Issues and Analysis on India's Poshan Abhiyan for UPSC Civil Services Examination (General Studies) Preparation

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    India's Poshan Abhiyan

     India has historically fared poorly on child nutrition indicators and has been plagued by periodical waves of malnutrition-related deaths in tribal areas. With 17 per cent of the world’s population, India is home to a quarter of the world’s hungry. The dismal health of Indian women and children is primarily due to lack of food security. 

    Poshan Abhiyan :-

    • National Nutrition Mission, launched recently now christened POSHAN (Modi’s overarching scheme for holistic nourishment) Abhiyaan aims to drastically reduce the prevailing high incidence of malnutrition, stunted growth and anaemia.
    • The intention is to do this through convergence, mass movements and leveraging technology.
    • Anganwadi workers (AWWs) are required to feed in details of the beneficiaries and monitor their growth in real time during pregnancy, as well as height and weight of the child once born, in the mobile phones given to them and follow up with SMS alerts to those who are at risk.
    • It is to ensure that malnutrition doesn’t affect children’s cognitive development or physical growth.
    • The initiative seeks to reduce the level of stunting, undernutrition and low birth weight by 2% each, and anaemia by 3%.
    • The programme aims to ensure service delivery and interventions by use of technology, behavioural change and lays down specific targets to be achieved over the next few years. 
    • To ensure a holistic approach, all 36 states/UTs and districts will be covered in a phased manner. More than 10 crore people will be benefitted by this programme. 
    • Ministry of Women and Child Development is the nodal ministry for anchoring overall 

    How POSHAN abhiyan tackles malnutrition:-

    • Complete approach towards malnutrition:-
      1. The programme through use of technology, a targeted approach and convergence strives to reduce the level of stunting, under-nutrition, anaemia and low birth weight in children, also focus on adolescent girls, pregnant women and lactating mothers, thus holistically addressing malnutrition. 
    • It targets to reduce level of under-nutrition and other related problems by ensuring convergence of various nutrition related schemes and provide performance based incentives to states and community nutrition and health workers, facilitating a focus on results.
    • It will monitor and review implementation of all such schemes and utilize existing structural arrangements of line ministries wherever available.
    • Its large component involves gradual scaling-up of the interventions supported by ongoing World Bank assisted Integrated Child Development Services (ICDS) Systems Strengthening and Nutrition Improvement Project (ISSNIP) to all districts in the country by 2022.
    • Union Government has signed $200 million loan agreement with World Bank for National Nutrition Mission (POSHAN Abhiyaan) for 315 districts across all states and union territories.
      1. The World Bank loan will be used for improving coverage and quality of ICDS nutrition services to pregnant and lactating women and children under 3 years of age.
      2. It will be also used for project in improving skills and capacities of ICDS staff and community nutrition workers, instituting mechanisms of community mobilization and behaviour change communication, strengthening systems of citizen engagement and grievance redress.
      3. It will be also used for establishing mobile technology based tools for improved monitoring and management of services for better outreach to beneficiaries during critical 1,000 day window for nutrition impact.
    • POSHAN Convergence Matrix looks at deploying a multi-pronged approach to mobilise the masses towards creating a nutritionally aware society. 
    • Community based events at anganwadi centres to engage the beneficiaries and their families towards nutritional awareness; sustained mass media, multimedia, outdoor campaigns; mobilisation of all frontline functionaries; SHGs and volunteers towards nutrition are the methods to be adopted. The aim is to generate a Jan Andolan towards Nutrition
    • Thus the POSHAN Abhiyan is to bring all of us together, put accountability and responsibilities on all stakeholders to help the country accomplish its desired potential in terms of its demographic dividend. 

    However, certain fundamental issues need fixing for the programme to be successfully implemented:-

    • Anganwadi centres :-
      1. Anganwadi centres(AWC) lack basic amenities and face infrastructure problems. Around 24% of them lacked their own building and operated from small rented premises. The cumulative effect was that children were forced into cramped, poorly lit and unhygienic spaces, often in searing heat.
      2. Administrative duties like organizing functions, and conducting exams and surveys distracted them from their core health and nutrition responsibilities. Thus, overburdened with work, undervalued and underpaid, Anganwadi women have become demotivated and demoralized.
    • Despite improvements, there is still much left to do in terms of achieving universalization of coverage and advanced service delivery. A 2015 evaluation carried out by NITI Aayog had found that over 24% of the AWCs surveyed maintained poor records
    • Technology constraints :- Information and communications technology-enabled real time monitoring (ICT-RTM) has been rolled out in POSHAN Abhiyaan districts. The programme will be ineffective due to the limited capacities of AWCs to handle smartphones owing to their lack of technological literacy.
    • Technical issues :- This is compounded by technical issues like slow servers and data deletion problems, resulting in irregular and improper recording of growth data of children.
    • Financial constraints:- Despite their indispensability, nearly 40% of Anganwadi women had to use their personal money to run the AWCs, 35% of them complained of delayed payments .

    Many schemes in India, including those tackling malnutrition, fails because states do not utilise funds allocated for the scheme. Although the states under will be provided with funds and technology for the new nutrition scheme, the effective use of these funds cannot be guaranteed.

    Possible problems with implementation

    • The scheme provides hope that the problems arising due to malnutrition could be curbed in the next three years. However, this will only occur with effective implementation of the schemes that are aimed at tackling the problem.

    Issues with monitoring:-

    • The recent scheme merely establishes a real-time monitoring system for the schemes that are currently in place. A large number of these schemes have been in existence for over a decade, and yet have failed to reduce malnutrition in India significantly.

    • A monitoring system would indeed help in the better implementation of these schemes on the grass-root level. However, it will not solve the pre-existing problems in those schemes which make them ineffective.

    •  The scheme however is most likely to suffer from the same implementation defects as the previous schemes. The government has however, set very ambitious goals to be achieved, which are unlikely to be met in merely three years.

    Way forward:-

    • Strategy of actively involving panchayatleaders in construction of AWCs and improvement in the quality of village health sanitation and nutrition, will make POSHAN Abhiyaan more effective
    • Further, if the government vests more powers in the district administration to fill vacant posts in AWCs, it would be a significant step towards overcoming the problem of shortage of staff. This is especially so at the supervisory level.
    • Comprehensive periodical and refresher training of AWWs, especially when it comes to usage of tablets for monitoring growth among malnourished children and high risk pregnant mothers, is crucial.
    • Further, supply of iron/folic acid tablets, allotment of ‘take-home rations’ and supplementary nutrition needs to be regular.
    • Supply side investments need to be complemented with the enhancement of the traditionally weak demand for health and nutrition services.
    • Package of basic measures like including programmes to encourage mothers to exclusively breastfeed their children for up to six months, fortifying basic foods with essential minerals and vitamins, and increased cash transfers with payments targeted at the poorest families can turn the tide.
    • Universal access to infant and young childcare, including ICDS and crèches, provisions to provide biannual critical nutrient supplements and programmes aimed at deworming children need to be implemented effectively.

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