New Delhi: Although Jan Andolan is an important part of National Nutrition Mission (NNM) since its launch in 2018, the issue of nutrition does not seem to be catching fire among actors in politics, government, media, civil society orgnisations and others as it catches in the belly of a malnourished child or mother or any other adult. The 46 million undernourished children in India are screaming to seek attention of the decision makers but it does not seem making enough sound to get quick and sincere attention.
According to Lancet, of the 10.4 lakh under-5 deaths in India in 2017, as many as 7, 06,000 deaths could be attributed to malnutrition. The burden of malnutrition is as high as 31% of the global burden and the progress is too slow. The 2nd report released by NITI Aayog on Sustainable Development Goals (SDGs) in December 2019 indicates that India has scored lowest in SDG 2 (nutrition and zero hunger): 35 and the highest score was achieved in SDG 6 (clean water and sanitation): 88. To understand how fundamental the nutrition is for development; it is important to mention that 12 of the 17 SDGs contain indicators related to nutrition.
Recently published World Nutrition Report 2020 finds that India is one among those 88 countries who are not on track for any of the WHA (World Health Assembly) nutrition target set for 2025. Six WHA Targets focuses on stunting, anemia, low birth weight, childhood overweight, breastfeeding and wasting. This situation prevails despite NITI Aayog is directly overseeing the progress of NNM and apprising Prime Minister on the progress every six months We have gone far off the track after the situation deteriorated due to COVID-19.
As per a report published in the journal New Scientist, 115 million Indian children, who were dependent on Mid-day meal scheme for their daily dietary requirements, are on the verge of malnourishment due to prolonged school closure due to Covid-19. As per the estimates of Standing for Nutrition Consortium, the potential, as published in The Lancet, the global prevalence of child wasting – lower weight for height- in 2020 could rise by 14.3%, adding an additional 6.7 million children under the age of five due to pandemic resulting in to disruption of food systems and impeded access to healthcare services,
The major question is why nutrition is not becoming a lucrative proposition for political entrepreneurs and decision makers despite malnutrition being big burden causing high economic cost of nearly 3000 billion of rupees every year to the country even though the return on investment is 18 times, more than any other sector. Can Poshan Abhiyan can get similar attention as of Swachch Bharat Mission (SBM) which changed the profile of sanitation in an exemplary way? Can the country write similar story in nutrition as well?
It is evident from operationalization of Swachh Bharat Mission that political commitment of present central government has been the most important part of the solution to a sustained and operational political commitment. It also reflected on the part of state and local government as they were engaged closely in the process and taken in to confidence. The Prime Minister made it a movement for everyone. The budget allocation also reflects this as for NNM, which aims to bring down malnutrition rate in India, has been Rs. 3,700 Crores where as for SBM, allocation made is Rs. 12644 Crores for financial year 2020-21.
Working for galvanizing this political commitment should be of prime importance for different actors in the field of nutrition. State governments need to be taken into confidence to give adequate focus to the issue of nutrition especially with the states having high burden of malnutrition. This can happen through close and sustained engagement with the States. Like SBM, the governance flowing through the channel of Prime Minister (PM) – Chief Minister (CM) – District Magistrate (DM) and Village Monitor (VM) can very well fit in NNM as well.
For long, we have seen that nutritional strategy in India have been largely implemented by one single route of Integrated Child Development Services (ICDS) programme for nearly 25 years till the launch Mid-day meal scheme (MDMS) was introduced in schools in 2001. Nutrition, having several sectors attached to it, requires high level of convergence with programmes of food, agriculture, health, sanitation, gender and several others.
We know because of various social, cultural and biological reasons, malnutrition impacts girls and women the most. This further generates negative consequences on status of nutrition and thus designing gender responsive programmes considering gender gaps would be highly effective.
How good it would be to hear messages on nutrition along with sanitation through vehicles that run for garbage collection as nutrition was brought to Village Health, Sanitation and Nutrition Day (VHSND). Although the Poshan Abhiyan has considered convergence as one of the key components to ensure that nutrition related programmes complement each other when reach to the households, it has to take proactive steps for making it effective and for that an exclusive institutional home to take complete charge and made accountable for all the coordination and facilitating convergence might be a good strategy.
Budgeting depends lot on the factors such as political prioritization and the bargaining power of different line departments. The significance of budgeting adequately and appropriately for nutrition interventions needs more emphasis and it can happen easily if people in powerful positions embrace the issue of nutrition as Prime Minister given Midas touch to the issue of sanitation. Certainly collaborations of parliamentarians, bureaucrats, academics, international agencies, civil society representatives, media, and corporates with community would be vital for raising coherent voices in every corner and taking convergent actions till it becomes a Jan Andolan for everyone.
(Sanjay Sharma, Deputy Director, Save the Children & Om Arya, Advocacy Manager, Save the Children)
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NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.