12 February 2024 – The Hindu

India’s Battle Against Malnutrition

• India has a serious problem with the high rate of malnutrition. The complex interplay of social, economic, and cultural disparities in the nation is linked to this problem. Due to the complex nature of this widespread issue, immediate attention and resources must be allocated if nutritional indicators are to continue to deteriorate.

Malnutrition: What Is It?

• The World Health Organisation (WHO) defines malnutrition as an excess, deficiency, or imbalance in a person’s energy and nutritional consumption.
• It is a disorder brought on by a diet lacking in important nutrients that are necessary for a person’s optimum growth, development, and health.

Categories:

Insufficient nourishment:

• Wasting: Low weight in relation to height is a form of waste. It happens when someone has an infectious condition or has not eaten enough food.
• Stunting: Stunting is defined as low height for age. It frequently results from consuming too few calories, which causes a low weight for a given height.
• Underweight: Kids that weigh less than average for their age are considered underweight. Underweight children might be wasted, stunted, or both.

Malnutrition caused by micronutrients:

• Vitamin A Deficiency: Low vitamin A intake can cause blindness, compromised immune system, and other health problems.
• Iron deficiency: Leads to anaemia, which affects the body’s capacity to carry oxygen, resulting in exhaustion and weakness.
• Iodine deficiency: Causes thyroid-related conditions that impair cognitive and growth development.
• Obesity: A sedentary lifestyle combined with an excessive calorie intake can cause obesity. It is marked by the buildup of extra body fat, which raises the risk of conditions like diabetes and cardiovascular disease.
• Adult obesity is defined as having a Body Mass Index (BMI) of 30 or higher, while overweight is defined as having a BMI of 25 or higher.
• Noncommunicable diseases (NCDs) connected to diet: These include heart disease and strokes, as well as other cardiovascular conditions that are frequently linked to elevated blood pressure and are mostly caused by poor eating habits and malnutrition.

Worldwide Prevalence:

• In 2022, it was anticipated that 149 million children under the age of five were stunted (too short for their age), 45 million wasted (too thin for their height), and 37 million overweight or obese worldwide.
• Undernutrition is a factor in about half of the deaths of children under the age of five.
• 462 million adults are underweight, compared to 1.9 billion who are overweight or obese.

How Serious Is Malnutrition in India?

National Family Health Survey 5 states that:

• The frequency of malnourishment
• 5% of children under five have stunted growth.
• 3% are squandered.
• 1% of people are underweight.
• Three percent are obese.
• 7% of women between the ages of 15 and 49 are malnourished.
• The frequency of anaemia
• 0% of males aged 15 to 49
• 0% of females aged 15 to 49
• 1% of teenage guys (15–19 years old)
• 1% among teenage girls
• 2% of expectant mothers (15–49 years old)
• In children (6-59 months), 67.1%
• The Global Status of Food Security and Nutrition, 2023: Approximately 74% of Indians lacked access to a healthy food, and 39% did not get enough nutrients in their diet.
• India has a 2023 Global Hunger Index (GHI) score of 28.7, which is serious per the GHI Severity of Hunger Scale.
• With a score of 18.7, India had the highest percentage of child wasting in the survey.

What Are the Repercussions of Undernourishment in India?

Consequences for Health:

• stunted Growth: stunted growth can have an adverse effect on a child’s physical and cognitive development, particularly if it occurs during childhood.
• Weakened Immune System: People who are underweight have a weakened immune system, which makes them more vulnerable to infections and increases their risk of illness and death.
• Micronutrient Deficiencies: Iron, zinc, and vitamin A deficiencies can be brought on by a regular diet deficient in certain micronutrients, which can compromise immunity.

Educational Repercussions:

• Cognitive Impairment: Early-life malnutrition can have a negative impact on cognitive function, which can impede learning and academic achievement.
• School Dropout Rates: Children who are malnourished may find it difficult to attend class on a regular basis and are more likely to discontinue their education altogether.

Economic Repercussions:

• Productivity Loss: A country’s entire economic production can be negatively impacted by malnutrition because it can lower work productivity in both youth and adulthood.
• Rising Healthcare Costs: The incidence of malnutrition puts more strain on the healthcare system, raising the price of healthcare for both the public and private sectors.

Impact Across Generations:

• Maternal and Child Health: The cycle of nutritional deficits is perpetuated when anaemic moms give birth to anaemic offspring.
• Long-term Health Effects: Children who are malnourished are more likely to experience health issues as adults, which has an additional negative influence on the general health and wellbeing of the populace.

Social Repercussions:

• Enhanced Vulnerability: Malnutrition exacerbates social inequality by affecting marginalised and economically disadvantaged communities more frequently.
• Stigma and Discrimination: People who are malnourished may be subjected to stigma and discrimination from society, which can have an adverse effect on their mental health and general wellbeing.

