Relevance: GS-2: Issues relating to poverty and hunger; Issues related to vulnerable sections (children).

Key Phrases: Under-nutrition, Stunting, Wasting, Underweight, Global Hunger Index, Decentralization of funds, functions, and functionaries, National Rural Health Mission, National Education Policy 2020, Women empowerment.

Why in News?

• The recently released NFHS-5 brings out the unfinished agenda and the slow rate of decline in under-nutrition.
• It reports that 35.5 percent of children under five are stunted, 19.3 percent wasted, and 32.1 percent underweight.
• These are unacceptable levels and compromise India’s coming generation’s learning and health.

Why proper nutrition is important?

• Science is certain that the persistence of under-nutrition creates irreversible changes in the learning abilities of many infants, besides susceptibility to disease as they grow.
• The first thousand days are the key to reversing changes and ensuring proper nutritional development of every infant and mother.

What needs to be done?

• Balanced and diverse meal:
  • While food grains contribute to food security, it does not alone address the challenge of chronic hunger and under-nutrition.
  • Infants in their growing age and pregnant women need a range of vitamins, minerals, and proteins that are not there in food grains alone.
  • They need a balanced and diverse meal where fruits and green vegetables, milk, eggs, pulses, oil, and paneer are all an integral part of the food.
  • Diversity of food in adequate quantity and of appropriate quality is the way forward.
• Well-defined responsibilities of stakeholders:
  • If India wants to improve its position on the Global Hunger Index, it will have to address under-nutrition as a societal mission where women SHGs, panchayat leaders, frontline workers, and households have well-defined responsibilities.
  • It is time every infant and pregnant mother is monitored by a frontline worker or a community volunteer, and local governments have the responsibility and resources to seek redress of deficits.
• Flexibility:
  • Flexibility and mid-course changes at the cutting edge to respond to felt need is a must in any system of public management.
  • The same size fits all is a recipe for disaster and flexibility calls for enormous public accountability.
• Community-led planning:
  • There is a need to develop institutions of accountability through community monitoring and action, social audit, and community-led planning and implementation.
  • The National Rural Health Mission pushed the community activity of Village Health, Sanitation, Nutrition, and Health Days (VHSND). This thrust translated into an improvement in nutrition indicators.
  • Communities need attractive and periodic activities with a role in the monitoring of their children’s progress.
  • If more people in a village including panchayat leaders and women SHG (self-help group) and cooperative institution representatives can weigh and measure infants, timely interventions to tackle under-nutrition are possible.
• Decentralization of funds, functions, and functionaries:
  • Decentralization through PRIs (Panchayati Raj Institutions) and urban local bodies with funds, functions, and functionaries become imperative to be able to make need-based choices and meet resource needs.
  • The Gram Panchayat Development planning process has to give primacy to nutrition as most of the 29 transferred sectors with Panchayats have a direct role in improving nutrition.
• Day Care Centres:
  • Some very poor villages or hamlets may well need Day Care Centres and other support and the program has to be flexible enough to provide for need-based interventions at the local level.
• Timely medical support:
  • The timely availability of basic medicines often reduces the incidence of wasting caused by seasonal illnesses drastically.
  • Measurement holds the key as it will facilitate a focus on those who need immediate attention. There may even be a need for care and support at a facility if infants have already fallen into severe under-nutrition.
• Women empowerment:
  • Undernutrition also calls for an appreciation of the need for mature age at marriage and first delivery.
  • Social movements for women’s rights and care during adolescence and pregnancy need a strong thrust. With more women in Panchayats and a large presence of women SHGs under the Livelihood Mission in rural areas, it is an opportunity to make a difference in gender relations.
• Behaviour change:
  • The nutrition challenge is also a women’s empowerment challenge. It is an important behaviour change challenge in favour of exclusive breastfeeding, natural foods instead of junk food, clean water, sanitation, and food diversity.
• Partnership with schools:
  • The National Education Policy 2020 has emphasized the continuum of learning and views pre-school learning as integral to primary learning.
  • It is hoped that the partnership with schools will improve access to food for children in the 3-6 age group. The duplication will lead to savings that should be used more effectively for 6–36-month infants.
• Focus on wider determinants of undernutrition:
  • There is a strong case for wider determinants of health priority, considering the impact of clean water on water-borne diseases, sanitation on vector-borne diseases, and improved housing and safe cooking on the physical and environmental health of the poor households.
  • With a thrust on these sectors as part of the pro-poor public welfare and improving ease of living, it is a good time to make quantum gains in nutrition.

Conclusion:

• The challenge of tackling under-nutrition is no rocket science. It can be tackled effectively over a short period if the thrust is correct.
• Technology can at best be a means and monitoring tool has to become local and community-led. Panchayats and community organizations are the best way forward.
• Support for immunization and health services and periodic health assessments by trained local community frontline workers will be helpful.
• Guidance to parents is needed and the greater the interaction of the frontline worker with households, the greater the likelihood of timely interventions.
• Let us address the curse of under-nutrition with the complete involvement of State, local governments, civil society, community organizations, industry, business, and all of society and government.

Source: The Hindu BL

Mains Question:

Q. Discuss the challenge of achieving good nutrition and suggest some suitable measures to improve undernutrition in India.