Topic: Fixing POSHAN Abhiyaan’s basics
Topic in Syllabus: GS Paper 1 : Indian Society
- The National Nutrition Mission, launched by Prime Minister Narendra Modi on 8 March—now christened POSHAN (Modi’s overarching scheme for holistic nourishment) Abhiyaan—aims to drastically reduce the prevailing high incidence of malnutrition, stunted growth and anaemia.
- The intention is to do this through convergence, mass movements and leveraging technology.
- Anganwadi workers (AWWs) are required to feed in details of the beneficiaries and monitor their growth in real time during pregnancy, as well as height and weight of the child once born, in the mobile phones given to them and follow up with SMS alerts to those who are at risk.
- However, certain fundamental issues need fixing for the programme to be successfully implemented.
- POSHAN Abhiyaan is a multi-ministerial convergence mission with the vision to ensure attainment of malnutrition free India by 2022.
- The objective of POSHAN Abhiyaan to reduce stunting in identified Districts of India with the highest malnutrition burden by improving utilization of key Anganwadi Services and improving the quality of Anganwadi Services delivery.
- Its aim to ensure holistic development and adequate nutrition for pregnant women, mothers and children.
- The Ministry of Women and Child Development (MWCD) is implementing POSHAN Abhiyaan in 315 Districts in first year, 235 Districts in second year and remaining districts will be covered in the third year.
- There are a number of schemes directly/indirectly affecting the nutritional status of children (0-6 year’s age) and pregnant women and lactating mothers.
- In spite of these, level of malnutrition and related problems in the country is high.
- There is no dearth of schemes but lack of creating synergy and linking the schemes with each other to achieve common goal.
- POSHAN Abhiyaan through robust convergence mechanism and other components would strive to create the synergy.
- POSHAN Abhiyaan was launched by Prime Minister Shri Narendra Modi in Jhunjhunu, Rajasthan in March 2018.
- It targets to reduce level of under-nutrition and other related problems by ensuring convergence of various nutrition related schemes.
- It also targets stunting, under-nutrition, anaemia (among young children, women and adolescent girls) and low birth rate.
- It will monitor and review implementation of all such schemes and utilize existing structural arrangements of line ministries wherever available.
- Its large component involves gradual scaling-up of interventions supported by on-going World Bank assisted Integrated Child Development Services (ICDS) Systems Strengthening and Nutrition Improvement Project (ISSNIP) to all districts in the country by 2022.
- The POSHAN Abhiyaan, as an apex body, will monitor, supervise, fix targets and guide the nutrition related interventions across the Ministries.
- The proposal consists of mapping of various Schemes contributing towards addressing malnutrition
- introducing a very robust convergence mechanism
- ICT based Real Time Monitoring system
- incentivizing States/UTs for meeting the targets
- incentivizing Anganwadi Workers (AWWs) for using IT based tools
- eliminating registers used by AWWs
- introducing measurement of height of children at the Anganwadi Centres (AWCs)
- Social Audits
- Setting-up Nutrition Resource Centres, involving masses through Jan Andolan for their participation on nutrition through various activities, among others.
The following components will form the pillars of the Mission:
- ICDS-CAS(Common Application Software)
- Behavioural change, IEC Advocacy
- Training and Capacity building
- Grievance Redressal
The followings are key Nutrition strategies and interventions of the mission:
- IYCF(Infant and Young child feeding)
- Food and Nutrition
- Institutional Delivery
- WASH(Water,Sanitation and Hygiene)
- Food Fortification
- Dietary Diversification
- Adolescent Nutrition
- Maternal Health and Nutrition
- ECD(Early childhood development)/ECCE(Early Childhood care and Education)
- ICT-RTM (Information and Communication. Technology enabled Real Time Monitoring)
- Capacity Building
Implementation Strategy and Targets:
- Implementation strategy would be based on intense monitoring and Convergence Action Plan right up to the grass root level.
- POSHAN Abhiyaan will be rolled out in three phases from 2017-18 to 2019-20.
- The programme through the targets will strive to reduce the level of stunting, under-nutrition, anemia and low birth weight babies.
- NNM targets to reduce stunting, under- nutrition, anemia (among young children, women and adolescent girls) and reduce low birth weight by 2%, 2%, 3% and 2% per annum respectively.
- Although the target to reduce Stunting is atleast 2% p.a., Mission would strive to achieve reduction in Stunting from 38.4% (NFHS-4) to 25% by 2022 (Mission 25 by 2022).
- It will create synergy, ensure better monitoring, issue alerts for timely action, and encourage States/UT s to perform, guide and supervise the line Ministries and States/UT s to achieve the targeted goals.
ICDS-CAS (Common Application Software):
- The Ministry also announced the development of the ICDS-CAS (Common Application Software) to strengthen the service delivery system as well as the mechanism for Real Time Monitoring for nutritional outcomes through effective monitoring and timely interventions in POSHAN Abhiyaan.
- By the year 2020, the application will be rolled out across 14 lakh Anganwadis and would impact 10 Crore beneficiaries.
- It is currently the largest e-Nutrition & Health programme in the World having 1.1 lakh data entry devices with frontline functionaries across 7 States – Madhya Pradesh, Andhra Pradesh, Chhattisgarh, Bihar, Jharkhand, Rajasthan and Uttar Pradesh.
- It enables data capture, ensures assigned service delivery and prompts for interventions wherever required.
- It makes available the data to the supervisory staff from sector, block, district, state to national level through a dashboard for monitoring purpose.
