The central principle that should guide the Centre in improving maternal and child nutrition is that early childhood is the foundation for the health and well-being of an individual. Tinkering with the existing national programme of providing hot-cooked meals to children three to six years old, and take-home rations for younger children and pregnant and lactating mothers is fraught with danger.
Why factory-made nutrients should not be promoted?
Attempts to substitute meals or rations with factory-made nutrients will inject commercialization into a key mission and upset the nutritional basis of the scheme. Good sense has prevailed, and the newly-formed inter-ministerial National Council on India’s Nutrition Challenges has chosen to continue the current practice, overruling the Minister for Women and Child Development, Maneka Gandhi, who proposed distribution of packaged nutrients to beneficiaries.
Raising nutritional standards for young children has become a policy imperative only in recent years, with the National Food Security Act, 2013, incorporating the mandate in Schedule II, and the Supplementary Nutrition (Integrated Child Development Services Scheme) Rules, 2017, laying down entitlements.
What are the reforms required?
Food and Public Distribution Minister Ram Vilas Paswan’s emphasis on strengthening these legal guarantees by providing more nutritious hot-cooked meals and rations with the help of local self-help groups is to be welcomed. If the ICDS scheme, now called the Anganwadi Services Scheme, is to achieve better outcomes, it must focus on the provision of physical infrastructure and funding, besides closer monitoring of the nutrition mission. Theoretically, the mission covers every child, but in practice it is not accessible to all.
What is the present position?
When the Centre recently launched POSHAN Abhiyaan, an integrator that will build capacity among nutrition workers, it acknowledged that while official data show a reduction in some of the depressing aspects of women and child health, the ground reality is far from comforting: the National Family Health Survey-4 shows a drop in underweight and stunted children under five years of age compared to the previous survey, but the absolute numbers are still high. An estimated 35.7% children are underweight and 38.4% are stunted in that age group. The body mass index of 22.9% women aged 15-49 indicates chronic energy deficiency. These figures should cause alarm that even after a long period of robust economic growth, India has not achieved a transformation.
What should be done?
To accelerate the pace of progress, POSHAN Abhiyaan should rigorously measure levels of access and quality of nutrition and publish the data periodically. It should be pointed out that NFHS data show several States performing worse than the national average. In a recent report, Nourishing India, the NITI Aayog refers to acute malnutrition levels of about 25% in some States. There is no quick fix, and the answer to better nutrition lies in fresh, wholesome and varied intake.
(Adapted from The Hindu)