Atul Mahajan
Rashtriya Poshan Maah 2020 is being observed/celebrated across the nation from 1st- 30th September 2020 as part of Jan Andolan (People’s movement) under Poshan Abhiyaan. Beginning from 2018, this is the third Rashtriya Poshan Maah, in succession which aims to carry forward the nation’s fight against the demon of Malnutrition.
Malnutrition is defined as an abnormal physiological condition caused by inadequate, unbalanced or excessive consumption of macronutrients and/or micronutrients. It includes undernutrition (child stunting and wasting and vitamin and mineral deficiencies) as well as overweight and obesity.
Malnutrition is a global phenomenon. Malnutrition in one form or other is estimated to affect one in three people globally and is inextricably linked to morbidity and mortality. According to WHO, Malnutrition is a world Health Crisis. In all its forms, it has become the leading cause of ill health and death, and in rapid rise of diet-related non-communicable Diseases (NCDs).
Malnutrition in India: India is facing a major malnutrition crisis as it holds almost a third of world’s burden for stunting.The spectre of Malnutrition continues to haunt India despite a series of laudable efforts and launch of specific interventionist strategies and programmes. According to Lancet Child Adolesc Health 2019 report, Malnutrition remains the predominant risk factor for deaths (68.2%) and disease burden in children younger than five years and the leading risk factor for disease burden in all ages combined (17.3% of the total disability adjusted life years-DALYs), in the country.
Further, according to the latest 2020 Global Nutrition Report, India is “off course” to meet the global targets for all indicators analyzed with adequate data. The national prevalence of under-five stunting is 37.9%, which is greater than the developing country average of 25%. India’s under-five wasting prevalence of 20.8% is also greater than the developing country average of 8.9%. In India, only 54.9% of infants under 6 months are exclusively breastfed. India’s adult population also faces a malnutrition burden. 51.4% of women of reproductive age have Anemia, and 9.1% of adult men have diabetes, compared to 8.3% of women.
As per Sustainable Development Report 2020, India ranked 117 (of 166 countries) in SDG Index 2020. As regards Sustainable Development Goal (SDG)-2 which emphasizes not only the need to ensure access to safe, nutritious and sufficient food for all people, but also to eradicate all forms of malnutrition and aspires for “Zero Hunger” and Sustainable Development Goal (SDG)-3 which aspires for “Good Health and well-being for all”, the SDG Trend vis-à-vis India, as per this report is only “Moderately improving”. It is pertinent to mention here that the report has categorized SDG-2 and SDG-3 as “Major Challenges” and these Goals are expected to be met by India by 2030. However, despite increase in agricultural productivity and overall food production in the country, the rate of malnutrition especially among women and children remains stubbornly high.
The country is standing at the cusp of a new era where more than half of the country’s population is below 25 years of age. With this young demographic profile and ambitious transformational Development agenda of the present Government, the country cannot afford to be lagging behind achieving inclusive growth in general and, in particular, targets of SDG-2 and SDG-3.
Policy interest in Nutrition acquired significance because of the fact that 12 of the 17 Sustainable Development Goals require “Good Nutrition” in order to be met.
Realizing that improving nutritional status of the country is a multi-sectoral and multi-dimensional challenge, on 8th March 2018, Hon’ble PM of India launched National Nutrition Mission (NNM), also known as POSHAN Abhiyaan to bring focus and momentum to this effort which has overarching goal of reducing child and maternal malnutrition in a holistic manner.
POSHAN Abhiyaan: POSHAN Abhiyaan is a multi-ministerial convergence mission with the vision to ensure attainment of malnutrition free India by 2022. It aims to ensure holistic development and adequate nutrition for pregnant women, mothers and children.
The goals of POSHAN Abhiyaan are to achieve improvement in nutritional status of children from 0-6 years, pregnant and lactating mothers in a time bound manner with fixed targets to reduce prevalence of Stunting, underweight, Low birth weight and Anemia in women and children.
Key Themes of Poshan Abhiyaan include both Nutrition specific and Nutrition sensitive interventions. They are:
1. Poshan (Overall Nutrition) 2. Optimal Breastfeeding 3. Complementary Feeding 4. Immunization 5.Growth Monitoring 6. Food Fortification and Micronutrients 7. Diarrhoea 8. Hygiene- Water- Sanitation 9. Anemia 10. Adolescent Education- Diet- Age of Marriage 11. Antenatal Checkup and 12. Early Childhood Care and Education (ECCE)
Of these themes, the five most critical actionable themes of POSHAN, which are popularly known as Paanch Sutras are:
* First 1000 Days: The child’s physical and mental development is rapid during the first 1,000 days. Mother and child require adequate nutrition, care and support during this period for optimal growth of the child
* Anemia prevention: Screening and testing of Anemia is important in all age groups so that appropriate treatment may be initiated as per the haemoglobin level of the individual. Women, adolescent girls and children should consume iron-rich foods, take iron supplement if prescribed, and deworm regularly.
* Diarrhoea Management: Mothers should exclusively breastfeed children up to six months to avoid diarrhoea. ORS and extra fluids should be given to a child immediately at the onset of diarrhoea and continued till diarrhoea stops. Zinc should be given for 14 days to children suffering from diarrhoea, even if diarrhoea stops.
* Hygiene and Sanitation: Consumption of clean water, always using a toilet and practicing good hygiene such as hand washing with soap are essential. Adolescent girls and women should practice personal hygiene during menstruation.
* Nutrient-rich Food (Paushtik Aahaar): All age groups, including children from 6 months of age need to consume a variety of nutritious food in adequate quantities. These include food prepared at home such as roti/rice and yellow and black pulses, green leafy and yellow vegetables, and if non-vegetarian, add eggs, fish and meat along with one spoon of ghee/oil/butter.
Rashtriya Poshan Maah 2020: The focus of Poshan Maah this year, is on three important objectives:-
* Identification and tracking of Children with Severe Acute Malnutrition (SAM)
* Promoting Optimal Breastfeeding (Early and Exclusive) of Newborn and Infants
* Promotion and Establishment of Nutri-Gardens in Anganwadi Centres/or on community vacant lands in convergence with Rural Development Department and Deptt. of Panchayati Raj.
Though celebrated in the spirit of a “Nutrition Festival” witnessing massive public participation, this year, due to the prevailing situation in the wake of spread of COVID-19, Poshan Maah 2020 is repositioned from its conventional mass mobilization format to a largely Digital mode of Jan Andolan (wherever feasible). MW&CD has called for encouraging digital mode for meetings and counselling. Other activities may be carried out by strictly adhering to COVID-19 protocols prescribed by the Ministry of Home Affairs, Ministry of Health & Family Welfare and MW&CD.
(The author is presently posted as Deputy Director ICDS, Jammu.)
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