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)