Good nutrition is essential for
overall well-being and is crucial for a nation’s health and development. Ensuring
adequate nutrition, especially during pregnancy, leads to the birth of
healthier babies, who are more likely to enjoy positive health outcomes
throughout their lives. Proper nutrition in childhood is associated with higher
IQ scores, increased productivity, and higher earnings in adulthood. Prioritizing
nutrition during the first 1,000 days from conception is vital for breaking the
cycle of malnutrition across generations. According to a report from the
Copenhagen Consensus last year, investing in nutrition is the most effective strategy for achieving
Sustainable Development Goals.
7th Rashtriya Poshan Maah
was observed from 1st September to 30th September, 2024. In
this context, it is important to acknowledge that malnutrition has long-lasting effects that go
beyond physical health, significantly influencing socio-economic conditions as
well. Over the years, collaborative efforts by various Ministries such as the
introduction of PM-POSHAN Scheme, Integrated Child Development Services (ICDS),
Targeted Public Distribution System, National Food Security Act (NFSA) reflect
this understanding.
Atmanirbhar in Nutrition: Saksham Anganwadis
and Poshan Vatikas
Programmes like Saksham Anganwadi
and Poshan 2.0, led by the Ministry of Women and Child Development (MoWCD),
represent a unique model of
institutional support aimed at improving nutrition outcomes and addressing the
challenges of malnutrition among children, adolescent girls, pregnant women and
nursing mothers. Under Saksham Anganwadi initiative, Anganwadi centres (AWCs) offer
comprehensive services that go beyond basic nutrition support. These services include,
guidance on healthy eating, prenatal and postnatal care, breastfeeding
practices and importance of complementary feeding. Through its regular health
screening exercises, it assesses children for malnutrition and other health issues
and provides appropriate interventions.
The AWCs are designed to offer a
continuum of care, by supporting maternal and child nutrition efforts while
fostering early childhood development. A significant advancement in ensuring
data-driven solutions in policymaking to combat malnutrition is the
introduction of the Poshan Tracker. This dynamic platform aids in the planning, execution, and monitoring of
nutrition services, helping Anganwadi workers identify malnourished children and
ensuring last mile delivery of services.
Another initiative under the scheme
is the introduction of Poshan Vatikas (nutrition gardens). These kitchen
gardens, usually set up at Anganwadi Centres, aim to enhance the nutritional
intake of children and women by providing fresh, locally grown vegetables and
fruits. This initiative not only improves the quality of food available to the
most vulnerable but also empowers communities by promoting self-reliance and
sustainable practices. It allows meal plans to be tailored to local
agro-climatic conditions, supporting dietary diversity and sustainable food
habits.
In response to the vulnerability of
food systems amid climate change, India has promoted millets, which are
climate-resilient and highly nutritious. Recognized as the International Year of Millets by the United
Nations General Assembly in 2023, these crops are rich in protein, essential
fatty acids, dietary fiber, B-vitamins, and key minerals, helping to address deficiencies
like anaemia, especially in women and children. Millets are a key component of
the Poshan Abhiyaan and are included in the supplementary nutrition provided through
Anganwadi centers to adolescent girls, pregnant and lactating women, and young
children.
Reaching the Vulnerable: Community
Management of Acute Malnutrition
Nutrition is a multisectoral issue
that demands a multi-sectoral solution. The recently launched protocol for
management of malnourished children, issued jointly by Ministry of Women and Child
Development and the Ministry of Health, is a commendable step toward identifying
and managing malnutrition among children, especially children with Severe Acute
Malnutrition. By outlining essential strategies like community mobilization and
regular screening and monitoring, these guidelines not only reflect a holistic
approach, but is also offer a cost-effective intervention to streamline the
management of malnutrition at the grassroots level.
The programme is supported with
additional screening on Village Health, Sanitation, and Nutrition Day (VHSND)
when children with Severe Acute Malnutrition (SAM) are assessed for medical
complications. Those found to have complications or poor appetite are referred
to Nutritional Rehabilitation Centres (NRCs) or Malnutrition Treatment Centres
(MTCs), while children without medical complications are managed at the AWCs.
In many states, meetings among frontline workers – AWWs, ASHAs and ANMs are
held during VHSNDs to reinforce the importance of managing uncomplicated cases
of SAM in community settings.
Opportunities for improvement
We have come a long way in our
fight against malnutrition, yet challenges persist. Existing programs have laid
a solid foundation, improving moderate and severe acute malnutrition rates in
children and enhancing nutritional outcomes for pregnant women. However,
continued efforts are essential, especially for non-pregnant and non-lactating
women, particularly adolescent girls suffering from micronutrient deficiencies
such as anaemia. Dedicated interventions and platforms are needed for this
group.
Nutrition counselling is integral
to many initiatives. Educating and training community leaders and the community,
tailoring messages to fit local cultural contexts, and involving communities in
program development are crucial for improving nutrition habits. Strategies must
also address food availability, economic conditions, and social factors to ensure
that nutrition services are accessible and practical.
Collaboration among all stakeholders, including government agencies,
healthcare providers, community organizations, and policymakers is essential. A
collaborative and inclusive approach will be instrumental in achieving more
impactful and a long lasting change.
India has often led the way in
overcoming health challenges. By
building on current program success, substantial progress can be made in breaking
the cycle of malnutrition and advancing towards a healthier and more developed
nation.
Dr Rajan Sankar: Dr. Rajan Sankar
is a physician and a retired Senior Advisor in Medicine and Endocrinology from
the Army Medical Corps. He previously served as the Director of Nutrition at
Tata Trusts. Before his role at Tata Trusts, Dr. Sankar was the Regional
Representative for South Asia at the Global Alliance for Improved Nutrition
(GAIN), where he contributed to program development and grant management in
India. Additionally, he worked as a project officer in the Child Development
and Nutrition section of UNICEF in India. Dr. Sankar has published over 100
scientific papers in national and international journals.
(Dr. Rajan Sankar is a physician
and a retired Senior Advisor in Medicine and Endocrinology from the Army
Medical Corps. He previously served as the Director of Nutrition at Tata
Trusts. Before his role at Tata Trusts, Dr. Sankar was the Regional Representative
for South Asia at the Global Alliance for Improved Nutrition (GAIN), where he
contributed to program development and grant management in India. Additionally,
he worked as a project officer in the Child Development and Nutrition section
of UNICEF in India. Dr. Sankar has published over 100 scientific papers in
national and international journals. A PIB Feature)