Integrated Child Development scheme
The Integrated Child Development Service (ICDS) Scheme providing for supplementary nutrition, immunization and pre-school education to the children is a popular flagship programme of the government. It is one of the world’s largest programs providing for an integrated package of services for the holistic development of the child. ICDS is a centrally sponsored scheme implemented by state governments and union territories.
- To improve the nutritional and health status of children in the age-group 0-6 years;
- To lay the foundation for proper psychological, physical and social development of the child;
- To reduce the incidence of mortality, morbidity, malnutrition and school dropout;
- To achieve effective co-ordination of policy and implementation amongst the various departments to promote child development; and
- To enhance the capability of the mother to look after the normal health and nutritional needs of the child through proper nutrition and health education.
- Children in the age group of 0-6 years
- Pregnant women and
- Lactating mothers
Services under ICDS
The ICDS Scheme offers a package of six services, viz.
- Supplementary Nutrition
- Pre-school non-formal education
- Nutrition & health education
- Health check-up and
- Referral services
- Anganwadi is a type of rural child care centre in India.
- They were started by the Indian government in 1975 as part of the Integrated Child Development Services program to combat child hunger and malnutrition. Anganwadi means “courtyard shelter” in Indian languages.
- It is a part of the Indian public health care system. Basic health care activities include contraceptive counseling and supply, nutrition education and supplementation, as well as pre-school activities.
- The centres may be used as depots for oral rehydration salts, basic medicines and contraceptives.
- As many as 13.3 lakh (a lakh is 100,000) Anganwadi and mini-Anganwadi centres (AWCs/mini-AWCs) are operational out of 13.7 lakh sanctioned AWCs/mini-AWCs, as of 31 January 2013.
- These centres provide supplementary nutrition, non-formal pre-school education, nutrition and health education, immunization, health check-up and referral services of which later three services are provided in convergence with public health systems.
The role of Anganwadi centres
- Anganwadi workers are required to feed the details of the beneficiaries.
- They should monitor their growth in real time during pregnancy, as well as height and weight of the child once born.
- Mobile phones are given to them, they have to follow up with SMS alerts, to those who are at risk.
- These are the focal point of delivery of health and nutrition services for pregnant women, lactating mothers and children.
Issues are associated with POSHAN Abhiyaan and Anganwadi centres:
- Anganwadi centres (AWCs) are the focal point of delivery of health and nutrition services for pregnant women, lactating mothers and children. There have been improvements in the quantity, quality and coverage of services provided to the beneficiaries. These have reflected positively in maternal and child health indicators. However, many of the AWCs lack basic amenities and face infrastructure problems.
- Around 24% of them lacked their own building and operated from small rented premises, and around 14% lacked pucca buildings. Only 86%, 67% and 68% of AWCs had drinking water facilities, electricity connections and toilets respectively, some of which are either dysfunctional or could not be used due to conditions imposed by landlords. The cumulative effect was that children were forced into cramped, poorly lit and unhygienic spaces, often in searing heat.
- Despite improvements, there is still much left to do in terms of achieving universalization of coverage and advanced service delivery. According to the Rapid Survey on Children (2013-14) carried out by the Union ministry of women and child development, 74% of AWCs had functional baby-weighing scales and 23% of them had adult-weighing scales.
- However, a 2015 evaluation carried out by NITI Aayog had found that over 24% of the AWCs surveyed maintained poor records.
- This could be rendered ineffective due to the limited capacities of AWWs to handle smartphones owing to their lack of technological literacy.
- This is compounded by technical issues like slow servers and data deletion problems, resulting in irregular and improper recording of growth data of children.
- AWWs are the fulcrum of POSHAN Abhiyaan and render vital services to mothers and children in villages. Despite their indispensability, nearly 40% of AWWs had to use their personal money to run the AWCs, 35% of them complained of delayed payments (Progress of Children Under Six Report, 2016), and administrative duties like organizing functions, and conducting exams and surveys distracted them from their core health and nutrition responsibilities.
- Thus, overburdened with work, undervalued and underpaid, AWWs have become demotivated and demoralized.
Measures taken from the government:
- Positive measures have been taken to rectify these issues. Expeditious construction of 36,000 AWCs which meet the required standards of space, cleanliness, convenience of locality etc.
- Recent visits to NITI Aayog’s aspirational districts demonstrated that the strategy of actively involving otherwise unsupportive panchayat leaders in construction of AWCs and improvement in the quality of village health sanitation and nutrition, will make POSHAN Abhiyaan more effective in these areas.
- If the government vests more powers in the district administration to fill vacant posts in AWCs, it would be a significant step towards overcoming the problem of shortage of staff.
- Comprehensive periodical and refresher training of AWWs, especially when it comes to usage of tablets for monitoring growth among malnourished children and high risk pregnant mothers, is crucial.
- Supply of iron/folic acid tablets, allotment of ‘take-home rations’ and supplementary nutrition needs to be regular.
- The prime minister’s recent video conference with front-line workers and the announcement of an increase in their remuneration, as well as the recent POSHAN Maah awards, send the right signals about the government’s commitment to recognizing and honouring AWWs’ efforts.
- Supply side investments need to be complemented with the enhancement of the traditionally weak demand for health and nutrition services.
Q) One cannot build a strong building on a weak foundation. Similarly, if the children of the country are weak, the progress of the country will also slow down. Critically examine the statements with government recent initiatives.