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Malnutrition in India: An overview

Tue 30 Apr, 2019

In News Because

  • India is facing a serious challenge of malnutrition. Many children have reportedly died due to malnutrition. Ending Malnutrition is on the agenda of Millennium development goals and National Nutrition Strategy of 2017.

 

What is malnutrition?

  • Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.
  • Malnutrition indicates that children are either too short for their age or too thin. Children whose height is below the average for their age are considered to be stunted.

 

Status of Malnutrition in India                 

  • As per the National Family Health Survey (NFHS)-4 (2015-16)
  • 7 percent children below five years are underweight.
  • 4 percent are stunted and 21 percent are wasted in the country.
  • About 8% of children are stunted
  • About 21% of children under the age of five are wasted according to the National Family Health Survey-4 data.
  • In the State of Madhya Pradesh 42.8 percent children below five years are underweight, 42 percent are stunted and 25.8 percent are wasted 

According to UNICEF,

  • India is at the 10th spot among countries with the highest number of underweight children,
  • India is on the 17th spot for the highest number of stunted children in the world 

Reasons for Lack of Nutrition

  • One of the primary reasons for children being undernourished is that often their mothers are undernourished.
  • Women without education or without much voice in their families often fail to ensure adequate diets for their children.
  • Malnourishment in a girl, combined with early marriage, has a cascading effect of health complexities across generations.
  • Poverty, dietary issues, poor sanitation and low social status of women.
  • Inadequate iron intake can lead to iron deficiency anaemia (IDA) which leads to permanently impaired cognitive abilities.

 

Facts from National Family Health Survey 4 data for 2015-16

  • Of the mothers who participated in the survey, more than 50% provided immunization to their children, across all categories based on caste and education.
  • Nutritional status varied across categories.

According to NFHS­4 data,

  • India has more stunted children in rural areas as compared to urban areas, possibly due to the low socio-economic status of households in those areas.
  • Almost double the prevalence of stunting is found in children born to mothers with no schooling as compared to mothers with 12 or more years of schooling.
  • Stunting shows a steady decline with increase in household income. The inter­generational cycle of malnutrition is to be tackled with effective interventions for both mother (pre­ and post -pregnancy) and child, to address the high burden of stunting.
  • In terms of geographical regions, Bihar (48%), Uttar Pradesh (46%) and Jharkhand (45%) have very high rates of stunting, while States with the lowest rates include Kerala, and Goa (20%). While nutrition has improved across all States, inter­State variabilities remain extremely high. The most significant decline has been noted in Chhattisgarh (a 15 percentage point drop in the last decade). Thus, the government can take lessons from Chhattisgarh. The least progress has been made in Tamil Nadu.
  • Percentage of children who were underweight and had stunted growth was greater among Scheduled Tribes compared with other caste categories. Children of around 44% of the women from Scheduled Tribes showed stunted growth and about 45% were underweight

 

Consequences of Malnutrition

  • There are many negative consequences of malnutrition. Some of them are given below:
  • The World Bank says, “A 1% loss in adult height due to childhood stunting is associated with a 1.4% loss in economic productivity”. Stunting also has lasting effects on future generations. Since 53.1% of women were anaemic in 2015­16, this will have lasting effects on their future pregnancies and children.
  • Undernourished children have significantly lower chances of survival than children who are well-nourished. They are much more prone to serious infections and to die from common childhood illnesses such as diarrhoea, measles, malaria, pneumonia, and HIV and AIDS.

 

Initiatives taken by government to reduce Malnutrition

  • The Government has accorded high priority to the issue of malnutrition in the country and is implementing several schemes and programme:

Direct Targeted interventions:

  1. Integrated Child Development Services (ICDS)
  2. National Health Mission (NHM)
  3. Mid-Day Meal Scheme
  4. Rajiv Gandhi Schemes for Empowerment of Adolescent Girls (RGSEAG) or SABLA,
  5. Indira Gandhi Matritva Sahyog Yojana (IGMSY)

Indirect Multi-sectoral interventions:

  • Targeted Public Distribution System (TPDS)
  • National Horticulture Mission
  • National Food Security Mission
  • Swachh Bharat Abhiyan

 

Other steps include:

  • National Nutrition Strategy (NNS) has been published by NITI Aayog in 2017 with Vision 2022: “Kuposhan Mukt Bharat”.
  • Promotion of appropriate infant and young child feeding practices that include early initiation of breastfeeding,
  • Exclusive breastfeeding till 6 months of age and appropriate complementary feeding after 6 months of age.
  • Central governments have initiated various programs like MAA (Mothers Absolute Affection) to promote exclusive breast feeding; PradhanMantriSurakshitMatritvaAbhiyan;
  • National Iron plus Initiative (NIPI) for Anemia control among children from 6 to 60 months of age.
  • Village Health and Nutrition Days and Mother and Child Protection Card are the joint initiative of the Ministries of Health & Family welfare and the Ministry of Woman and Child for addressing the nutrition concerns in children, pregnant women and lactating mothers.
  • Specific program to prevent and combat micronutrient deficiencies of Vitamin A and Iron & Folic Acid (IFA) in under-five children, children of 5 to 10 years of age, and adolescents.
  • Management of malnutrition and common neonatal and childhood illnesses at community and facility level by training service providers in IMNCI (Integrated Management of Neonatal and Childhood Illnesses) training.Rashtriya Bal Swasthya Karyakram (RBSK) provides child health screening for common health conditions by expanding the reach of mobile health teams at block level and establishment of District Early Intervention Centres (DEICs) at the districts for early interventions services. Under the Rashtriya Bal Swasthya Karyakram (RBSK), systematic efforts are undertaken to detect nutrition deficiency among children and adolescents respectively.

Malnutrition is high despite all the efforts due to:

  1. Corruption in implementation of schemes
  2. Diversion of ration meant for mid-day meal
  3. Poor quality of food given in mid-day meals.
  4. Poor sanitation and hygiene decreases the nutrition absorption rate
  5. Low social status of women
  6. Lack of infrastructure in rural areas.

 

Conclusion

  • Boosting nutrition levels across the country is one of the biggest low hanging fruit in the Indian public policy sphere. If we can conquer space, we can conquer the malnutrition.