MALNUTRITION: Time to turn spotlight it : Daily Current Affairs

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

Key phrases: Child malnutrition, hunger, food insecurity, global hunger index, child wasting,

Why in News?

Child malnutrition is one of the most pressing public health issues currently in India. According to the Global Hunger Index (GHI) Report 2021, India recorded the highest child wasting rate of any country at 17.3 per cent in 2020.

Malnutrition in India:

Child malnutrition is one of the most pressing public health issues currently in India.
According to the Global Hunger Index (GHI) report 2021, India recorded the highest child wasting rate of any country at 17.3 per cent in 2020.
Moreover, recent data from National Family Health Survey-5 (2019-21) shows that roughly 35 per cent of children under the age of five are affected by stunting in India.
The UN Policy 2018 reports that nearly four out of 10 children in India do not meet their full human potential owing to chronic malnutrition.
Besides, with one in every three children malnourished, malnutrition is also thought to be the predominant risk factor for deaths in children under five, accounting for 68.2 per cent of the total under-five deaths.

Child 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.
Child stunting is defined as low height-for-age. It is the result of chronic or recurrent under nutrition, usually associated with poverty, poor maternal health and nutrition, frequent illness and/or inappropriate feeding and care in early life. Stunting prevents children from reaching their physical and cognitive potential.

Underweight is defined as low weight-for-age. A child who is underweight may be stunted, wasted or both

Reasons for prevalence of malnutrition in India:

Food insecurity: In various countries in which the prevalence of child malnutrition is high, shows that an important cause of this problem is household food insecurity. This, in fact, is likely to be the case for India as well since the level of household food insecurity is alarmingly high in the country. Indeed, the State of Food Security and Nutrition in the World (SOFI) report 2020 shows that while 27.8 per cent of India's population suffered from moderate or severe food insecurity in 2014-16, the proportion rose to 31.6 per cent in 2017-19. India accounted for 22 per cent of the global burden of food insecurity, the highest for any country, in 2017-19.
Ineffective targeting, implementation, and coverage: In recent decades, India has established a framework of programs with the potential to combat malnutrition, including a Public Distribution System (PDS), an Integrated Child Development Services (ICDS) program, a National Mid-day Meals Program (NMMP), and several employment schemes providing food for work. But these programs have failed to meet the needs of the poorest because of ineffective targeting, implementation, and coverage.
Inadequate financial allocation: While the PDS, for example, absorbs 0.5 percent of GDP, it fails to reach the segments of the population that need it most. Furthermore, spending on direct nutritional programs, mainly the ICDS, the NMMP, and the micronutrients programs now amounts to only 0.19 percent of GNP. Sri Lanka, which successfully dealt with malnutrition in the 1980s, spent about 1 percent of GNP on direct nutritional programs while simultaneously improving health services, education for females, and antipoverty measures.
Lacking political commitment: lack of political commitment to the problem of malnutrition is another reason for increasing malnutrition.
Pandemic impact: The ongoing pandemic has wreaked havoc in the lives of billions of Indians, especially those belonging towards the lower end of the economic ladder. There has been a substantial growth of joblessness in the economy, and many have unfortunately been thrown into the clutches of poverty and destitution.

Government initiatives to tackle Malnutrition

Integrated Child Development Services: It was launched on 2nd October 1975 and it represents one of the world’s largest and unique programmes for early childhood care and development. The beneficiaries under the Scheme are children in the age group of 0-6 years, pregnant women and lactating mothers
Matritva Sahyog Yojana: Indira Gandhi Matritva Sahyog Yojana (IGMSY) is a Conditional Maternity Benefit (CMB) Scheme launched in 2010. It was launched for pregnant and lactating women to improve their health and nutrition status to better-enable the environment by providing cash incentives to pregnant and nursing mothers.
Mid-Day Meal Scheme: The Mid-day Meal Scheme is a school meal programme in India designed to better the nutritional standing of school-age children. It covers all school students studying in Classes 1 to 8 of government schools, government-aided schools, special training centres, including madrasas supported under Samagra Shiksha Abhiyan.
National Nutrition Mission or POSHAN Abhiyaan: It is the government’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers. Its aim to reduce stunting and wasting by 2 per cent per year (total 6 per cent until 2022) among children and anaemia by 3 per cent per year (total 9 per cent until 2022) among children, adolescent girls and pregnant women and lactating mothers.
National Nutrition Strategy: The Strategy aims to reduce all forms of malnutrition by 2030, with a focus on the most vulnerable and critical age groups.

Constitutional Provisions

Art 14 provides right to equality to all
Art 38 provides for welfare of all
Art 39(e) and (f) further provide for development of child
Art 42 Maternity relief for women which further translates into timely attention and nutrition to new- born

Way Forward:

There are two major approaches in addressing malnutrition: Nutritional planning and direct nutrition and health development.
Nutritional planning involves formulation of a nutrition policy and overall long term planning to improve production and supplies of food, ensure its equitable distribution and programs to increase the purchasing power of people.
Direct nutrition and health development involves nutrition education, early detection of malnutrition and intervention and Nutrition supplementation.
Integrated nutrition policy can be brought by harmonization of efforts across ministries, political will and good governance.
There is a need for systematic data collection at the district level for formulation of policy and programme.
An institutional mechanism in form of a Food and nutrition commission should be established, headed by the Prime Minister.
The fortified foods need to be incorporated into a mid-day meal, public distribution shops and anganwadi centres.

Case Study

Community Management of Acute Malnutrition (CMAM) programme in Odisha

In 2015, the Odisha government piloted CMAM in tribal-dominated Kandhamal district which had the highest levels of under 5-year child mortality in the state in 2012–13.
A standard CMAM approach consisted of setting-up of treatment sites closer to the community, weekly monitoring of uncomplicated SAM children, an in-patient facility to admit children with SAM and associated medical complications along with provision of Modified Energy Dense Nutritional Food (EDNRF), Modified Hot Cook Meal (HCM) and Modified Take Home Ration (THR).
The targeted programme resulted in children achieving the desired weight after treatment, thereby significantly improving the nutritional status in the district.

Source: The Hindu BL

Mains Question:

Q. According to the Global Hunger Index (GHI) Report 2021, India recorded the highest child wasting rate of any country at 17.3 per cent in 2020. Discuss the factors which increase malnutrition in India. What measures are needed to improve malnutrition in India? Critically examine.