From treating to preventing: A journey Modi 2.0 must make in tackling malnutrition
Since 1991, India has not been able to tackle its nutritional challenges efficiently despite a remarkable increase in GDP, almost 50 per cent; even after 70 years of independence over 34 per cent of the world's malnourished children reside in India. India has about 25.5 million wasted, 46.6 million stunted kids.
As per WHO, malnutrition is defined as the deficiencies, excesses, or imbalances in a person's intake of nutrients and/or energy. One of the most effective entry points for enhancing the overall development status of a country is through investing in nutrition, with an estimated cost -benefit analysis ratio of roughly 16:1 for low and middle-income countries.
POSHAN Abhiyaan (Prime Minister's Overarching Scheme for Holistic Nutrition) is a policy for addressing malnutrition which mainly draws attention to under-nutrition by adopting a life cycle approach; it was inaugurated by Prime MinisterNarendra Modi on 8 March 2018 with an opening three-year budget of INR 9046.17 crores. POSHAN Abhiyaan is principallya monitoring and revising initiative for taking comprehensive monitorable indicators of nutrition centric schemes and programs requiring convergent actions. POSHAN Abhiyaan marks to reduce stunting, anaemia (among young children, women and adolescent girls), under-nutrition and lessen low birth weight by 2 per cent, 2 per cent, 3 per cent and 2 per cent per annum respectively. Convergence, behavioural change (BCC), IEC advocacy, training and capacity building, innovations, incentives and grievance redressal are the key supports of POSHAN Abhiyaan.
Severe Acute Malnutrition (SAM) is defined by very low weight-for-height/length and is a vital subdivision of malnutrition that is increasing. It is projected that around 93.4 lakh children in India are suffering from SAM (NFHS IV).
SAM is a crucial preventable and curable source of morbidity and mortality in children below five years of age. In India, most children with SAM are treated in facilities called Nutrition Rehabilitation Centre (NRC). Additionally, positive efforts are also being made in a few states to address SAM through community-based management facilitated by the Anganwadi Workers (AWW) either through Village Health and Nutrition Days (VHNDs) or through frequent home visits.
POSHAN Abhiyaan is a "People's Movement". To drive POSHAN Abhiyan, ‘National Council on India's Nutrition Challenges' decided to celebrate the month of September as RashtriyaPOSHAN Maah. Every year, during this month, events centred on nutrition awareness are supported by all the states/UTs up to the grass-root level. Activities during POSHAN Maahare relevant to Social Behavioural Change and Communication as well. The theme from 2018 to 2019 has evolved from ‘Har GharPoshanTyohar‘ to ‘Har GharPoshanVyavahar'. This year, by the Ministry of Women & Child Development, five key focus areas have been identified for POSHAN Maah: first 1000 days of a child, anaemia, diarrhoea, hand wash & sanitation, and PoshtikAahar. For example: It is quite frequent that stunting affects a child within 2 years of age, and the impairment caused tends to be largely irreversible in the long term affecting the physical, cognitive, and socioeconomic outcomes of the child in his/ her adulthood. Thus, the focus on the first 1000 days as the first sutra is anadmirablemove in the right course of track.
The POSHAN Maah activities focus on informing communities on adequate nutrition and POSHAN Abhiyaan, through specific strategies such as technology based real time monitoring of service delivery and food fortification, is aiding enhanced access to added nutrition for women and children, and provision of micronutrients to tackle hidden hunger.
Last year, the outreach through the various activities undertaken during POSHAN Maah was more than 12.2 crore women, 6.2 crore men and 13 crore children. It is quite remarkable that 30.6 crore people were touched in 30 days last year and this statistic is expected to be higher this year.
In conclusion, POSHAN Maah has given foremost impetus to the Abhiyaan. Let us hope that in due course of time through POSHAN Abhiyaan India achieves a point where we no longer are needed to treat severely malnourished children and instead have a robust preventive mechanism of preventing malnourishment with nutritional supplements.
*Disclaimer: The article has been contributed by Dr Chandrakant S. Pandav who is a Member National Council for India Nutritional Challenges, POSHAN ABHIYAN. He is a Regional Coordinator, Iodine Global Network (South Asia) and President, ICCIDD, India. He has been a former Professor & Head, CCM, AIIMS, New Delhi. The opinions expressed in this article are the personal opinions of the author. The facts and views appearing in this article do not reflect the views of Deccan Chronicle and Deccan Chronicle does not assume any responsibility and liability for the same.
