Poshan Maah 2020: What Has Been The Impact Of COVID-19 Pandemic On India’s Malnutrition Targets

New Delhi: “COVID has been the worst time of my life..I have seen many struggles but this one by far has been the worst one. There was a time, when we had nothing to eat, we couldn’t go out to get food nor there was any delivery of the ration. I have two children – one is 3 1/2 year old and the other one is 5 months, because of coronavirus, I couldn’t get the proper vaccination done for my small one and the older one couldn’t go to the anganwadi centre where her nutrition was taken care of through mid-day meal. I have seen both my children shedding weight in six months of time, there was a time, 3 out of 5 members at our home were unwell because of lack of food. Both my children are very weak now and it is very very hard to see them like that,” says Aarti Hasda from one of the zillas from Jharkhand who is living with her husband and mother-in-law.

Also Read: Poshan Maah 2020: How Indira Didi, An Anganwadi Worker Is Braving All Odds Amid Coronavirus To Keep Her Village Healthy

Aarti’s children are not alone. It is  a real fear for the roughly 77 million undernourished children in India, according to the last edition of the  National Family Health Survey (NFHS) – 4, done in 2015-16, which concluded that every second child in India suffers from at least one form of nutrition failure. It might be stunting, wasting or being underweight, the survey found India has children who are 38.4 per cent stunted, 35.8 per cent underweight, 21 per cent wasted, and 7.5 per cent severely wasted. And in the last decade, severe acute malnutrition has increased from 6.4 per cent (NFHS-3, 2005-06) to 7.5 per cent (NFHS -4, 2015-16) in India. While the malnutrition has always remained a silent killer in the country and a major health issue, it has become more pronounced during the coronavirus outbreak this year.

As India observes September as Poshan Maah or Nutrition Month to strengthen the nutritional goals for the country and make India free from Malnutrition by 2025, we speak with experts to understand the impact of coronavirus pandemic on India’s nutritional goals and malnutrition targets.

Also Read: Poshan Maah: Focus On Identifying Acutely Malnourished Children, Planting Nutri Gardens, Says Government To States

What Are India’s Goals Under The Poshan Abhiyan 

To strengthen India’s nutritional targets and eradicate malnutrition from the country, the government introduceD a flagship initiative Poshan Abhiyan in 2018. The aim of the programme is to reduce stunting, underweight, and low birth weight, by 2 per cent every year; and anaemia among young children, adolescents and women each by 3 per cent per year until 2022. A special target for stunting is set at 25 per cent by the year 2022, according to Ministry of Women and Child Development under which Poshan Abhiyan was introduced.

Also Read: National Nutrition Month 2020: How These Initiatives Are Helping India Eat Nutritious Food Amid Coronavirus Crisis

Will India Be Able To Achieve Malnutrition Goals Amid Coronavirus Pandemic?

Speaking to NDTV about the impact of the pandemic on Nutritional targets in India, Basanta Kumar Kar, Recipient of 2019 Global Nutrition Leadership Award also known as Nutrition Man of India said,

Like all other disasters and emergencies, this pandemic with invisible virus has compounded the vulnerability and uncertainty. It is likely to further compound the nutrition vulnerability specifically among the women and children and migrants who are hardest hit.

Talking about how pandemic has made accessing basic nutrition a big problem, Mr Kar added,

The first one thousand days of life is key and critical and it is the first window of opportunity. The future generation growing in the womb need special care and attention. They need a new life and new world. With disruption of services and supplies, pregnant women and lactating mothers are finding difficulties in accessing and consuming safe and nutritious foods, care, support, nutrition services and supplies.

Expressing that it looks hard for India to meet the required malnutrition or nutrition targets such as reducing stunting, wasting, anaemia, low birth weight, Mr Kar further added,

As per National Family Health Survey (NFHS) – 4, only 21 per cent women used to receive full Antenatal Care (ANC), 1 dosage of iron folic acid tablets, 60 per cent of children aged 6-59 months were given Vitamin A supplementation and 9.6 per cent Children aged 6-23 months used to receive adequate diet. The lockdown and closure of Anganwadi centers affected access to key nutrition supplies and services. There are reported cases of poor bed occupancy in the Nutrition Rehabilitation Centres (NRCs) due to movement restrictions thus affecting the lives of Severely Affected Malnourished (SAM) children. In the times like these the resources are already stretched to meet basic public health and nutrition needs become scarcer. The worst affected are pregnant and lactating mothers, adolescents, and children who may be anaemic, malnourished, needing additional nutrition, special care, support and institutional rehabilitation.

Even UNICEF’s India Chief for Nutrition, Arjan De Wagt cautions about the ill-effects of the pandemic on country’s health. He said,

Increase in joblessness and poverty due to the pandemic will lead to a rise in hunger as well as malnutrition in the country. When poverty will increase, it will automatically result in food insecurity. Which means that many people will not have the money to buy food and will not be able to afford nutritious food. Another thing that we are worried about is the impact of COVID-19 on the services that were stopped during the lockdown. Even after the lockdown, which has been lifted in many parts of the country,  we saw that the immunisation rates are still not back to what they were before the COVID times. And then of course is the fact that the frontline workers and authorities  are busy trying to deal with COVID and identify people with COVID and helping them, in such a situation, importance on other subjects such as nutrition interventions is ignored.

