According to WHO, Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition covers 2 broad groups of conditions. One is ‘undernutrition’—which includes stunting (low height for age), wasting (low weight for height), underweight (low weight for age) and micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals). The other is overweight, obesity and diet-related non-communicable diseases (such as heart disease, stroke, diabetes and cancer).

Body:

India is home to one of the largest populations of malnourished children in the world. One cannot build a strong building on a weak foundation.

Current Scenario of Malnutrition in India:

• India is home to over 40 million stunted and 17 million wasted children (under-five years).
• Despite a fast-growing economy and the largest anti-malnutrition programme, India has the world’s worst level of child malnutrition
• Though anaemia among children has declined, it affects every second child in the country. There has been no perceptible decline in anaemia among 15 to 49-year old women; it affects around 60 per cent of them.
• The daily consumption of iron rich dark green leafy vegetables has reduced from 64 per cent to 48 per cent of the population in the last decade.
• Many, in fact, argue that the NFSA’s focus on wheat and rice has forced millets — traditional source for iron and minerals — out of the market.
• The government’s iron supplementation programme to overcome IDA has led to only 30 per cent of pregnant women consuming iron and folic acid tablets.
• Lack of sanitation and clean drinking water are the reasons high levels of malnutrition persists in India despite improvement in food availability

A public emergency:

The scale of malnutrition in India constitutes a public health crisis, which not only violates a fundamental right of humanity, but also undermines significant advances made in economic, social, and cultural indicators.

Failure of Government Schemes:

• India already has two robust national programmes addressing malnutrition the Integrated Child Development Service (ICDS) and the National Health Mission but these do not yet reach enough people.
• The delivery system is also inadequate and plagued by inefficiency and corruption. Some analysts estimate that 40 per cent of the subsidised food never reaches the intended recipients
• More specifically, the current institutional structure has so far failed to correctly map the time frame for focused intervention, and state spending directed at nutrition and micronutrient supplementation continues to be low.
• These challenges are compounded by the continued lack of clarity in identifying the nodal ministry from which to coordinate the Government’s various nutrition programmes, including the Integrated Child Development Scheme (ICDS) and the National Rural Health Mission (NRHM).
• With current interventions retaining a focus on addressing malnutrition post-birth, the importance of intervening during the first 1,000 days of a child’s life cannot be over emphasised.

Fortified foods are those that have nutrients added to them that don’t naturally occur in the food. These foods are meant to improve nutrition and add health benefits. For example, milk is often fortified with vitamin D, and calcium may be added to fruit juices.

Significance:

• Food fortification has been identified by the World Health Organization, the Copenhagen Consensus and the Food and Agriculture Organization as one of the top four strategies for decreasing micronutrient malnutrition at the global level.
• It helps to address micronutrient deficiencies across populations, countries and regions. For instance, iodine deficiency can have a bearing on children’s cognitive functions, whereas deficiencies in vitamin A and zinc can affect their immunity.
• Fortification of centrally-processed staple foods is a simple, affordable and viable approach to reach large sections of a country’s population with iron, folic acid, and other essential micronutrients.
• Adding micronutrients to common staple foods can significantly improve the nutritional quality of the food supply and improve public health with minimal risk.
• Food fortification is considered an efficient public health strategy because it can reach wider susceptible populations through existing food delivery systems without requiring major changes in existing consumption patterns.
• It acts as an effective short-term approach to address the nutrition gaps within a population.
• Compared to other nutrition interventions, food fortification is also more cost-effective, if advantage can be taken of existing technology and large-scale distribution systems such as the MDM Scheme, ICDS, PDS, etc.
• An effective way to secure micronutrients for beneficiaries is to include fortified foods as an additional supplement to the nutritious meals that are served to them as part of such programmes.
• According to NFHS 2015-16, every second tribal child suffers from growth restricting malnutrition due to chronic hunger.
• Such acute food insecurity in tribal households is due to a loss of their traditional dependence on forest livelihood and the State’s deepening agrarian crisis.
• Adding fortified foods are also useful in lowering the risk of the multiple deficiencies that can result from deficits in food supply or a poor quality diet.

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 malnutrition.