Strengthening efforts at community level will play a key role in stepping up the fight against malnutrition

By Aparajita Sarangi, 

Amid all the chatter about COVID-19 and immunity, there is, unfortunately, one aspect of good health that has gone amiss, which is the nutritional needs of infants and children. Good nutrition is critical for the physical growth, mental development, and the overall well-being of a child. The Government had duly recognised this need and piloted the Anganwadi Services and Pradhan Mantri Matru Vandana Yojana among other schemes under the umbrella of the Integrated Child Development Services Scheme to address the issue of malnutrition among children. Mission Indradhanush and the Swachh Bharat Mission also work in furthering the same goal.

On Women’s Day in 2018, Prime Minister Modi had unveiled the agenda adopted by the Government for achieving a malnutrition-free India. He announced that all the schemes which are put in place for fighting malnutrition will now be taken under the umbrella of POSHAN Abhiyan which aims to bring down stunting among children upto the age of 6, among other goals. It was indeed reassuring to hear the head of the state affirm his continued commitment to ending malnutrition in India.

In a commendable effort to bolster public participation, the Government had also celebrated the first Rashtriya Poshan Maah in September 2018. Since then, to keep the tradition alive, States and Union Territories across India have conducted activities to disseminate awareness related to nutrition in the month of September. Activities undertaken as a part of Poshan Maah yielded impressive results as they placed great emphasis on identifying and managing the needs of children who are severely acute malnourished (SAM). In furtherance to this, the Government has also worked towards setting up Nutrition Rehabilitation Centres which work relentlessly to provide inpatient health facilities for children who are severely malnourished, including any medical complications they may have.

The National Family Health Survey-4 and the remarkable improvement in the results, when compared to its predecessor, stands testament to the Government’s efficiency in implementing the schemes directed at reducing malnourishment in India. The NHFS-3 conducted in 2004-2005 painted a grim picture with nearly 48% of children under the age of 5 stunted and 42.5% children in the underweight category. However, the NHFS-4 conducted about a decade after, in 2015-2016, shows a drastic improvement in the conditions. India witnessed a 6.7% decrease in cases of underweight children and the number of children recorded to have stunted growth, too, decreased by nearly 10%.

Although the Government has been putting in earnest efforts to reduce malnutrition, the situation continues to remain grim as the data indicates an increase in the number of cases of wasting. The fact that wasting was recorded in 20.8% of children below the age of 5 is worrisome and calls for an active implementation and further strengthening of the schemes currently in force.

In an unfortunate turn of events, COVID-19 has put a damper on the Government’s efforts, making it exceedingly difficult for India to meet the global targets. The sudden and unprecedented onset of the pandemic poses a grave threat to nutritional status as there is a social and economic crisis triggered by COVID-19. This has led to a steep decline in household income which could lead to a decrease in affordability and access to food of high nutritional quality. A fear of spike in cases of child malnutrition and wasting looms as India fights its hardest battle with the pandemic.

In these trying times, there is an urgent need to shift focus to a community-based approach based on best practices. Gujarat leads India by example with its Community-based Management of Malnutrition (CMAM) programme. Identifying children with such deficiencies and providing them with nutrition-dense food and routine medical care at a community level has proved to be an effective strategy as only a fraction of the SAM cases develops medical complications warranting hospitalisation. Children who do not need immediate hospitalization can be steered away from serious complications with timely interventions at community-level.

The CMAM programme adopts a humane and WHO-approved approach to fighting malnutrition where they harness resources available at the community-level to fight India’s SAM crisis. CMAM is a model that can be easily replicated across the country to save lives.

The nature of the issue at hand demands a convergence of multiple sectors – spanning from agriculture and food to health, sanitation, and several others. Though India is abundant in resources, COVID-19 requires most of the resources to be directed towards fighting the pandemic. It, thus, becomes pertinent to have unity in this fight against childhood malnutrition. The aim of POSHAN Abhiyan, too, is to generate a Jan Andolan towards nutrition. This battle against malnutrition would require a collaborative and multi-sectoral approach, raising voices everywhere.

To be malnutrition-free, India must utilize kitchen gardens and locally grown food. Strengthening efforts at the community level to diversify food consumption will play a key role in fighting the looming fear of an increase in malnutrition.

The columnist is Member of Parliament -Lok Sabha (BJP), Bhubaneshwar. Views expressed are the columnist’s own.