Also Read: “Nutrition Is More Than food, More Than Hunger,” UNICEF India’s Arjan De Wagt Talks About The Impact Of COVID-19 On Poshan Abhiyan 

Talking about the nutritional targets for India, Mr Wagt added,

We are really worried that some of the progress made in the last 2 and a half years in respect to the nutrition and malnutrition in India, may be lost due to COVID. I am a big fan of the Poshan Maah initiative in India, but I always say that India needs 12 Poshan Maah, it needs to celebrate nutrition month not just in September but throughout the year, one is not enough.

On the other hand, talking about the day-to-day situation and how COVID-19 has changed that thereby affecting life in general, which can affect Nutrition and Malnutrition target for the country, Raghwesh Ranjan, Director, Social and Economic Empowerment, IPE Global, an international development consultancy group providing expert technical assistance in developing countries, said,

There are some of the early signs that we are seeing due to COVID-19 pandemic there might be a delay in meeting the nutritional targets that India has set for itself. The first connect is that since the schools are shut across the country, there are chances that many girls will not come back to schools, which also means that they will be married off early and therefore get into the whole process of frequent and early pregnancies. This in turn will affect their ability to deliver normal weight babies and under the national nutrition mission, reduction of low-weight babies is an important target. Secondly, there is an issue with access of nutritious food as lot of people still have poor access to social security and public entitled programmes, so overall it can have a potential impact on nutritional targets for the country.

Sharing examples of Rajasthan and Odisha and how these states are tackling the issue of nutrition and why there should be more states doing the same, especially during these unprecedented times, Mr Ranjan added,

COVID will impact nutrition or health of India, but the problem is that no-one knows how much it will impact as currently no one has the answer till when the pandemic will go on. At such a juncture, what is important is that all the states in India should come together and unite in the fight against malnutrition and help the country become swasth or healthy and not completely forget about such issues in the wake of the pandemic. What Rajasthan has done is something I would like the other states to follow – the state is giving a mix of dry-ration, which is basically a high-protein combination to its pregnant women and their families. The packet has 1kg of dal, 500 grams of ground nut, half a litre of oil and 100 grams of sesame seeds. The combination is what I would suggest other states should focus on – it should be a mix of all important nutrients instead of something which will be only good for making a halwa or khichadi. Secondly, I think all the states should have separate nutrition budget just like Odisha, which is currently the only state that has a separate nutrition budget. Moreover, it is the only state that has a nutrition action plan under which it allows 15 departments in the state to come together and tackle one issue of nutrition, it is also being monitored by top bureaucrats and health experts. Both these states were once known as the BIMARU states of India but due to such developments, these states have come out from that parameter, I think now other states should start replicating the nutritional learnings from these states and fight for good health.

Also Read: Gujarat NGO Helps Distressed Families Grow Kitchen Gardens During COVID-19 Pandemic To Improve Their Nutritional Well-Being

To get a picture of on-ground reality of nutrition and its impact on children’s health, NDTV also spoke with Sudarshan Suchi, Secretary General SOS Children’s Villages of India, an organisation working towards providing opportunities for young children and local communities across the country. Mr Suchi said,

The whole system of Nutrition is designed in our country in a way thinking that the picture on-ground is perfect.

Giving an example, Mr Suchi said,

The government has a programme for free treatment for severely malnourished children in India, but if a child is suffering from malnutrition to take him to the nearby institution where he can get checked, the parents will have to for one day leave work, which means they will have to say goodbye to one day’s wage, then there is also the transport cost attached to it to take the child to the institution. It is not that they will be located near every house. Now on book the solution seems perfect, but practically in rural areas, no one will have the luxury to lose their daily wages. Secondly, the question arises, the government has a policy to treat the severely acute malnourished children and  moderately acute malnourished children in the government centres for several days, even if the parents get their child treated for days there, after getting treated the child is going back to the household which has certain amount of income, he or she might not be able to receive nutritious food at home, So, how are we tackling and bridging that gap. It is these scenarios that makes achieving the nutritional goals hard for our country.

Key Findings Of Some Of The Recent Studies Done To Understand Impact Of COVID On India’s Health

There have been many studies and survey done in past few months that highlight how the spread of novel coronavirus-led pandemic has left many in India hungry and deprived of food and good nutrition, as the income of families income have fallen drastically. According to Centre For Science And Environment large-scale survey of around 5000 respondents across 12 states of India to study the impact of COVID-19 pandemic containment measures (lockdown) on employment, livelihoods, food security and access to relief measures, it was found that there has been a massive increase in unemployment, an equally dramatic fall in earnings among informal workers, large increases in food insecurity, depletion of savings and patchy coverage of relief measures. The survey found that almost eighty percent or 8 in 10 people are now eating less food than before.

A very recent phone survey which was done for 115 households across Uttar Pradesh, Jharkhand, Chhattisgarh, Odisha, Madhya Pradesh, Gujarat and Himachal Pradesh also showed a similar trend. According to the survey the “Jaccha-Baccha Survey” which was conducted under the guidance of development economists Reetika Khera and Jean Dreze ON about the impact of the lockdown and to examine the impact of two major relief measures announced by the Centre on March 26, about 68 per cent households are skipping their meals as their income has fallen since lockdown.

Apart from the surveys,  a study published in journal Global Health Science on July 16, 2020 highlighted that the nationwide lockdown done to curb the spread of the novel coronavirus disease is contributing to food shocks and, in turn is increasing the chances of malnutrition in India.  The study pointed out that five million children are at risk of falling in the wasting category of malnourishment, while an additional two million children are at risk of being pushed into the severe wasting category due to the pandemic.

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.