Notwithstanding the sizeable economic and social gains made by India over the last two decades, the pernicious, often invisible, challenge of maternal and child under nutrition remains a national public health concern. This undermines the assumption that economic growth is in itself a sufficient condition for improvement in public health.
Under Nutrition | Extent of the problem
India is home to over 40 million stunted and 17 million wasted children (under-five years. Despite a marked trend of improvement in a variety of anthropometric measures of nutrition (for example, rates of stunting, wasting in children under-five) over the last 10 years, child undernutrition rates in India persist as among the highest in the world. This inequality in access is accentuated by the stark state-level disparity in nutritional status.
Under Nutrition | Issues
Malnutrition is also responsible for lowering individuals’ immunity to infections and diseases; for instance, low body weight is responsible for 50 per cent of tuberculosis (TB) in India, and also leads to higher death rate. Future growth will require significant investments into human resources of which health investments are critical.
Under Nutrition | Way Forward
In response, policy-makers must account for two key facts:
- Direct nutrition interventions (adequately scaled up), while essential, can reduce stunting only by 20 per cent; indirect interventions (for example, access to WASH) must tackle the remaining 80 per cent, and
- 50 per cent of the growth failure accrued by two years of age occurs in the womb owing to poor nutrition of the mother. A lack of nutrition in the first 1,000 days of a child’s life causes irreversible, long-term damage to a child’s cognitive functions, undermining later-stage investments aimed at realising the developmental potential of India’s children (such as the Government of India’s flagship programme, Skill India).
Hence, there exist significant policy returns from investing in this critical window of opportunity, that is, from the period of conception of the child to the two-year post-natal period.
Under Nutrition | Key Recommendations
- Establish a nodal body for multi-programme coordination on nutrition.
- Strengthen and restructure the Integrated Child Development Services (ICDS) programme, and leverage the Public Distribution System (PDS).
- Extend coverage of food fortification of staples.
- Target multiple contributing factors, for example, water, sanitation, and hygiene (WASH).
- Align agricultural policy with national nutritional objectives.
- Boost private sector engagement in nutrition-interventions through PPP.
Direct and indirect policy implementation requires grass root intervention instead of a top-down approach. The generic as well as local factors should be accommodated during policy formulation. Isolationist approach has bred a plethora of schemes which often end up being ineffective at the ground. Output à Feedback à Input à Output model should be strictly and consistently followed for better policy formulation and better results.