Nutritional Policies and Programs
- 05 Sep 2023
According to the National Family Health Survey 2021, 33 lakh children in India are malnourished. Also, India ranks 107 out of 121 countries on the Global Hunger Index 2022 in which it fares worse than all countries in South Asia barring war-torn Afghanistan. India’s GHI score of 29.1 places it in the ‘serious’ category. Owing to such alarming rates, studies are being conducted to analyse and explore the innate factors for such disparities in the socio-economic background of caregivers. These surveys have encouraged the government to take remedial measures to rectify the situation of malnutrition in the country over the years, through the medium of nutritional policies and programs.
Impact of Malnutrition on National Development:
Malnutrition is a serious problem that affects the health, education, economy, and social welfare of the nation. Some of the effects are the stunted physical and mental growth of children, leading to lower learning, productivity, and income. Malnutrition increases the risk of diseases, resulting in high mortality rates and healthcare costs, strengthening the cycle of poverty and underdevelopment. It reduces human capital, labour force, and economic growth potential.
Malnutrition is a complex problem that requires comprehensive nutritional policies that address its multifaceted impact, targeted towards improving the food security and quality of the population, enhancing nutrition education and awareness to help people make informed and healthy dietary choices, and strengthening the healthcare services to prevent, diagnose, and treat malnutrition and its related diseases and coordinating with different sectors and stakeholders, such as agriculture, education, environment, social protection, and private sector, to create an enabling environment for nutrition.
National Food Security Act (NFSA) and Its Implementation:
The National Food Security Act (NFSA), 2013 is a law that provides food and nutrition security to the people of India. It covers about two-thirds of the population, who can get subsidised food grains through the Targeted Public Distribution System (TPDS). The NFSA also provides nutritional support to pregnant women, lactating mothers, and children up to 14 years of age. It also has a grievance redressal mechanism and provisions for transparency and accountability.
The challenges during implementation include the high fiscal cost and subsidy burden, the inaccurate identification and targeting of beneficiaries, the poor quality and quantity of food grains, and the inadequate infrastructure and capacity of the agencies. The strategies to overcome these loopholes include using information technology, adopting a decentralized procurement system, strengthening the grievance redressal mechanism and social audits, and diversifying the food basket.
PM POshan SHAkti Nirman (PM-POSHAN) and Child Nutrition:
The PM Poshan scheme is a program that provides free, nutritious cooked meals to children in government schools and other centres in India. It aims to improve the enrolment, attendance, retention, and health of the children. The PM Poshan scheme has improved completion rates of primary education, especially for girls, enhanced the attendance of children, has improved the nutritional status and micronutrient intake of children. The scheme has also had positive effects on the cognitive development, academic performance, and social behaviour of children.
Some ways to better the scheme are to allocate more funds and improve accuracy, quality, and capacity to reach the needy and hungry without mediators. It also needs better technology, inclusivity, and accountability on behalf of the administration. The food should be wholesome so that the dual purposes of education and nutrition are solved.
Anaemia and Micronutrient Deficiency Programs:
Anaemia and micronutrient deficiencies are common health problems in India. They affect the blood, growth, development, and immunity of the body, causing fatigue, weakness, infections, mental retardation, blindness, and birth defects. They can also impair learning, work, and reproductive health. The programs to eliminate these diseases include the National Iron Plus Initiative, the National Iodine Deficiency Disorders Control Programme, the Integrated Child Development Services, and the National Prophylaxis Programme.
These programs have significantly reduced the levels of anaemic conditions in the nations. There are still some challenges which include the low coverage, compliance, and quality of the supplementation programs, the poor dietary diversity and quality of the population, and the high prevalence of infections and parasitic infestations. Some strategies to ensure smooth implementation include using information technology, adopting a decentralized system, promoting nutrition education, and behaviour change communication.
Poshan Abhiyaan (National Nutrition Mission):
Poshan Abhiyaan is a program of the Government of India (GoI) to improve the nutrition of children, women, and adolescent girls. It converges various nutrition schemes and programs, using information and communication technology, providing incentives to states and districts, and promoting behaviour change communication and community mobilization. It has four key programme pillars: ICDS-CAS (Integrated Child Development Services-Common Application Software), which is a mobile application for data capture and analysis; ILA (Incremental Learning Approach), which is a training program for frontline workers; CAP (Convergence Action Plan), which is a framework for coordination and collaboration among stakeholders; and Jan Andolan, which is a social campaign for nutrition awareness. The challenges to Poshan Abhiyaan are similar to the challenges faced in implementing other programs like the PM Poshan scheme.
Maternal and Child Nutrition Initiatives:
Nutrition prevents malnutrition, supports fetal and infant growth, reduces chronic disease risk, and enhances cognitive and socio-emotional development. Women should eat well, take supplements, exercise, and rest before and during pregnancy and breastfeeding. Infants should be breastfed exclusively for six months and receive complementary foods afterwards. Women and children should have access to nutrition services.
The government runs three programs to improve maternal and child nutrition:
- Integrated Child Development Services (ICDS) Scheme: Launched on 2nd October 1975, the ICDS scheme is the world's largest community-based programme. The scheme is targeted at children upto the age of 6 years, pregnant and lactating mothers and women 16–44 years of age. The scheme is aimed to improve the health, nutrition and education (KAP) of the target community.
- The India Newborn Action Plan (INAP): It was launched in September 2014 with the aim of ending preventable newborn deaths and stillbirths by 2030. INAP has set the goals for neonatal mortality and stillbirths. The goal is to attain Single Digit Neonatal Mortality and Stillbirth Rates by 2030.
