Monday 27 November 2017

National Strategy for Malnutrition Free India



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In news: NITI Ayog came with a national strategy to fight maternal and child malnutrition and anaemia among women and girls. The basis is that every third child of the country is undernourished which leads to several diseases, child death and maternal mortality.
Kuposhan mukt bharat (Malnutrition Free India) is the slogan given by PM and with this aim, the focus on 100 poor performing districts in terms of stunting is placed. The focus will be on decentralised planning and local innovation.
Recognising that India pays an income penalty of 9-10% due to a workforce stunted during childhood, the National Nutrition Strategy aims to bring nutrition to the centre-stage and remove all forms of malnutrition by 2030.
The strategy paper by NITI Ayog has to be a targeted approach which is monitorable and aims at
  • Reduction in the percentage of underweight below 5 from 35.7 at present to 20.7 by 2022.
  • Reduction in prevalence of anemia amongst children in age 6-59 months from current 58.4% to 19.5% by 2022.
  • Reduction in anemia among women in age group pf 15-49 years from 53.1% to 17.7%
Though these standards still lag behind from world standard, solid planning for achievement of all the goals has to be done. Several programmes under ICDS for food supplementation and anganwadis for children. Yet, we have not been able to overcome malnutrition.
  • Malnutrition child death can be prevented as soon as possible. When the women is pregnant, before the pregnancy, there can be a follow-up about common causes of death in women, how to conceive and what nutrition to take at time of pregnancy. There can be folic acid and iron supplementation for better nutrient intake. This can help to deliver a healthy baby.
  • Protein deficiency is a rare deficiency all over world and India is a protein deficiency country. The below poverty countries like Uganda, Columbia have combated malnutrition but India is still facing it.
  • Besides a medical doctor in PHC and CHC, there should be a social and preventive medicine doctor who can be good counsellor and help the pregnant women to fight malnutrition.
  • Aangawadi has good programmes but due to lack of coordination between them and PHCs, children tend to miss the necessary nutrient updates. If baby is healthy, the immunity will be strong. Comfortable to fight with the disease.
4 pillar strategy
  1. Improving health services
  2. Food
  3. Drinking water and sanitation
  4. Income and livelihood
Focus areas
Sanitation is a very important pillar of health sector. Vector borne disease can be prevented due to proper sanitation with regards to how to use food (boiled, cooked, not stale), how to store food (cover with lid), how to wash hands is very basic preventive techniques.
Most of air borne disease and vector borne disease can be prevented through proper hand wash practice.
Currently 50% of pregnant women and 60% of children in the country are estimated to be anaemic. The focus has been more on teenage girls and women who are anemic. If women is healthy, her child will also be healthy.
How to reach last man with polices like food security, swachh bharat, drinking water facility has to be still implemented with high success rate. There are people still left out from availing benefits from such policies. Proper laws can be made concerning nutrition, PPP mode can be entered to tackle the malnutrition challenges and support from civil society can help fight the grave issue. If the message is spread, it has to be taught too. It is not about just announcing programme but to teach the meaning of programme.
Communication is more important than information as it interacts with beneficiaries. And service is more important than communication as it shows the commitment to provide benefits that are communicated.
Infrastructure needs to be upgraded in terms of space, proximity to beneficiary and ease of access. Medical human resource should also be trained to focus on serving the nation where it is required the most. This points towards giving good health services to all people.

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