Beating the Rhetoric
The NITI Aayog has recently drafted the National Nurtition Strategy. The strategy was formulated through an extensive consultative process. The Strategy lays down a roadmap for effective action, among both implementers and practitioners, in achieving our nutrition objectives. This roadmap has come at a crucial time for the country. As India steps into the new era of multipolar world and an increasing acceptance of its role in global order, the question of basic neceissties for the citizens is a puzzle which continues to keep the policymakers in tenderhooks. Hunger and nutrition form important part of the basket of basic necessities. Periodic reports released by various agencies have not painted a pretty picture of either the state of hunger or nutrition and the recently released Hunger Index is no different. Despite making considerable strides India’s performances in food and nutrition contiues to be challenged and a lot of ground remains to be covered.
The National Nurtition Strategy will primarily seek to address the problem of malnutrition in the country. Malnutrition in essence is an indicator or a state where children are either too short for their age or too thin for their age group. These children whose height is below the average for their age are considered to be stunted. Similarly, children whose weight is below the average for their age are considered undernoursihed or malnutrinioed. Together, the stunted and wasted children are considered to be underweight – indicating a lack of proper nutritional intake and inadequate care post childbirth. And these children form the core group of kids who suffer from malnutrition.
India’s performance on key malnutrition indicators is poor according to most national and international studies despite making rapid progress in the past few years. According to UNICEF, India was at the 10th spot among countries with the highest number of underweight children, and at the 17th spot for the highest number of stunted children in the world. Malnutrition affects children in many ways. It decreases the chances of survival for children, increases their susceptibility to illness, reduces their ability to learn, and makes them less productive in later life. It is estimated that malnutrition is a contributing factor in about one-third of all deaths of children under the age of 5. And thus it was imperative that a compehensive strategy to tackle the problem of malnutrition was brought on board and the National Nutrional Strategy could not have come at a better time.
The key features of the strategy would look at addressing these issues in a comrehensive manner. One of the first goals of the strategy is to reduce all forms of malnutrution by 2030. It seeks to specially focus on the most vulnerable and critical age groups. The Strategy also aims to assist in achieving the targets identified as part of the Sustainable Development Goals related to nutrition and health. The Strategy aims to launch a National Nutrition Mission, similar to the National Health Mission. This is to enable integration of nutrition-related interventions cutting across sectors like women and child development, health, food and public distribution, sanitation, drinking water, and rural development.The strategy aims to replu on decentralised approach. This will be promoted with greater flexibility and decision making at the state, district and local levels. Further, the Strategy aims to strengthen the ownership of Panchayati Raj institutions and urban local bodies over nutrition initiatives. This is to enable decentralised planning and local innovation along with accountability for nutrition outcomes. Local partnership is an important component should a comprehensive strategy towards defeating malnutrition be put in place.
Targeted interventions are an important tool that this strategy will seek to deploy.The Strategy proposes to launch interventions with a focus on improving healthcare and nutrition among children. These interventions will include: promotion of breastfeeding for the first six months after birth, universal access to infant and young child care (including ICDS and crèches), enhanced care, referrals and management of severely undernourished and sick children, bi-annual Vitamin A supplements for children in the age group of 9 months to 5 years, and micro-nutrient supplements and bi-annual de-worming for children. These interventions will go a long way in stemming those causes which contribute to the infant mortality rate and higher mortality rate among children when they are in a vulnerable age.
Special focus has been given to imporve maternal care and nutrition and measures to improve both have been put in place. These measures include supplementary nutritional support during pregnancy and lactation, health and nutrition counselling, adequate consumption of iodised salt and screening of severe anaemia, and institutional childbirth, lactation management and improved post-natal care.
As part of the governance induced reforms the strategy lays down the following governance reforms envisaged in the Strategy includeing convergence of state and district implementation plans for ICDS, NHM and Swachh Bharat, focus on the most vulnerable communities in districts with the highest levels of child malnutrition, and service delivery models based on evidence of impact. In totality the National Nutrition Strategy will go a long way towards curbing malnutrition in the country.
(Views expressed by the author are personal)