Context:

• Despite programme commitments since 1975, such as creating Integrated Child Development Services and national coverage of the mid-day meal scheme, India continues to grapple with a high rate of undernutrition.
• Improving nutrition and managing stunting continue to be big challenges.

Concerns:

• According to the National Family Health Survey (NFHS)-4, India has unacceptably high levels of stunting, despite marginal improvement over the years.
• According to NFHS-4 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.
• Stunting has lifelong consequences on human capital, poverty and equity. It leads to less potential in education and fewer professional opportunities.
• India ranks 158 out of 195 countries on the human capital index.
• Lack of investment in health and education leads to slower economic growth.

Do you know?

• 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%).

National Nutrition Strategy

• NITI Ayog came with a national strategy to fight maternal and child malnutrition and anaemia among women and girls.
• The aim of the National Nutrition Strategy of 2017 is to achieve a malnutrition-free India by 2022.
• The plan is to reduce stunting prevalence in children (0-3 years) by about three percentage points per year by 2022 from NFHS-4 levels, and achieve a one-third reduction in anaemia in children, adolescents and women of reproductive age.

This is an ambitious goal, especially given that the decadal decline in stunting from 48% in 2006 to 38.4% in 2016 is only one percentage point a year.

Measures need to address the challenges of under-nutrition

• There is a need for serious alignment among line ministries, convergence of nutrition programmes, and stringent monitoring of the progress made in achieving these goals.
• Stunting prevalence tends to increase with age and peaks at 18-23 months. Timely nutritional interventions of breastfeeding, age-appropriate complementary feeding, full immunisation, and Vitamin A supplementation have been proven effective in improving outcomes in children.
• India must improve in areas like breastfeeding children within one hour of their birth, breastfeeding for minimum next 6 months, providing timely complementary foods and adequate diet.
• About 40% of children don’t get full immunisation and Vitamin A supplementation. Vitamin A deficiency can increase infections like measles and diarrhoeal diseases.
• They must be provided these for disease prevention.
• Stunting shows a steady decline with increase in household income and years of schooling or education.

Conclusion:

• It is imperative to push for convergence of health and nutrition programmes right from pregnancy until the child reaches five years of age.
• India must adopt a multi-pronged approach in bringing about socio-behavioural change.
• What is really needed is effective monitoring and implementation of programmes to address malnutrition.