- Reproductive and Child Health (RCH) Programme: It is a comprehensive sector wide flagship programme, under the umbrella of the GoI’s NHM, to deliver the RCH targets for reduction of maternal and infant mortality and total fertility rates. The programme aims to reduce social and geographical disparities in access to and utilisation of quality reproductive, maternal, newborn, child and adolescent health services. Launched in April 2005 in partnership with the State governments, RCH is consistent with GoI's National Population Policy-2000, the National Health Policy-2001 and the Millennium Development Goals. Six key components of the RCH programme are Maternal Health, Child Health, Nutrition, Family Planning, Adolescent Health (AH) and PCPNDT.
The programs need more monitoring, evaluation, budget, expenditure, convergence, and coordination to address the challenges of maternal and child nutrition.
Rural vs. Urban Disparities in Nutritional Access:
Rural vs. Urban disparities in nutritional access are major challenges for India, as they strongly affect the health and well-being of millions of people. The results of a popular survey conducted to analyse trends and disparities between rural and urban areas show that the rate of malnutrition and stunted growth is higher in the poorer sections of the society as compared to the wealthier socio-economic backgrounds. The urban residential areas have more accessibility to better healthcare and nutritional resources while the rural and slum areas are still relatively backward in this forte.
These results show that there is a need for more research and policies to address the multiple burdens of malnutrition, especially among rural and urban slum households, and to ensure equitable access to healthy food for all.
Public Distribution System (PDS) and Nutritional Support:
The Public Distribution System (PDS) implemented by the Ministry of Consumer Affairs, Food, and Public Distribution is a program that aims to provide subsidized food grains to needy people. It covers commodities such as wheat, rice, sugar, and kerosene, and some states also distribute pulses, edible oils, iodized salt, spices, etc. through the PDS outlets. The PDS is operated by the central and state governments on decentralized levels.
Some of the challenges in PDS implementation are leakages and diversion of food grains from the supply chain, corruption, and inefficiency in the procurement, storage, transportation, and distribution processes, poor quality and adulteration of food grains and other commodities, inequity in the access to subsidized food, lack of awareness and access among the poor and marginalized sections of the society, regional disparities and variations and inadequate monitoring and evaluation mechanisms to track the performance and impact of PDS on food security and nutrition outcomes.
Some of the possible measures for enhancing PDS are strengthening the procurement, storage, transportation, and distribution systems, improving the transparency and accountability of PDS Improving census data community participation and self-declaration, etc.
Promotion of Nutrient-Rich Indigenous Foods:
Indigenous foods provide essential nutrients that may be lacking in conventional foods. They can also offer variety and flavour to the local cuisine and enhance the cultural identity and food sovereignty of the indigenous communities. Furthermore, indigenous foods can support the agroecological farming practices that preserve natural resources and ecosystems. Therefore, indigenous and nutritious foods should be valued and promoted as part of the global efforts to improve human and environmental health.
The consumption of nutritious food can be encouraged by creating awareness and improving accessibility at the grassroots level. It can also improve by including cost-effectiveness in such resources so that people from all walks of life can avail the food and maintain health.
Nutrition Education and Behaviour Change:
Nutrition education is a key to unlocking the secrets of health and wellness in India, where confusion and misinformation abound. It teaches us how to eat according to our needs and preferences to avoid diseases and to defeat the myths and misconceptions that interfere with our eating habits and regimes.
Nutrition education is not just information but a skill that empowers us to choose rightly. It is a tool that builds a healthy nation. These nutrition programs can be incorporated through educational schemes that promote both the inclination and involvement towards education and improve immunity and cognitive and social abilities of an individual.
Urbanisation and Changing Dietary Patterns:
India is a land of diversity with different foods and cuisines. Urbanisation brings more differences and changes in what people eat, with the amalgamation of Western cuisines. These foods have more sugar, fats, and processed food and relatively less cereals, pulses, and greens These are the signs of the nutrition transition that affects the health of millions. Gaps like unequal distribution, pollution, and unhealthy lifestyles are the challenges that increase the risk of diseases like obesity, diabetes, and hypertension.
Some possible strategies to address the nutritional implications of shifting dietary patterns in urban areas can be promoting nutrition education and awareness among urban residents and improving the availability, accessibility, and affordability of nutritious and diverse foods in urban food environments, such as supermarkets, food vendors, and restaurants. Reducing food waste and encouraging sustainable consumption patterns are a great way to protect the environment and our own bodies and immunity.
Public-Private Partnerships in Nutrition Programs:
Public-private partnerships (PPPs) are ways of working together between the public and private sectors to improve nutrition and health. PPPs can have benefits, such as increasing funds and awareness for nutrition and health, improving food and delivery systems to make nutritious foods more available, accessible, and affordable, and sharing technology and knowledge to make food products better, safer, and more diverse.
PPPs can be associated with risks, like balancing private profits with public health and ensuring accountability and transparency, avoiding conflicts of interest and undue influence, following ethical codes, and respecting human rights and environmental standards. PPPs need careful design, implementation, monitoring, and evaluation to be effective, efficient, equitable, and sustainable. PPPs should also follow national and global nutrition goals and strategies.
Some of the latest developments in the policies and programs for nutrition are initiatives like the IGC (International Grains Council) which analyses the nutrition policy and gives suggestions to fight malnutrition, the FAO (Food & Agriculture Organisation) offering a toolkit, e-learning courses, and nutrition-sensitive agriculture and food systems, and UNICEF which works with many nutrition partners to scale up nutrition policies, strategies and programs that support the Sustainable Development Goals (SDGs). Thus, nutrition policies play an inevitable role in national development.
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Tanmaya Kshirsagar is an artist, writer and musician. She works with UN Women as a Youth Ambassador and her work has found a place on platforms like Times of India, Indian Review, Women's Web and Medium to name a few.Blogs Home