NEWS Poor nutritional outcomes in NFHS-5 show that a piecemeal approach does not work.
CONTEXT The Ministry of Health and Family Welfare has released data fact sheets for 22 States and Union Territories (except Tamil Nadu, Rajasthan, Punjab,Uttar Pradesh, Jharkhand, Odisha and Madhya Pradesh) based on the findings of Phase I of the National Family Health Survey5 (NFHS5) . The data so far paints a troubling picture in relation to nutrition outcomes.
- There is an increase in the prevalence of severe acute malnutrition in 16 States/UTs (compared to NFHS4 conducted in 201516). Kerala and Karnataka are the only two big States among the six States and UTs where there is some decline.
- The percentage of children under five who are underweight has also increased in 16 out of the 22 States/UTs.
- Anaemia levels among children as well as adult women have increased in most of the States (only four States/UTs— Lakshadweep, Andaman and Nicobar Islands, Dadra and Nagar Haveli and Daman and Diu, and Meghalaya showed decline in anaemia among children).
- There is also an increase in the prevalence of other indicators such as adult malnutrition most States/UTs also see an increase in overweight/obesity prevalence among children and adults.
- Thus, the data indicates towards the inadequacy of diets in India both in terms of quality and quantity.
ECONOMIC GROWTH Vs HEALTH
- Over the last three decades, there have been phases where India has experienced high rates of economic growth. But this period has also seen increasing inequality, greater informalisation of the labour force, and reducing employment elasticities of growth. This has resulted in the rising number of reported starvation deaths from different parts of the country.
- There are also continuous attempts to weaken the mechanism of protection schemes and public programmes such as the Mahatma Gandhi National Rural Employment Guarantee Scheme, the Public Distribution System, the Integrated Child Development Scheme (ICDS), and school meals through underfunding.
- For instance, according to the data presented by the Minister for Women and Child Development in 2019 showed that only about 32.5% of the funds released for Poshan Abhiyaan from 201718 onwards had been utilised.
- Field surveys such as the recent ‘Hunger Watch’ are showing massive levels of food insecurity and decline in food consumption, especially among the poor and vulnerable households as compared to before lockdown.
There are some improvements seen in determinants of malnutrition such as access to sanitation, clean cooking fuels and women’s status – a reduction in spousal violence and greater access of women to bank accounts.
CAUSES OF POOR OUTCOMES
- Poor nutritional outcomes show that the piecemeal approach is unable to address the problem adequately.
- Universal maternity entitlements and child care services to enable exclusive breastfeeding, appropriate infant and young child feeding as well as towards recognizing women’s unpaid work burdens have been on the agenda for long, but not much progress has been made on these.
- Slowdown in economic growth for the last few years have resulted in stagnant rural wages and highest levels of unemployment and the current pandemic has further worsened the situation.
- An employment centred growth strategy which includes universal provision of basic services for education, health, food and social security should be the imperative.
- Direct interventions such as supplementary nutrition (of good quality including eggs, fruits, etc.), growth monitoring, and behaviour change communication through the ICDS and school meals must be strengthened and given more resources.
- Need for serious introspection on not just for the programmes to address the problem of child malnutrition but also on the overall model of economic growth of the country for equitable growth.
- Need to leverage agricultural policies and programmes to be more “nutrition-sensitive”.
- Experience of the pandemic as well as the results of NFHS-5 indicates serious rethinking of issues related to nutrition and accord these issues priority.
Thus, India needs to take urgent action with commitment to fight against the problem of malnutrition.