services.
Conclusion: Thus Community action, with a focus on women’s well-being is the best way to fight malnutrition.