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The need to come together to tackle malnutrition

Ashutosh Mishra
Wednesday, August 9, 2023, 08:00 Hrs  [IST]

India strives to become malnutrition-free by 2030. As a country of huge diversity, multiple climatic zones, and distribution of people across various socio-economic segments, India can be malnutrition-free only when it becomes a people's movement (Jan Andolan).

From the government, we have seen increasing and unprecedented focus on nutrition in recent years. This is a needed trend. But when the political will is coupled with a will to increase budgets on nutrition services, and on improving operational efficiency, it is a winning combination. This is one half of the story. The other half rests with markets, people, and changemakers. A large section of our society comprises low-income families, often in rural areas, and struggle to access affordable nutritious food products. Also, there is an increasing number of social entrepreneurs and corporations meaning to increase their volumes reaching such geographies. With some conscious and concerted effort, and a favourable policy scenario, we must increase access to nutritious products and services to customers in the low-income population.

And finally, there is increasing consciousness in our urban folk about nutrition and its long-lasting impact on our lives. So, the final piece of the puzzle is by raising such awareness about nutrition among vulnerable and hard-to-reach communities also, to help them make informed dietary choices. Special attention must be given to tribal communities by utilizing disaggregated data, traditional food systems, and strengthening existing health projects under government schemes.

Malnutrition continues to pose a significant public health challenge globally, affecting more than 2 billion people worldwide. In India, its effects are more severe. Micronutrient deficiencies – which lead to malnutrition – are notorious for being hard to detect in the beginning with their manifestations more pronounced once the deficiencies become severe, giving them the name "hidden hunger.” The impact of malnutrition is also multifaceted. Insufficient access to nutritious diets deprives individuals of the vital nutrients necessary for their growth, development, and wellbeing. It adversely affects physical health, weakens the immune system, and increases susceptibility to diseases and infections. Consequently, this perpetuates the intergenerational cycle of poverty and poor health and hampers an individual’s opportunity for jobs and livelihood, leading to lower economic output. Children are the most vulnerable as malnutrition can lead to irreversible harm.
For instance, stunting impacts children’s cognitive development, including their ability to learn in school, which further affects their economic productivity when they become adults. Vitamin A deficiency can lead to childhood blindness, iodine deficiency impairs learning ability, and iron deficiency increases the risk of death during childbirth.
The nutritional status of children is directly influenced by the nutrition level of their mothers. Malnutrition-induced anemia, a common problem among young women and pregnant and new mothers in India, is influenced by limited dietary diversity, food insecurity, infectious diseases, lack of awareness, and educational backwardness. Anemia contributes to high maternal mortality rates.
To break this intergenerational cycle, however, it is crucial to prioritize access to healthy diets and promote appropriate nutritional practices. Addressing child malnutrition, especially, is a complex challenge. It requires a combination of nutrition-specific and nutrition-sensitive interventions that follow a lifecycle approach.

If we are to put India on the path to being a developed country, and one of the largest economies in the world, we have to first ensure that our people – especially the young ones – have the nutrition and cognitive ability to be full economic citizens. Our odds of becoming such a country are significantly higher when we put all our energies to deal with all aspects of malnutrition.

Recognizing the challenges, the Government of India have implemented various programmes in the past such as the Integrated Child Development Services (ICDS) and the mid-day meal scheme to provide comprehensive health and nutrition services to populations most at risk of malnutrition. The present day government launched Mission Poshan, Poshan Abhiyan, and Poshan Jan Andolan to prioritize pro-nutrition policies and choices among people. And the Swachh Bharat Mission to promote sanitation and hygiene. Every year, the Union government also celebrates Rashtriya Poshan Maah (National Nutrition Month), a flagship programme aimed at improving nutritional outcomes among children ages up to six and pregnant and lactating women. Nutrition Rehabilitation Centers (NRCs) and Child Malnutrition Treatment Centers (CMTCs), which are managed by the health departments, provide facility-based management for children with severe malnutrition. The Ministry of Women and Child Development and health departments also promote health education related to nutrition to facilitate behavior change.
However, even as there are various initiatives and programs aimed at addressing malnutrition, there are challenges in reaching socio-economically disadvantaged women and children, who often face barriers such as limited access to healthcare facilities, financial constraints, and lack of awareness about proper nutritional practices. To overcome these challenges, we need to establish public-private partnerships to bridge the gap and ensure that these vulnerable populations receive the necessary support they need. Collaborating with diverse organizations is essential to effectively reach and assist these groups. Government agencies, nonprofit organizations, community-based organizations, and private sector entities, who each have unique resources, expertise, and networks, can combine their strengths against this fight. A framework of interventions involving all stakeholders is necessary to optimize impact.
When the state governments and civil society organizations come together, the results are remarkable. For instance, Vitamin Angels has partnered with both the Government of Maharashtra and the Government of Nagaland to supply vitamin A and deworming tablets to children under the age of five at the last mile. In both states, the interventions’ coverage among under-five children has seen a marked improvement. Continued implementation of government programs requires social mobilization, which can be achieved through the active participation of grassroots organizations, which play a crucial role in supporting frontline workers and reaching at-risk populations, particularly in underserved areas.
Improving infant and young child feeding practices right from the start can have a lasting impact. Establishing practical and cost-effective creches for these children, where they can receive early stimulation and supplementary nutrition while their parents pursue livelihood opportunities, can play a positive role. Gram panchayats can facilitate these creches, building upon the existing rural livelihood program, the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), which supports setting up creches at worksites with five or more children below the age of five. While the funding could come from MGNREGS, the day-to-day operations can be managed by local women’s self-help groups (SHG), ensuring training in childcare, early stimulation, and nutrition at a large-scale level.
It is essential that we view the fight against malnutrition as a shared responsibility and work together to build a healthier, more prosperous future for all Indians. Let us join hands and prioritize the wellbeing of our citizens, creating a just society where no child or woman suffers from the burden of malnutrition.

(Author is senior regional Technical Director, Asia, Vitamin Angels)


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