Malnutrition in India is a Worry in a Modern Scenario : Daily Current Affairs

Relevance: GS-2: Issues relating to poverty and hunger.

Key Phrases: Malnutrition, Anaemia, Women and children, National Family Health Survey, Undernutrition, Wasting and stunting, Poverty, Social inequality, Sanitation, POSHAN Abhiyaan, Anemia Mukt Bharat, Integrated Child Development Scheme, Public Distribution System, Midday meal scheme,

Why in News?

The country’s response to its burden of malnutrition and growing anaemia has to be practical and innovative.

Context:

Good nutrition has the power to make the present and future generations fit,healthy and strong.
Even after 75 years of independence, a majority of people — especially women and children — do not get the required diet to meet their nutritional needs.
Poor nutrition among pregnant women affects the nutritional status of the child and has a greater chance to affect future generations.
Undernourished children are at risk of under-performing in studies and have limited job prospects. This vicious cycle restrains the development of the country, whose workforce, affected mentally and physically, has reduced work capacity.

What is malnutrition?

WHO has defined malnutrition as deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.
The term malnutrition addresses 3 broad groups of conditions:
- undernutrition, which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age);
- micronutrient-related malnutrition, which includes micronutrient deficiencies (a lack of important vitamins and minerals) or micronutrient excess; and
- overweight, obesity and diet-related noncommunicable diseases (such as heart disease, stroke, diabetes and some cancers).

Key Facts

1.9 billion adults are overweight or obese, while 462 million are underweight.
Globally in 2020,
- 149 million children under 5 were estimated to be stunted (too short for age),
- 45 million were estimated to be wasted (too thin for height), and
- 38.9 million were overweight or obese.
Around 45% of deaths among children under 5 years of age are linked to undernutrition. These mostly occur in low- and middle-income countries. At the same time, in these same countries, rates of childhood overweight and obesity are rising.
The developmental, economic, social, and medical impacts of the global burden of malnutrition are serious and lasting, for individuals and their families, for communities and for countries.

National Family Health Survey (NFHS)-5 on Malnutrition:

The National Family Health Survey (NFHS)-5 shows
- Negligible gains in nutritional outcomes among under-five children.
- There has been tardy progress in reducing undernutrition, wasting and stunting.
- 35.5% of under-five children are stunted
- 19.3% are wasted.
- Childhood anaemia has worsened from NFHS-4.
- Anaemia among adolescent girls and women aged 15-49 has also worsened.
- More than 57% of women (15-49 years) and over 67% children (six-59 months) suffer from anaemia.
- Assam, is among the low-performing States, with a huge burden of anaemic cases — 66.4% of women (15-49 years) and 68.4% children (6-59 months) are affected.

Anaemia is a condition in which the number of red blood cells or the haemoglobin concentration within them is lower than normal. Iron deficiency is the most common cause of anaemia, although other conditions, such as folate, vitamin B12 and vitamin A deficiencies, chronic inflammation, parasitic infections, and inherited disorders can all cause anaemia.
Anaemia reduces the work capacity of individuals, in turn impacting the economy and overall national growth. Developing countries lose up to 4.05% in GDP per annum due to anaemia; India loses up to 1.18% of GDP annually.
Stunting is defined as low height-for-age. It is the result of chronic or recurrent undernutrition, usually associated with poverty, poor maternal health and nutrition, frequent illness and/or inappropriate feeding and care in early life.
Wasting is defined as low weight-for-height. It often indicates recent and severe weight loss, although it can also persist for a long time.It usually occurs when a person has not had food of adequate quality and quantity and/or they have had frequent or prolonged illnesses.
Underweightis defined as low weight-for-age. A child who is underweight may be stunted, wasted or both.

Reasons for malnutrition in India:

Poverty: It is the main reason behind the lack of adequate nutritional food which results in malnutrition.
Social inequality: For example, girl children are more likely to be malnourished than boys. Similarly the low-caste children are more likely to be malnourished than upper-caste children.
Sanitation:
- Most children in rural areas and urban slums still lack sanitation. This makes them vulnerable to the kinds of chronic intestinal diseases that prevent bodies from making good use of nutrients in food, and they become malnourished.
- Lack of sanitation and clean drinking water are the reasons high levels of malnutrition persists in India despite improvement in foodavailability.
Lack of diversified food:
- With the increase in diversity in food intake malnutrition (stunted/underweight) status declines.
- Only 12% of children are likely to be stunted and underweight in areas where diversity in food intake is high, while around 50% children are stunted if they consume less thanthree food items.
Lack of food security:
- The dismal health of Indian women and children is primarily due to lack of food security.
- Nearly one-third of adults in the country have a Body Mass Index (BMI) below normal just because they do not have enough food to eat.
Failure of government approaches:
- Although India already has following two robust national programmes addressing malnutrition but these are yet to reach enough people:
  - Integrated Child Development Service (ICDS) and
  - The National Health Mission

Meaures to reduce Malnutrition:

There is a greater need now to increase investment in women and children’s health and nutrition to ensure their sustainable development and improved quality of life. While the Government’s focus has been on the consolidation of several programmes to improve outcomes, there is a need for increased financial commitment.
India must adopt an outcome-oriented approach on nutrition programmes. It is crucial that MPs/MLAs begin monitoring needs and interventions in their constituencies and raise awareness on the issues, impact, and solutions to address the challenges at the local level.
There has to be
- direct engagement with nutritionally vulnerable groups (this includes the elderly, pregnant women, those with special needs and young children), and
- contribute toward ensuring last-mile delivery of key nutrition services and interventions.
With basic education and general awareness, every individual is informed, takes initiatives at the personal level and can become an agent of change.
Various studies highlight a strong link between mothers’ education and improved access and compliance with nutrition interventions among children.
We must ensure our young population has a competitive advantage; nutrition and health are foundational to that outcome.

Steps taken by Government for nutritional enhancement

POSHAN Abhiyaan or National Nutrition Mission: It is Government of India’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers.
Under it the Anemia Mukt Bharat (AMB) Strategy was launched in 2018 with efforts to improve Iron and Folic Acid (IFA) supplementation, behaviour change and anaemia-related care and treatment across six target groups including pregnant women, lactating mothers, and children.
Integrated Child Development Scheme (ICDS): It aims to improve the nutritional and health status of children in the age-group 0-6 years and reduce the incidence of mortality, morbidity, malnutrition and school dropout.
Public Distribution System: It provides coverage to upto 75% of rural population and upto 50% of urban population for receiving highly subsidized food grains under Targeted Public Distribution System.
Midday meal scheme: The scheme provides meals for all school children studying in Classes I-VIII of Government, Government-Aided Schools.

Way Forward:

There should be a process to monitor and evaluate programmes and address systemic and on the ground challenges.
A new or existing committee or the relevant standing committees meet and deliberate over effective policy decisions, monitor the implementation of schemes, and review nutritional status across States.
The country’s response to malnutrition and its growing anaemia burden should be practical and innovative. This is critical to make an India that is malnutrition-free and anaemia-free a reality, and not just an aspiration. Every one is a stakeholder and should contribute towards ending malnutrition and anaemia. We should not become part of a tragedy that is preventable.

Source: The Hindu

Mains Question:

Q. What are the reasons formalnutrition in India? What step needed to reduce malnutrition in India?