Syllabus: General Studies Paper 2 (Indian Society)
The double burden of obesity and undernutrition needs to be tackled as part of India’s national nutrition strategy. Discuss
According to WHO, Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition covers 2 broad groups of conditions. One is ‘undernutrition’—which includes stunting (low height for age), wasting (low weight for height), underweight (low weight for age) and micronutrient deficiencies or insufficiencies (a lack of important vitamins and minerals). The other is overweight, obesity and diet-related non-communicable diseases (such as heart disease, stroke, diabetes and cancer). The scale of malnutrition in India constitutes a public health crisis, which not only violates a fundamental right of humanity, but also undermines significant advances made in economic, social, and cultural indicators.
In India, under nutrition levels have remained persistently high especially in disadvantaged groups as reflected in UNICEF’s report one in three malnourished child in world belongs to India, half of the children under three years old are underweight and a third of wealthiest children are over-nutrient-ed. The 2018 Global Hunger Index (GHI) report ranked India 103rd out of 119 countries as per NFHS reports every third woman in India was undernourished and every second woman was anaemic also overweight/obesity has affected almost one-fifth of urban population
Reasons for malnutrition and obesity in India
- One of the major causes for malnutrition in India is economic inequality
- Poor people lack diet both in terms of quality and quantity. Low pay traps them in a vicious circle of under-nutrition.
- Societal norms of early marriages, early and multiple pregnancies that result in undernutrition and mortality of both women and children.
- Lack of education and awareness regarding role of sanitation, ideal nutrition, deficiencies, prevention of diseases etc.
- Though anaemia among children has declined, it affects every second child in the country. There has been no perceptible decline in anaemia among 15 to 49-year old women; it affects around 60 per cent of them.
- Many, in fact, argue that the NFSA’s focus on wheat and rice has forced millets — traditional source for iron and minerals — out of the market.
- The government’s iron supplementation programme to overcome IDA has led to only 30 per cent of pregnant women consuming iron and folic acid tablets.
- According to world bank report India loses 6% of GDP due to health caused by unhygienic sanitation
- Climate change is dragging people in poverty and thereby vicious cycle of poverty, malnutrition further deepens.
- On the other hand people are getting obese due to unhealthy lifestyle: unconventional food, sleep, physical activities
- The daily consumption of iron rich dark green leafy vegetables has reduced from 64 per cent to 48 per cent of the population in the last decade.
- Government expenditure in health is very low – 1.15% of GDP, which is very low when compared to similar placed economies like China , Brazil.
Impact of Malnutrition and Obesity
- Lower immunity and predisposition to higher mortality
- Malnutrition is a contributing factor in about one-third of all deaths of children under the age of 5.
- Undernourished children are at high risk of permanently stunted growth and development affecting their cognitive abilities.
- Children who are malnourished from an early age are severely disadvantaged in their ability to learn.
- Maternal undernutrition increases the risk of morbidity and death and of having undernourished babies thus increasing MMR and IMR.
- Overweight adults and children are at greater risk for non-communicable diseases such as diabetes and cardiovascular heart disease.
- It also brings inefficiency to the society, especially in India where labour is a major input factor for economic production.
National Nutrition Strategy and its Significance
Various government initiatives have been launched over the years which seek to improve the nutrition status in the country. These include the Integrated Child Development Services (ICDS), the National Health Mission, the Janani Suraksha Yojana, the Matritva Sahyog Yojana, the Mid-Day Meal Scheme, and the National Food Security Mission, among others. However, concerns regarding malnutrition have persisted despite improvements over the years. It is in this context that the National Nutrition Strategy has been released.
- The Strategy aims to reduce all forms of malnutrition by 2030, with a focus on the most vulnerable and critical age groups. The Strategy also aims to assist in achieving the targets identified as part of the Sustainable Development Goals related to nutrition and health.
- The Strategy aims to launch a National Nutrition Mission, similar to the National Health Mission. This is to enable integration of nutrition-related interventions cutting across sectors like women and child development, health, food and public distribution, sanitation, drinking water, and rural development.
- A decentralised approach will be promoted with greater flexibility and decision making at the state, district and local levels. Further, the Strategy aims to strengthen the ownership of Panchayati Raj institutions and urban local bodies over nutrition initiatives. This is to enable decentralised planning and local innovation along with accountability for nutrition outcomes.
- The Strategy proposes to launch interventions with a focus on improving healthcare and nutrition among children. These interventions will include: (i) promotion of breastfeeding for the first six months after birth, (ii) universal access to infant and young child care (including ICDS and crèches), (iii) enhanced care, referrals and management of severely undernourished and sick children, (iv) bi-annual vitamin A supplements for children in the age group of 9 months to 5 years, and (v) micro-nutrient supplements and bi-annual de-worming for children.
- Measures to improve maternal care and nutrition include: (i) supplementary nutritional support during pregnancy and lactation, (ii) health and nutrition counselling, (iii) adequate consumption of iodised salt and screening of severe anaemia, and (iv) institutional childbirth, lactation management and improved post-natal care.
- Governance reforms envisaged in the Strategy include: (i) convergence of state and district implementation plans for ICDS, NHM and Swachh Bharat, (ii) focus on the most vulnerable communities in districts with the highest levels of child malnutrition, and (iii) service delivery models based on evidence of impact.
- Farmers should be encouraged and incentivised for agricultural diversification.
- Innovative and low-cost farming technologies, increase in the irrigation coverage and enhancing knowledge of farmers in areas such as appropriate use of land and water should be encouraged to improve the sustainability of food productivity.
- The government should improve policy support for improving agricultural produce of traditional crops in the country.
- The targeting efficiency of all food safety nets should be improved, especially that of the Targeted Public Distribution System (TPDS), to ensure that the poorest are included.
- In addition, fortification of government-approved commodities within the social safety net programmes can improve nutritional outcomes.
- Child feeding practices should be improved in the country, especially at the critical ages when solid foods are introduced to the diet.
- Fortification, diversification and supplementation may be used as simultaneous strategies to address micro and macronutrient deficiencies.
- Storage capacity should be improved to prevent post-harvest losses.
- There is a need for more robust measures that can take cognizance of all aspects of SDG 2.
- All the major welfare programmes need to be gender sensitive.
- The inherited dehumanising poverty explains the persistence of malnutrition on a large scale.
- Children born in impecunious circumstances suffer the most from malnutrition. It is all the more reason for governments to intervene to provide adequate nutrition to all.
- Funds for food to all yield great returns and help in unlocking the full potential of citizens besides strengthening the workforce.
National nutrition strategy seeks to achieve the targets identified as part of the Sustainable Development Goals related to nutrition (SDG 2)and health (SDG 3). Nutrition is acknowledged as one of the most effective entry points for human development, poverty reduction and economic development, with high economic returns. Thus India’s national nutrition strategy is significant initiative in highlighting a pressing development problem.
Join our program now and study smartly towards your dream
Our App link:
Google Play Store: https://play.google.com/store/apps/details?id=com.iasjunior