un 23 2014 : The Economic Times (Bangalore)
Why India Eats Badly
Veena S Rao
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For an aspiring global power, India suffers from shocking levels of malnutrition
We must overcome our reservations about private sector cooperation in our campaign against malnutrition, and motivate them to do something
We must overcome our reservations about private sector cooperation in our campaign against malnutrition, and motivate them to do something
T he bad news is that India continues to lead most cou ntries in several malnutri tion and mortality indica tors. The latest UN report places India's maternal mortality as highest in the world at 17% of global maternal mortality . The good news is that the BJP manifesto said that “extreme poverty and malnutrition will be treated as a national priority and will be addressed on mission mode“. This has to be done, because our malnutrition dimensions have now reached a situation of alarm with more than 50% suffering from some form of malnutrition or micronutrient deficiency , resulting in suboptimal cognitive and physical development, low productivity and high health costs.Malnutrition in India is not a woman and child phenomenon, but a population problem. Data of underweight/stunting of children of both sexes, low body mass index and chronic energy deficiency of adolescent girls and boys, and adults, are worrisome, and not what an aspiring world power should have. This demographic emergency should have been addressed through a national programme.
Previous governments have failed to curb this. The Budget speech of 2012 announced a multi-sectoral programme to be rolled out during 2012-13 to address maternal and child malnutrition in 200 high-bur den districts. However, no imple mentation template was sent out to state governments, and I am in formed that this is currently still the subject of discussion in states.
But, wisely , the government real ised that malnutrition needed more than ICDS to cure it, and initiated the policy shift towards the inter sectoral strategy , something that a had been recommended by the Na tional Nutrition Policy , 1993.
We must pick up from this multi sectoral shift and compose a stratet gy that rectifies the disconnect bes tween the causes of malnutrition l and the interventions on offer. Ins dia's under-nutrition is intergenert ational, and rooted not only in pov erty and the lack of balance between y calories, proteins and micronu trients, but also lack of information e and gender inequity .
e The present interventions do not address structural and systemic causes of India's malnutrition; they are inadequate with poor coverage, n and riddled with gaps. This is why l their impact has been suboptimal.
d Start at the Block The unit for inter-sectoral intervena tions should be the block, and not the district, as the former is more h compact and homogeneous, making it easier to engineer “convergence“.
The minimum, basic inter-sectoral e convergence requires that every tar geted family must receive simultas neously benefits of calorie-proteind micronutrient supplementation, full immunisation of children, IFA for addressing anaemia, safe drink ing water and hygienic sanitation.
Actual convergence must happen l at the community level; its success g can be tested through monitoring d how many families in a village have t simultaneously received these five c benefits, four of which are ongoing y government programmes. Gender e, equity and female literacy , also bacy ked by national programmes, are in direct interventions that result in improved nutritional status, throu gh late marriage, fewer children and better awareness.
t But who will ensure and monitor e this convergence at the community g level? Regardless of government “. orders and advisories from above, l there must be one functionary in reach village who should be given reasponsibility to ensure this. Present ly, there is no one, and we have no , data about how many households A have received the complete package of their benefits.
n Let Private Players in s We must also overcome our reserva g tions about private sector coopera e tion in our campaign against mal nutrition, and motivate them to assume some responsibility . Maybe companies could make available ap propriate low-cost energy foods for poor and malnourished children, women, adolescent girls and boys, the sick, aged and infirm, in rural and urban markets. There is a huge market vacuum in this respect, which has been filled by forcefully advertised low-cost junk food and tobacco products.
Just Do It India has a sound National Nutrition Policy, 1993, which requires a little updating and lots of implementation. On its recommendation, the National Nutrition Council headed by the Prime Minister was constituted in 1994. This council never met, and after much criticism, was replaced by the PM's Committee on Nutrition Challenges in 2008.
The terms of this panel were limited to providing policy direction and reviewing nutrition programmes, without any mandate for fresh strategies for specifically reducing malnutrition.
The new government could begin by revisiting the committee's composition and mandate, and tasking it with the responsibility of drawing up its blueprint for addressing malnutrition in mission mode.
The writer is a former secretary to the government of India
Previous governments have failed to curb this. The Budget speech of 2012 announced a multi-sectoral programme to be rolled out during 2012-13 to address maternal and child malnutrition in 200 high-bur den districts. However, no imple mentation template was sent out to state governments, and I am in formed that this is currently still the subject of discussion in states.
But, wisely , the government real ised that malnutrition needed more than ICDS to cure it, and initiated the policy shift towards the inter sectoral strategy , something that a had been recommended by the Na tional Nutrition Policy , 1993.
We must pick up from this multi sectoral shift and compose a stratet gy that rectifies the disconnect bes tween the causes of malnutrition l and the interventions on offer. Ins dia's under-nutrition is intergenert ational, and rooted not only in pov erty and the lack of balance between y calories, proteins and micronu trients, but also lack of information e and gender inequity .
e The present interventions do not address structural and systemic causes of India's malnutrition; they are inadequate with poor coverage, n and riddled with gaps. This is why l their impact has been suboptimal.
d Start at the Block The unit for inter-sectoral intervena tions should be the block, and not the district, as the former is more h compact and homogeneous, making it easier to engineer “convergence“.
The minimum, basic inter-sectoral e convergence requires that every tar geted family must receive simultas neously benefits of calorie-proteind micronutrient supplementation, full immunisation of children, IFA for addressing anaemia, safe drink ing water and hygienic sanitation.
Actual convergence must happen l at the community level; its success g can be tested through monitoring d how many families in a village have t simultaneously received these five c benefits, four of which are ongoing y government programmes. Gender e, equity and female literacy , also bacy ked by national programmes, are in direct interventions that result in improved nutritional status, throu gh late marriage, fewer children and better awareness.
t But who will ensure and monitor e this convergence at the community g level? Regardless of government “. orders and advisories from above, l there must be one functionary in reach village who should be given reasponsibility to ensure this. Present ly, there is no one, and we have no , data about how many households A have received the complete package of their benefits.
n Let Private Players in s We must also overcome our reserva g tions about private sector coopera e tion in our campaign against mal nutrition, and motivate them to assume some responsibility . Maybe companies could make available ap propriate low-cost energy foods for poor and malnourished children, women, adolescent girls and boys, the sick, aged and infirm, in rural and urban markets. There is a huge market vacuum in this respect, which has been filled by forcefully advertised low-cost junk food and tobacco products.
Just Do It India has a sound National Nutrition Policy, 1993, which requires a little updating and lots of implementation. On its recommendation, the National Nutrition Council headed by the Prime Minister was constituted in 1994. This council never met, and after much criticism, was replaced by the PM's Committee on Nutrition Challenges in 2008.
The terms of this panel were limited to providing policy direction and reviewing nutrition programmes, without any mandate for fresh strategies for specifically reducing malnutrition.
The new government could begin by revisiting the committee's composition and mandate, and tasking it with the responsibility of drawing up its blueprint for addressing malnutrition in mission mode.
The writer is a former secretary to the government of India
