Stepping up nutrition

Stepping into a new decade, India is also taking with it the heavy burden of rampant malnutrition. Although the nation has scaled remarkable heights of developments in the past decades and has accomplished the feat of having a 50 per cent increase in the Gross Domestic Product since 1991, it is in spite of such achievements that more than one third of the world's malnourished children live in India—about half of whom are under the age of three years old and underweight. In contrast to this, one-third of the wealthiest children happen to be over-nutriented. The government has taken requisite steps to address the situation but it is in the implementation of these measures that any result may be expected. As matters are reported to stand, except for three states, none of the state governments used even half of the sum allocated for the nutrition programme. The State governments and the Union Territories have so far utilised merely 30 per cent of the funds released under the Poshan Abhiyaan—the National Nutrition Mission, since it was launched in 2017. The Union Territory of Lakshadweep, Mizoram, Himachal Pradesh and Bihar are the exceptions and besides these, as per an analysis of the data shared in Parliament, none of the governments used even half of the sum granted in the past three years. The Poshan Abhiyaan in the Central government's flagship programme aimed at improving nutritional outcomes among pregnant women, lactating mothers, and children by reducing the level of stunting, underweight, anaemia and low birth weight by 2022. Seeking to benefit more than 10 crore people, this scheme was launched after a Cabinet decision on December 1, 2017, with a total budget of Rs 9,046.17 crore for three years, 50 per cent of which is through budgetary support, which 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 per cent for the Union Territories without legislature. The remaining 50 per cent of its budget comes from the World Bank or other multilateral development banks. Consequently, the Centre's total share is at Rs 2,849.54 crore. At the end of three years, a close analysis of the funds utilised paints a grim picture. A total of Rs 4,283 crore was disbursed by the Centre to different States and Union Territories, of which, Rs 1,283.89 crore was utilised until October 31, 2019—which amounts to only 29.97 per cent of the funds granted.

It has been established time and again that a major cause of malnutrition in this country is economic inequality. Social status of groups of people affects their diet in terms of both quality and quantity. Women suffering from malnutrition are less likely to have healthy babies. This very information contains the means to resolve this serious problem impeding India's prosperity. Researches have concluded that malnutrition at the time of pregnancy causes the child to have increased risk of future diseases, physical retardation, and reduced cognitive abilities. With respect to the programme, during 2019-20, funds were released for 19 States and 12 of them had used less than a third of the funds released in the previous two years. The programme was conceptualised to be implemented in phases. So, a steady increase in the utilisation of funds over the years may be expected. But it is in fact the rate of increase that is more of an indicator of matters materialising favourably. Associated activities such as the Integrated Child Development Services-Common Application Software meant to monitor anganwadis have been picking up steadily but given the targets, it remains to be seen how these activities translate into outcomes of consequence. According to the CNNS released by the Ministry of Health and Welfare in October, 35 per cent of children under the age of 5 are stunted and in this age group, 17 per cent are wasted (low weight for height) and 33 per cent underweight (low weight for age). Malnutrition is the cause of two-thirds of child deaths in India. The ministry recently collaborated with Bill Gates, co-chair of the Bill and Melinda Gates Foundation (BMGF) to launch the Bharatiya Poshan Krishi Kosh, which will be a repository of diverse crops across 128 agro-climatic zones in India for better nutritional outcomes. At the behest of the ministry, the Harvard TH Chan School of Public Health through its India Research Centre and BMGF will document and evaluate promising regional dietary practices, and develop a food atlas on regional agro-food systems. On the Global Hunger Index, India stands 67 among the 80 nations having the worst hunger situation which is worse than nations such as North Korea or Sudan. 25 per cent of all hungry people worldwide live in India. Decades following 90's have seen some improvement for children but the proportion of hungry in the population has only increased. 44 per cent children under age 5 are underweight, 72 per cent of infants and 52 per cent of married women are anaemic—indicating nutritional deficiency that is shown to have an impact beyond one's bodily functions and has affected societies and their economic statuses. The vicious cycle of malnutrition begins with a malnourished mother, making her unborn child more susceptible to the dangers of nutritional deficiency and permanent disorders as the lack of proper nutrition among children affects not only the physical development of the child growing into adulthood but also affects brain development. It goes without saying that addressing the problem ofmalnutrition effectively will have substantial long-term impacts that will valuably contribute to a healthier nation in many ways.