The country’s development:

• Diminished Human Capital: The development of human capital is impeded by malnutrition, which restricts the possibility of social and economic advancement.
• Increased Healthcare Burden: The prevalence of malnutrition adds to the strain on healthcare systems, taking funds and time away from other vital health projects.

What are the Main Obstacles in India’s Malnutrition Management System?

• Economic Inequality: Poor people frequently lack access to or cannot purchase nutrient-dense food due to their low socioeconomic standing. They also experience food insecurity as a result of price volatility, natural catastrophes, or conflicts.
• In India, 74% of people cannot afford a nutritious food.
• Insufficient Dietary Intake and Dietary Shifts: Processed and sugar-filled foods have replaced a variety of balanced and diversified dietary options in dietary patterns. Malnutrition in India is also largely caused by the consumption of poor-quality food and a lack of variety in the diet.
• The Indian cuisine is often low in critical nutrients such as Iron, Vitamin A, and Zinc.
• Inadequate Hygiene: Inadequate hygiene and sanitation can expose people more to viruses and parasites that can lead to infections and illnesses. Malnutrition may result from these as they may interfere with the body’s ability to absorb and use nutrients.
• Just 69% of households use an improved sanitation facility, according to the NFHS-5.
• Absence of Primary Health Infrastructure: Many Indians live in poverty and lack access to basic health care, including immunisations, prenatal care, and infection treatment. This raises the possibility of illnesses and other issues that could exacerbate malnutrition.
• The WHO suggests that there should be one doctor for every 1000 people and three nurses for every 1000 persons. In India, for every 1000 individuals, there are 1.74 nurses and 0.73 doctors.
• Delays in programme implementation and uneven service delivery are two factors that lead to gaps in nutritional treatments.
• Just 50.3% of children under the age of six received any service from an Anganwadi, according to the NFHS-5.
• Insufficient Monitoring and Evaluation: Inadequate methods for monitoring and evaluating programmes make it more difficult to determine their efficacy.
• Without precise data on program outcomes, it becomes impossible to detect gaps and execute essential modifications.

What Actions Has the Indian Government Taken to Combat Malnutrition?

Mission Poshan 2.0:

• The scheme for Integrated Child Development Services (ICDS)
• PMMVY, or Pradhan Mantri Matru Vandana Yojana
• Mid-Day Meal Plan

Adolescent Girls’ Scheme (SAG):

• The whole affection of a mother (MAA)
• Poshan Vatikas

How Can Malnutrition Be Effectively Combated in India?

• Adoption of Fortification: Adding necessary nutrients to staple foods during processing is a reasonably inexpensive technology that may be implemented on a broad scale without breaking the bank.
• The National Iodine Deficiency Disorders Control Programme’s adoption of iodized salt in 1992 dramatically lowered the incidence of goitre.
• Create a Targeted SBCC Action Plan: To combat malnutrition, the government should work together to create a targeted, well-organized Social and Behaviour Change Communication (SBCC) action plan.
• The main messages, target audience, objectives, and tactics for successful communication should all be outlined in this strategy.
• Improve Healthcare Infrastructure: More emphasis should be placed on enhancing the ability of healthcare professionals to identify and treat malnutrition. The government will take action to fortify healthcare facilities, particularly in rural areas, and to enable early detection and management of malnutrition.
• An additional 3.5 million hospital beds are required in India to meet the country’s population’s healthcare needs.
• By 2025, the National Health Policy suggested raising government health spending from the current 1.2% to 2.5% of GDP.
• Monitoring and Assessment: To track the effects of nutrition interventions, put in place reliable monitoring and assessment methods.
• For example, each Anganwadi’s Poshan Tracker collects real-time data on malnourished and “severe acute malnourished” children.
• Consumption of Nutritious Foods Found Locally: The government ought to encourage people to eat traditional foods found locally that are high in vital nutrients. Dietary diversity is improved by promoting the consumption of a range of locally available foods.
• Empowerment of the Community: Include the local community in the planning and execution of nutrition initiatives. Creating neighborhood-based projects will encourage self-sufficiency in the production of wholesome food.
• Communication Strategies: To establish trust with the beneficiaries, make use of channels of communication such as community radio, films, and door-to-door contact.
• Create messages that speak to local situations and are understood by using vernacular languages.
• India needs to put its people’s health and wellbeing first and make investments in this area if it is to meet the UN Sustainable Development Goal 2 of Zero Hunger by 2030 and eradicate malnutrition. The country can considerably reduce malnutrition, unleash the potential of its people, and promote a healthier, more prosperous future by implementing a comprehensive and cooperative strategy.