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Opinion: Nutrition Is An Issue Of National Interest And Deserves Prioritisation Beyond The Central Level

The findings of phase 1 of the National Family Health Survey-5 may not be confused as indicators of the progress on ongoing interventions commissioned under POSHAN Abhiyaan and Anemia Mukt Bharat, writes Priyanka Bajaj, Nutrition Expert, WeCan

Opinion: Nutrition Is An Issue Of National Interest And Deserves Prioritisation Beyond The Central Level

The National Family Health Survey (NFHS-5) report has been much awaited by the health and nutrition fraternity. Rightly so, as the report aids in tracking progress made on the goals of various national programmes as well as the sustainable development goals. Phase I of the survey gives an overview of 22 states and union territories (UTs). However, a complete picture of health and nutrition status in India will only emerge after the Phase II data becomes available.

Also Read: Policy Makers Need To Focus On The First 1,000 Days Of Life: Experts React To NFHS-5 Survey Trends

While experts are deliberating on the report, a key point to be considered is that the survey findings may not be confused as indicators of the progress on ongoing interventions commissioned under the National Nutrition Mission, that is POSHAN Abhiyaan and Anemia Mukt Bharat. It is prudent to recognise that the data collection for NFHS-5 was done at a time when the states were just launching these programmes. Though the NFHS-5 report does not reflect on the progress of interventions being delivered under the umbrella of POHSAN Abhiyaan, what it does highlight is to achieve the envisaged targets is an uphill task and requires intensive work at all levels of administration.

Also Read: How Haryana Is Fighting Anaemia And Improving Its Score Under Anaemia Mukt Bharat Campaign

Progress has been made across various health indicators such as infant mortality rate, antenatal care, and immunisation. However, undernutrition and overnutrition among under-five children, breastfeeding and anemia have once again emerged as pain points. The data collected from 14 remaining states and UTs in phase II might reveal a more dire picture as COVID -19 has impacted health and nutrition service delivery across India.

The majority of the states have shown a substantial increase in the prevalence of anemia among children under-five and women of reproductive age. Even the states which have been performing well in past such as Kerala and Goa have not shown improvements. We do have a lesson here, and a crystal clear one anaemia and undernutrition prevalence can only be tackled if all aspects of the Anemia Control Programme and POSHAN Abhiyaan are implemented with precision.

Also Read: Anaemia Continues To Rise Among Women Of Childbearing Age And Children In The Country, Shows Fifth National Family Health Survey

Looking across the spectrum, there are piece meal success stories. It is evident that while states are taking actions to combat anaemia, unfortunately, it is not comprehensive. States are either addressing issues on supply-side or the demand side. However, available data and learnings show that to tackle anaemia, states need to have a glitch free supply chain of iron and folic acid, robust monitoring systems for course correction, intensive demand generation, and awareness campaigns, and a system which is accountable at multiple levels. In addition to these initiatives, large scale food fortification of staples supported by private players needs to become a ground reality.

Also Read: Pros And Cons Of Food Fortification, An Effective Way To Address Micronutrient Deficiency

Breastfeeding indeed is a priority at the national level yet the survey evidently shows gaps as well as advancements. Both early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) for the first six months are a must to ensure a healthy childhood and adulthood. Gujarat, Karnataka, and Maharashtra have shown improvement in EBF rates, but a majority of the states have shown a decline in the rates of EIBF.

With significant improvement in the rates of institutional deliveries, EIBF is a low hanging fruit. However, there is a catch. What further needs to be analysed is whether EIBF is a challenge in the private or public sector. Probably, it would be appropriate to identify where the challenges lie and accordingly take corrective actions. It has been globally recognised that counselling pregnant women in their last trimester about the benefits of EIBF is key to prepare the mother, an area where extensive work still needs to be done to improve the outcomes.

Also Read: Early Initiation Of Breastfeeding Declines In 12 States And Union Territories, Reveals NFHS-5 Report

When it comes to malnutrition, there is a silver lining with approximately 5 per cent reduction in stunting that is low height for age among under-five children in Bihar. However, the picture is undeniably alarming in other states. On the other end, there is a spike in the rates of overweight among children in 20 states. This is indeed a paradox. Programmatic investments have already been made to tackle undernutrition, it is time that even overweight, obesity and non-communicable diseases are taken up as a priority in both facility-based and community-based programmes.

Flood-prone states like Bihar and Assam have seen a rise in the prevalence of diarrhoea, especially in rural areas. Studies show a correlation between poor sanitation and undernutrition. It is crucial to bring in a systems approach to see that progress on all other fronts to sustain progress on the nutrition front. The simple message is, do not let the guard down.

