India’s march towards nutrition
While a lot is talked about the growth and development of India, the mainstream focus has been on the country’s infrastructure - transport, connectivity, and public facilities - or its ease of doing business and rate of employment, and, to some extent, education, farmers’ issues and challenges in agriculture, and the like. A much-neglected topic is the health of the Indian population, and more so the health of women and children, both of whom determine the health of future generations. For decades, India is known to have high rates of malnutrition among women and children and a high maternal mortality ratio and infant mortality rate in comparison to global standards. This scenario is gradually changing though - as per the National Health Profile 2020, life expectancy in India has significantly increased from 49.7 years in 1970-75 to 69 years in 2013-17; there has been a significant decline in infant mortality between the years 2006 and 2018, from 57 to 32 per 1000 live births, and the maternal mortality ratio has dropped from 212 deaths per 100 000 live births in 2007–09 to 113 deaths in 2016–18 (SRS Bulletin, 2020). In order to align the country’s goals towards a healthier population, the National Nutrition Mission, popularly known as POSHAN Abhiyaan, was launched by the Government of India as a flagship scheme in 2018. It aims to improve nutritional outcomes for children, pregnant women, and lactating mothers. A lot of its interventions depend on community participation through mass movement, or “Jan Andolan.” Therefore, since 2018, September is celebrated as Poshan Maah or Nutrition Month in India. During this month, various programs have been organized by the Women and Child Development Ministry to spread broad awareness on the issues related to malnutrition like stunting, under-nutrition, anemia, and low birth weight in children, and how to overcome them.
The need for such an intervention
While the general conception of malnutrition is being underweight and/or short in stature, being overweight is also a form of malnutrition. India is suffering from the triple burden of malnutrition, that is, undernutrition, which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age); micronutrient-related malnutrition, which includes micronutrient deficiencies such as anemia; and overweight, obesity and diet-related non-communicable diseases (such as heart disease, stroke, diabetes, and some cancers).
The World Health Organization states that globally, 1.9 billion adults are overweight or obese, while 462 million are underweight. In 2020, 149 million children under 5 were estimated to be stunted (too short for age), 45 million were estimated to be wasted (too thin for height), and 38.9 million were overweight or obese. Around 45% of deaths among children under 5 years of age are linked to undernutrition. These mostly occur in low- and middle-income countries. At the same time, in these same countries, rates of childhood overweight and obesity are rising.
In India, the National Family Health Survey (NFHS), released periodically, provides information on population, health, and nutrition for India and each State/Union territory. As per NFHS-4 (2015-16), 35.8% of children under the age of 5 in India are underweight, 21% are wasted, 38.4% are stunted, and 58.6% are anemic; while 20.6% women in the age group 15-49 years are obese, 53.1% are anemic. In Maharashtra, as per NFHS-5 (2019-20), 36.1% of children under 5 are underweight, 25.6% are wasted, 35.2% are stunted, and an alarming 68.9% are anemic; 4.1% of children are overweight (5.2% of the urban population, and 3.4% of the rural population). In the case of women aged 15-49 years, 23.4% are obese, while 54.2% are anemic. The nutritional levels have shown little or no change since the previous NFHS round in 2015-16.
What can be done to combat malnutrition
Given that a majority of the population is affected by malnutrition, addressing it would require the involvement of not only the government and its development partners but also the masses, for which awareness must be generated on the prevalence of the issue. While the traditional approach in addressing social issues and generating awareness among the masses has been strategic use of Information, Education, and Communication (IEC), global evidence suggests that action through Social Behaviour Change Communication (SBCC) is proving to be more effective in generating quicker outcomes. Guided by the principles of behavioral science, innovative communication strategies are used to overcome social, cultural, and structural barriers so as to help people adopt healthy behaviors. While there is no standard approach, the context, local knowledge, and data help in determining the right mix of interventions.
A simple example would be understanding SBCC in the context of hygiene practices. Health and hygiene are interlinked - good hygiene practices result in a healthier life by reducing the chances of falling ill. SBCC involves using beliefs and practices of the community concerned in helping them adopt more hygienic practices in their daily lives - the approach used in one community (e.g., an urban area having water shortage) would need significant modification to work in another community (e.g., a rural area with ample water but no proper sanitation and drainage facilities).
Large-scale events such as Poshan Maah capitalize on Jan Andolan and the power of media and technology to reach out to the masses. The key to change is educating people about the issue, its causes, and ways to tackle it. Adolescence is the right time to put into practice healthy habits so that a healthier future is guaranteed.
ABOUT THE AUTHOR
Vaishnavi Iyer graduated with the Xavier's Economics batch of 2015. She currently works with NITI Aayog.
Comments
Post a Comment