Report on National Nutrition Mission: NITI Aayog

• 25 Nov 2020

Why in News

Recently, the NITI Aayog has released “Accelerating Progress On Nutrition In India: What Will It Take”, the third progress report on the National Nutrition Mission or the Poshan Abhiyaan.

Key Points

• National Nutrition Mission:
  
  • Launched in 2018, it is the Government of India’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers.
    
    • It is backed by a National Nutrition Strategy prepared by the NITI Aayog with the goal of attaining “Kuposhan Mukt Bharat" or malnutrition-free India, by 2022.
  • Aims:
    
    • To reduce stunting, undernutrition, anemia (among young children, women and adolescent girls) and low birth weight by 2%, 2%, 3% and 2% per annum respectively.
    • To address the problem of malnutrition in a mission-mode.
  • 50% of the total budget comes from the World Bank or other multilateral development banks and the rest of the 50% is through Centre’s budgetary support.
    
    • The Centre's budgetary support is further divided into 60:40 between the Centre and the States, 90:10 for the north-eastern region and the Himalayan States and 100% for the Union Territories (UTs) without legislature.
  • Prevalence:
    
    • More than a third of children under five suffer from stunting and wasting and 40% of children between one and four are anaemic.
    • Over 50% of pregnant and non-pregnant women were found to be anaemic, according to the National Family Health Survey-4 released in 2016.
• About the Report:
  
  • The third progress report (October 2019-April 2020) takes stock of the roll-out status on the ground and implementation challenges encountered at various levels through large scale datasets.
    
    • These datasets are the NFHS-4 and Comprehensive National Nutrition Survey (CNNS).
  • The initial Reports I and II, focused majorly on the mission’s preparedness and implementation by States and UTs, respectively.
  • The review report was drafted in March 2020 and does not factor worsening poverty and hunger levels since then, which are expected to have gone down further due to the Covid-19.
• Concerns Highlighted:
  
  • On stunting, India's targets are conservative as compared to the global target defined by the World Health Assembly (WHA), which is a prevalence rate of 5% of stunting as opposed to India’s goal of reducing stunting levels to 13.3% by 2022.
  • The target of reducing prevalence levels of anaemia among pregnant women from 50.3% in 2016 to 34.4% in 2022 and among adolescent girls from 52.9% in 2016 to 39.66%, is also considered to be conservative as compared to the WHA's target of halving prevalence levels.
  • In the wake of the pandemic, experts warn that deepening poverty and hunger may delay achieving the goals defined under the Mission.
• Suggestions:
  
  • On Stunting:
    
    • To improve complementary feeding using both behaviour change interventions and complimentary food supplements in the Integrated Child Development Services (ICDS).
    • To work towards investments in girls and women (education during childhood, reducing early marriage and early pregnancy, improving care during and after pregnancy) along with other social determinants.
    • To improve water, sanitation, handwashing with soap and hygienic disposal of children’s stools with other effective interventions.
  • On Wasting:
    
    • To include interventions that go beyond the treatment of severe acute malnutrition (SAM) and also address moderate wasting, have the potential to achieve larger declines in wasting.
    • To scale-up to reach facility-based treatment of SAM to all those needing in-patient care.
    • To urgently release a full strategy for prevention and integrated management of wasting nationally.
  • On Anaemia:
    
    • To scale-up scenario that focuses only on health sector interventions which will achieve modest improvements in anaemia among women of reproductive age.

Way Forward

• As the National Nutrition Mission continues to play an important role in India’s endeavour against malnutrition, India needs to now accelerate actions on multiple fronts. The projections are optimistic, and will need to be re-adjusted for the Covid-19 disruptions to health and nutrition services.
• There is a need to quickly graduate to a POSHAN-plus strategy which apart from continued strengthening the four pillars of the mission (Technology, Convergence, Behavioral change and Capacity building), also requires a renewed focus on other social determinants in addition to addressing the governance challenges of the National Health Mission (NHM) and ICDS delivery mechanisms.

Source: TH