Spotlight

New Delhi, 4 December 2021

Poshan Abhiyan

TACKLING MALNUTRITION VITAL

By Dr OisheeMukherjee

Poshan Abhiyan, also known as National Nutrition Mission should be implemented in a mission mode in each State with a complete  government approach. While this is desired by the Centre, the outreach and uptake on the Abhiyan hasn’t been encouraging. More so, in the background of the National Family Health Survey 2019-20 (NFHS-5) data, which revealed India’s limited progress on malnutrition, particularly among children and adolescents.

While reviewing the scheme during the 39th PRAGATI Interaction, Prime Minister Modi talked about participation of Self-Help Groups (SHGs) and other local organisations in promoting awareness about children’s health and nutrition at the grass-root level. This is a follow-up of the government announcing earlier this year the merger of supplementary nutrition programme and the Poshan Abhiyan to launch Mission Poshan 2.0 to strengthen nutritional content, delivery, outreach, and outcome across 112 aspirational districts in the initial phase.

Though the scheme intends  to improve utilisation of key anganwadi services and improving the quality of such services, due to lack of sufficient funds, not much success has been achieved. Besides, funds for 2020-21 too have been cut and there is need for a bigger thrust on the issue of nutrition.

The NHS report pointed out that the number of anaemic children under 5 years rose to 67.1 per cent from 58.6 per cent in the previous survey. This means that two out of three children (under 5 years) in India are anaemic. The percentage of anaemic women increased to 57 per cent from 53.1 per cent and anaemic teenage girls (between 15-19 years) from 59.1 from 54 per cent.

A report of the UN Food and Agriculture Organization co-authored with the Global Panel on Agriculture and Food Systems for Nutrition, had noted that poor quality diet is a greater threat to public health across the world than diseases like malaria, TB or measles as diet related factors account for six of the top nine contributors to the global burden of diseases. Though the world is producing more food than it possibly needs, an estimated three billion people have inadequate diets.

“Every year, approximately 1.3 billion metric tonnes of food produced for human consumption – one-third of the total – never reaches the consumer’s plate or bowl”, observed the report titled ‘Preventing Nutrient Loss & Waster Across the Food System: Policy Action for High Quality Diets’. It stated that getting more of the nutrient rich food already being produced would “result in savings to land, water and energy consumption tied to food production and resources used in industrial food fortification”. It advised the need to scale up the pace of food production to meet the demand of an additional 1 billion people by 2030.

The traditional response for food security was to promote higher output of staple crops such as grains, tubers and starchy foods to provide nutrient energy (kilocalories). However, policy makers the world over are increasingly acknowledging the challenge of meeting the rising demand for a healthy diet rather than just calorie sufficiency.

The world’s total supply of calories has never been greater in human history, thanks to remarkable gains in agricultural productivity. It is recommended that there is need for higher consumption of vegetables and fruits and greater diet diversity to tackle micronutrient deficiencies. More so, as it’s been estimated that globally over the years till the end of last decade one in five deaths was associated with poor diets, including increasing non-communicable diseases associated with the rise of obesity, also linked to poor quality diets.  

The Niti Aayog has found “that every second woman is anaemic, every third child is stunted and malnourished and every fifth child is wasted. Further over 70 percent of the population consumes less than 50 percent of the Recommended Dietary Allowance. . .” Moreover, the rising incidence of non-communicable diseases like obesity, diabetes and heart ailments are the result of consumption of processed foods which are usually high in salt, sugar and bad fats.     

Today, 22.5 per cent of adults are undernourished and 38 per cent are stunted. Consumption patterns across income levels are skewed towards cereals, staple crops. As such, Indians eat more carbohydrates and less protein and fewer vegetables. High protein foods such as dairy, eggs and legumes, which have high nutrient value, are often consumed in very low quantities.

As per latest reports, mostly older States such as Maharashtra, Uttar Pradesh, Tamil Nadu, Goa and Telengana did not take necessary steps to address the question of providing food to children either because of local elections or the second wave of the pandemic. A writ petition of Mahila Ekta Manch sought directions from the Delhi government to provide cooked mid-day meals or food security allowances to children during the Covid lockdown and the case is still pending. Even in Tamil Nadu, the Madras High Court directed the State government to supply eggs, sanitary napkins and dry rations to students who are part of the mid-day meal scheme.

It may be pertinent to mention that National Sample Survey Office (NSSO) data showed that while 50 gm of lentils and 25 gm of soya foods are recommended per day, Indians consume half that amount of lentils and almost very little soya foods. As per a study, about 68 per cent of the country’s population is protein deficient and soya, which is not very costly, is said to have ten times more protein than milk.

A good side is that the Food Safety and Standards Authority (FSSAI)  has set up a Food Fortification Resource Centre which works with Nutrition International, World Food Programme, The India Nutrition Programme and many other organisations. Though the food industry is quite powerful and there is no bar on the aggressive marketing of ultra-processed foods, the government remains a silent spectator.

Experts believe that given the negative impact of unhealthy food on human health, food industry should not be partnering with these industry partners but scientific panels would have to be formed by FSSAI to go deep in examining the real nutrient content of all types of food available in the market. In fact, these panels would have to outline the dietary pattern of children, lactating women and also adults.

Proper strategies need to be evolved to ensure balanced nutrition. But there is need to generate awareness to overcome malnutrition and maintain balance in consumption patterns. Apart from this, solutions include mainstreaming nutrition in approaches to agriculture, reducing food loss and waste in pre-and post-harvest, prioritise children’s nutrition as the category in greatest need and embedding nutrition in national social protection systems.

Goal 2.1 of SDG aims to end hunger and ensure access of all people to “safe, nutritious and sufficient food all year round”. Current projections suggest it may not be possible to achieve ‘zero hunger’ target by 2030, specially for Third World countries like India. Thus, there is a lot more which needs to be done than just rethink policies and programmes. Funds availability and tangible action on the ground could help lessen the wide gap to meet targets. ---INFA

(Copyright, India News & Feature Alliance)