Dr Anikta
The month of September is being celebrated as National Nutrition Month across India. The Government of India has set-up POSHAN Abhiyaan (National Nutrition Mission) which was launched by the Prime Minister of India on 8th March, 2018. Never before has nutrition been given such prominence at the highest level in the country. Nutrition is a broad term with a larger perspective. According to WHO, ‘Nutrition is the intake of food, considered in relation to the body’s dietary needs.’ Dietary needs are different for different individuals depending on their age, gender, physique, occupation, physical activity etc. Why adequate nutrition is important? As a famous saying goes we become what we eat. The overall growth and health of an individual depends on his nutritional status as a child. First 1000 days of a new born are very crucial. Under nutrition in the first 1,000 days of children’s lives can have irreversible consequences. For millions of children, it means they are, forever, stunted. Child under nutrition is assessed by measuring height and weight and screening for clinical manifestations and biochemical markers. Stunting (inadequate length/ height for age), wasting (inadequate weight for height) and underweight for age are various elements of under nutrition. Under nutrition is clearly a major contributing factor to child mortality, disease and disability. For example, a severely stunted child faces a four times higher risk of dying, and a severely wasted child is at a nine times higher risk. Specific nutritional deficiencies such as vitamin A, iron or zinc deficiency also increase risk of death. Under nutrition can cause various diseases such as blindness due to vitamin A deficiency and neural tube defects due to folic acid deficiency. Brain and nervous system development begins early in pregnancy and is completed by the age of 2. Nutritional deficiencies during this period affect brain development in different ways. Under nutrition is often an invisible problem. It completely jeopardizes children’s survival, health, growth and development, and it slows national progress towards development goals.
According to UNICEF, 90 percent of the developing world’s chronically undernourished children are living in Asia and Africa. In India, According to the NFHS-4, 38 percent of children under age five years are stunted, 21 percent are wasted, 36 percent are underweight and 2 percent are overweight. In Jammu and Kashmir, percentage of Children with stunted growth is found to be slightly lower i.e. 27 percent as compared to national level. Nutritional status is influenced by three broad factors: food, health and care. Food, health and care are affected by social, economic and political factors. The leading causes of under nutrition in India are lack of adequate knowledge about nutrition, poverty, lack of education, gender bias, increasing population, uneducated, under nourished and economically dependent mothers, poor sanitation, unavailability of food and resources, non deliverance of government facilities etc.
First and foremost step is initiation of breastfeeding within first hour of birth; exclusive breastfeeding for the first six months of the child’s life; and continued breastfeeding for two years or more. It ensures early skin-to-skin contact which prevents hypothermia and establishes the bond between mother and her child. Colostrum, the milk produced by the mother just after delivery provides protective antibodies and essential nutrients, acts as a first natural immunization for newborns and strengthens their immune system. The second step is to start safe, age-appropriate and hygienically prepared complementary foods starting at 6 months of age along with breastfeeding. Optimal use of locally available foods, improving access to quality foods for poor families through social protection schemes and safety nets is very important. Third step is to start vitamin and micro nutrient supplements along with complementary feeding. Inclusion of Iron, Folic acids, Zinc, Vitamin A, iodized salt should be encouraged.
Fourth step is to educate about personal hygiene and sanitation. Hand washing with soap by caregivers’ and children prior to food preparation and eating, serving foods immediately after preparation, using clean utensils and avoiding feeding bottles helps reduce diarrhea and associated under nutrition in the child. Fifth step is to take care of future mothers. As one of the basic causes of under nutrition in India is it’s under nourished women. Every adolescent girl must be protected against under nutrition and nutritional deficiencies. Avoidance of early marriage and early pregnancy is also vital.
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 was released in September, 2017. The Strategy aims to reduce all forms of malnutrition by 2030, with a focus on the most vulnerable and critical age groups. National Nutrition Mission has been launched. Much importance is to be given to cater the nutritional requirements of pregnant women, lactating mothers and the children up to 2 years. Community support includes services such as counseling, education and communication. The Anganwadi workers and the ASHA workers are the integral part of the framework dealing with the children below five years of age and their mothers. It is imperative for the Government to take steps to strengthen the underlying framework and manpower.
Strong and decisive steps should be taken to meet the challenges. Children and women are the backbone of our society but under nutrition and nutritional deficiency diseases are most common among them. Adequate nutritive diet is the rightful demand of any child as well as any citizen. A country can only progress when its citizen are healthy and its children are not under nourished, stunted, wasted or under weight. No one should die of hunger. Then only can India shine. Therefore during this Nutrition Month, we must pledge to do our best as parents, as care givers, as service providers, as Government functionaries and as a progressive society in order to eradicate Under Nutrition and nutritional deficiencies from our country. It can be the best gift to our next generation.
(The author is Assistant Professor, Govt. Ayurvedic Medical College, Jammu)
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