The ‘POSHAN Abhiyaan’ seems to have made some headway with an ambitious target of achieving a malnutrition-free India by 2022
It is disconcerting that every second child in India suffers some form of nutritional failure in India. Over the years, Government data have borne witness to how many people, especially women and children, do not get three square meals in a day. Worryingly, the potential disruptions caused by the lockdown may make the varied forms of malnutrition a lasting reality. However, the launch of the Government’s flagship programme ‘POSHAN Abhiyaan’, seems to have made some headway, with an ambitious target of achieving a malnutrition-free India by 2022.
It also aims to reduce stunting in children aged between zero and five years from 38.4 per cent to 25 per cent during the same period, along with reducing the level of anaemia and low birth weight in children.
With inter-sectoral convergence being the key strategy, the programme makes a shift from the existing approach of making planning and implementation the responsibility of one Ministry. Instead, it rightly notes the various critical components of success and makes ‘POSHAN Abhiyaan’ a multi-ministerial initiative. While the Ministry of Women and Child Development acts as the nodal office, the Ministry of Drinking Water and Sanitation is responsible for the Swachh Bharat Mission (SBM) that ensures cleanliness and hygiene and the Ministry of Education is responsible for the Mid-Day Meal Scheme (MDMS).
Two other Ministries, that of Health and Family Welfare and the one responsible for Rural Development, are looking after health programmes such as Mission Indradhanush for immunisation coverage and rural income schemes, such as MNREGA, respectively. The LPG distribution scheme by the Ministry of Petroleum and Natural Gas enabled safe and hygienic cooking in underprivileged households.
But will India accept malnutrition as everyone’s problem? The copious fund allocation for the ‘POSHAN Abhiyaan’ and its increase in the past three years have shown the Government’s sincerity in taking the mission to its intended conclusion. From Rs 950 crore in 2017-18, the current allocation for the ‘POSHAN Abhiyaan’ reached a sum of Rs 3,400 crore for the financial year 2019-20. However, the potential challenge can be bringing social and behavioural change towards malnutrition at the community level. Ensuring equitable nutrition to build a healthier nation will require the following.
Eating local and seasonal food: This comprises a part of the trend known as “sustainable eating” and has been proven to be an economical solution to the food crisis globally. This saves time and the cost of transportation while promoting the use of fewer preservatives. Such food items are also suitable to fulfil the nutritional needs of the people in a way that is commensurate with the local environment.
The concept of introducing kitchen gardens in schools to fulfil some part of the requirements under the MDMS is an innovative step. In the coming days, introducing more steps, such as promotion of local, nutritious millet and crop diversification to promote traditional millet will be the right steps to complement this ongoing effort. Recent studies have observed that investing $1 in nutrition-related interventions will have economic gains of about $19 to $22.
Addressing intrinsic social and cultural biases: In his paper ‘POSHAN Abhiyaan: Making Nutrition a Jan Andolan’, NITI Aayog member Vinod K Paul and co-authors observe that despite the Prohibition of Child Marriage Act, 2006 mandating the legal age of marriage at 18 for girls, 30 per cent of them are married before that age and eight per cent are already pregnant by the time they are 15-19 years of age. Facing intra-household deprivations due to their sex and abject poverty, these young girls often forego necessary nutrition, care, and rest even during their pregnancy, thus delivering low birth weight babies. For these babies, the cycle of malnutrition has already begun, they note.
This long-standing social bias deepens with socio-economic nuances. For example, in tribal households, the overall amount of food is anyway low and the men, by tradition, get the larger share of it, considering the physical labour they must undertake. A male child may get less to eat than his father, but is likely to get more than his mother, grandmother or sister. There is a need to free nutrition from the perceived requirement of the receiver. Disseminating a scientifically-validated diet chart according to age and sex to the Panchayat level can help in spreading awareness and help households modify their practices.
Clear and visible measures for better accountability: Owing to the possible institutional leakages, Government initiatives should be monitored by some metric for accountability. For this, an enhanced information and process system is crucial. Monitoring, surveillance, and evaluation remain critical to all Government initiatives not only to firm up the people’s trust but for better outcomes as well. Understanding ground-level realities will not only enrich policymakers’ understanding, it may help in building a positive perspective among beneficiaries about public interventions. Public consultations, surveys among beneficiaries and social audits are some of the most effective ways to do this.
Building a case against hidden hunger: Few realise that malnutrition is not exclusively a rural phenomenon. Many people, especially children, in the cities, too, suffer from malnutrition, albeit of a different kind. Since a good part of their diet is filled with refined and finished items, not to mention the large amounts of salt, sugar and trans-fat they consume, the children lack micronutrients such as iron and zinc. Traditional crops and millet, marked as nutri-cereals that should have been part of our diet, are fast becoming a favourite of the educated and wealthier part of the society. However, as companies producing fast-moving consumer goods look to the rural market to revive from the economic effect of the pandemic, it is important to ensure that rural consumers do not acquire the habits of cities. The onus is on the Government to ensure that the learnings from the cities reach the villages before it is too late.
(The writer is Associate Professor, Health Economist, IIHMR University, Jaipur)