Malnutrition in India: National Nutrition Strategy by NITI Aayog (Important) (Download PDF)

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To fight undernutrition and malnutrition, National Institution for Transforming India (NITI) Aayog launched National Nutrition Strategy. Aim is “Kuposhan Mukt Bharat” . Prevalence of underweight children in India among the highest in the world.

Map of Malnutrition in India
  • Makes nutrition the centre-stage of National Development Agenda by laying down roadmap for targeted action to address India՚s nutritional needs.

Undernutrition and Malnutrition in India

  • The World Bank estimates that India is one of the highest-ranking countries in the world for the number of children suffering from malnutrition.
  • The 2017 Global Hunger Index (GHI) Report ranked India 97th out of 118 countries- third behind only Afghanistan and Pakistan among South Asian nations with a GHI score of 29.0
  • 20 % of children under five years suffer from wasting due to acute under-nutrition.
  • Despite India՚s 50 % increase in GDP since 1991 more than one third of the world՚s malnourished children, live in India.
  • Half of malnourished children under 3 are underweight and a third of wealthiest children are over-nutritioned.
  • Indian pays an income penalty of 9 to 10 % due to workforce stunted during childhood.
  • The National Family Health Survey results show decline in under nutrition in both women and children.
  • Lack of real time measurement of nutritional determinants reduces capacity for targeted action among most vulnerable mothers and children.

Consequence of Malnutrition- The Vicious Cycle

  • Indian suffers from inter-generational cycle of undernutrition transmitted from mothers to children.
  • Undernourished children likely to suffer from infection and die from common childhood illnesses (diarrhea, pneumonia, measles, and malaria) .
  • More than a third of all deaths in children aged five years or younger is attributable to undernutrition.
  • Undernutrition also puts women at a greater risk of pregnancy-related complications and death (obstructed labor and hemorrhage) .
  • Undernourished boys and girls lag in school and as adults are less productive and make lower wages.
  • With lower waves the household again suffers from malnutrition- widespread child undernutrition thus impedes India՚s socio-economic development and potential to reduce poverty.

Time to Break the Vicious Cycle of Malnutrition

The critical window of opportunity when nutrition interventions offer children the best chance for survival and development to their full potential are:

  • Girl՚s adolescence
  • Women՚s pregnancy
  • Children՚s first two years of life. After the age of two, the window closes and the opportunity for the child is lost.

How to Break the Vicious Cycle of Malnutrition?

There are ten proven interventions to halve child undernutrition rates:

  • Timely initiation of breastfeeding within one hour of birth
  • Exclusive breastfeeding in the first six months of life
  • Timely introduction of complementary foods at six months
  • Age-appropriate foods for children six months to two years
  • Safe and hygienic complementary feeding practices
  • Full immunization and bi-annual vitamin A supplementation with deworming
  • Appropriate feeding for children during and after illness
  • Therapeutic feeding for children with severe acute malnutrition
  • Adequate nutrition and anemia control for adolescent girls
  • Adequate nutrition and anemia control for pregnant and breastfeeding mothers

The Will to Fix Malnutrition

  • Leadership at the highest level should prioritize child nutrition outcomes, with large investments in nutrition interventions and poverty alleviation together with rapid economic growth.
  • ] Targeted nutrition interventions to prevent and treat undernutrition as part of a continuum of care, particularly in children and women.
  • Reliance on community-based primary health care for delivery to ensure high coverage with essential nutrition interventions for the youngest children, adolescent girls, and pregnant women.
  • Strong supervision, independent monitoring and evaluation, and knowledge management to provide timely and effective policy, program, and budgetary action.

International Success Stories

Emergent economies have successfully addressed nutrition challenge:

  • China reduced child undernutrition by more than half (from 25 % to 8 %) between 1990 and 2002
  • Brazil reduced child undernutrition by 60 percent (from 18 % to 7 %) from 1975 to 1989
  • Vietnam reduced child undernutrition by 40 percent (from 45 % to 27 %) between 1990 and 2006.

National Nutrition Strategy

  • Calls for convergence between four proximate determinants of nutrition- uptake of health services, food, drinking water & sanitation and income & livelihoods.
  • Envisages Kuposhan Mukt Bharat - linked to Swachh Bharat and Swasth Bharat.
  • Strategy lays down a roadmap for achieving nutrition objectives.
  • Enables states to make strategic choices, through decentralized planning and local innovation, with accountability for nutrition outcomes.
  • Provides demand and community mobilization to address India՚s nutritional needs.
  • Envisages bringing behavioural change to generate demand for nutrition services.

What is NFHs?

  • The National Family Health Survey (NFHS) is a large-scale, multi-round survey conducted in a representative sample of households throughout India.
  • Collaborative project of the International Institute for Population Sciences (IIPS) - Mumbai, ORC Macro, Calverton, Maryland, USA and the East-West Center, Honolulu, Hawaii, USA.
  • Designated IIPS are the nodal agency responsible for providing coordination and technical guidance for the NFHS.
  • NFHS was funded by the United States Agency for International Development (USAID) with supplementary support from United Nations Children՚s Fund (UNICEF) .

NFHs 1,2, and 3

  • First National Family Health Survey (NFHS-1) was conducted in 1992 - 93 collecting extensive information on population, health, and nutrition, with an emphasis on women and young children.
  • Second National Family Health Survey (NFHS-2) conducted in 1998 - 99 in 26 states with additional focus on the quality of health and family planning services, domestic violence, reproductive health, anemia, the nutrition of women, and the status of women.
  • Third National Family Health Survey (NFHS-3) carried out in 2005 - 2006 in 29 states with additional focus on AIDS funded from National AIDS Control Organization (NACO) and the National AIDS Research Institute (NARI) .

Fourth National Family Health Survey (NFHs-4)

  • Fourth National Family Health Survey (NFHS-4) was conducted in 2014 - 2015 with technical assistance provided by ICF International, USA and major financial support from the United States Agency for International Development and Ministry of Health and Family Welfare.
  • In addition to the 29 states, NFHS-4 includes six union territories for the first time and also provides estimates of most indicators at the district level for all 640 districts in the country as per the 2011 census.
  • NFHS-4 sample size is approximately 568,200 households, up from about 109,000 households in NFHS-3- yielding samples of 625,014 women and 93,065 men.
  • Data will be collected using Computer Assisted Personal Interviewing (CAPI) on mini-notebook computers.

- Published/Last Modified on: October 14, 2017


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