Also Read: There Has Been Drastic Rise In Obesity Among Children Under 5-Years In 20 States, Reveals NFHS 5 Report

Iodine deficiency disorders control programme has been the most successful public health program in India, yet this survey shows nearly 10 per cent decline in the household use of iodized salt in Meghalaya. The survey also does not answer if the salt being used is adequately iodised. This calls for a deep dive into the issue with a focus on the quality along with coverage.

Lastly, let’s talk about the elephant in the room. Health services have improved at large, including immunisation, mother, and child health services to name a few. Regrettably, most interventions that have not shown desired outcomes are the indicators for which interventions are being delivered through multiple channels, involving more than one department or ministry. Nutrition is a cross-cutting subject, efforts will have to be multidimensional and if that is done well, outcomes will positively contribute to the wellbeing and progress of the country. It is high time to acknowledge that nutrition is an issue of national interest and deserves prioritization beyond the central level.

Also Read: Top Highlights Of NFHS-5 Report: Malnutrition And Anaemia Have Increased In The State Of Gujarat Since 2015

(Priyanka Bajaj is a Nutrition Expert at WeCan, a nutrition coalition.)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

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 (WaterSanitation 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 pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

23,96,06,768Cases
20,13,42,617Active
3,33,82,100Recovered
48,82,051Deaths
Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 23,96,06,768 and 48,82,051 have died; 20,13,42,617 are active cases and 3,33,82,100 have recovered as on October 15, 2021 at 4:15 am.

India

3,40,37,592 16,862Cases
2,03,6782,908Active
3,33,82,100 19,391Recovered
4,51,814 379Deaths
In India, there are 3,40,37,592 confirmed cases including 4,51,814 deaths. The number of active cases is 2,03,678 and 3,33,82,100 have recovered as on October 15, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

65,86,280 2,384

33,157 6

64,13,418 2,343

1,39,705 35

Kerala

48,29,944 9,246

96,421 1,802

47,06,856 10,952

26,667 96

Karnataka

29,82,399 310

9,607 43

29,34,870 347

37,922 6

Tamil Nadu

26,83,396 1,259

15,451 199

26,32,092 1,438

35,853 20

Andhra Pradesh

20,59,122 540

6,588 27

20,38,248 557

14,286 10

Uttar Pradesh

17,10,008 12

135 4

16,86,976 16

22,897

West Bengal

15,79,012 530

7,576 81

15,52,491 601

18,945 10

Delhi

14,39,311 28

337 1

14,13,885 29

25,089

Odisha

10,33,809 521

4,890 38

10,20,645 477

8,274 6

Chhattisgarh

10,05,614 16

203 4

9,91,841 20

13,570

Rajasthan

9,54,382 8

42 6

9,45,386 2

8,954

Gujarat

8,26,244 34

215 20

8,15,943 14

10,086

Madhya Pradesh

7,92,669 12

111 1

7,82,035 11

10,523

Haryana

7,71,035 16

105 158

7,60,881

10,049 174

Bihar

7,26,016 8

42 6

7,16,313 2

9,661

Telangana

6,68,618 168

4,171 40

6,60,512 207

3,935 1

Assam

6,05,847 207

3,646 157

5,96,263 362

5,938 2

Punjab

6,01,971 33

234 11

5,85,199 16

16,538 6

Jharkhand

3,48,406 11

130 4

3,43,141 7

5,135

Uttarakhand

3,43,729 28

175 22

3,36,157 6

7,397

Jammu And Kashmir

3,30,834 93

935 11

3,25,473 104

4,426

Himachal Pradesh

2,21,113 182

1,387 5

2,16,011 173

3,715 4

Goa

1,77,356 68

679 27

1,73,342 39

3,335 2

Puducherry

1,27,259 49

647 4

1,24,763 53

1,849

Manipur

1,22,432 69

1,444 15

1,19,099 84

1,889

Mizoram

1,10,719 901

13,601 435

96,744 1,332

374 4

Tripura

84,295 4

110 8

83,369 12

816

Meghalaya

82,734 87

892 31

80,411 115

1,431 3

Chandigarh

65,295 10

32 5

64,443 15

820

Arunachal Pradesh

54,958 4

202 22

54,476 26

280

Sikkim

31,722 6

224 1

31,108 7

390

Nagaland

31,516 9

230 8

30,613 17

673

Ladakh

20,867 6

44 2

20,615 4

208

Dadra And Nagar Haveli

10,675

3 1

10,668 1

4

Lakshadweep

10,365

2 0

10,312

51

Andaman And Nicobar Islands

7,640 3

10 1

7,501 2

129

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