• Malnutrition, in all its forms, includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related noncommunicable diseases.
• It is a chronic problem and a longstanding challenge for the public administration of India.

Malnutrition – Consequences

1. Affects the productivity of the population
2. Affects the country’s mortality rates
3. Affects the survival rate of children
4. Affects the learning capability of children, making them unproductive in their later life.

Reasons for malnutrition in India

• Poverty: It is the main reason behind the lack of adequate nutritional food which results in malnutrition.
• Social inequality: For example, girl children are more likely to be malnourished than boys. Similarly the low-caste children are more likely to be malnourished than upper-caste children.
• Sanitation:
• Most children in rural areas and urban slums still lack sanitation. This makes them vulnerable to the kinds of chronic intestinal diseases that prevent bodies from making good use of nutrients in food, and they become malnourished.
• Lack of sanitation and clean drinking water are the reasons high levels of malnutrition persists in India despite improvement in foodavailability.
• Lack of diversified food:
• With the increase in diversity in food intake malnutrition (stunted/underweight) status declines.
• Only 12% of children are likely to be stunted and underweight in areas where diversity in food intake is high, while around 50% children are stunted if they consume less thanthree food items.
• Lack of food security:
• The dismal health of Indian women and children is primarily due to lack of food security.
• Nearly one-third of adults in the country have a Body Mass Index (BMI) below normal just because they do not have enough food to eat.
• Failure of government approaches:
• Although India already has following two robust national programmes addressing malnutrition but these are yet to reach enough people:
• Integrated Child Development Service (ICDS) and
• The National Health Mission

Measures to reduce Malnutrition

• There is a greater need now to increase investment in women and children’s health and nutrition to ensure their sustainable development and improved quality of life. While the Government’s focus has been on the consolidation of several programmes to improve outcomes, there is a need for increased financial commitment.
• India must adopt an outcome-oriented approach on nutrition programmes. It is crucial that MPs/MLAs begin monitoring needs and interventions in their constituencies and raise awareness on the issues, impact, and solutions to address the challenges at the local level.
• There has to be
• direct engagement with nutritionally vulnerable groups (this includes the elderly, pregnant women, those with special needs and young children), and
• contribute toward ensuring last-mile delivery of key nutrition services and interventions.
• With basic education and general awareness, every individual is informed, takes initiatives at the personal level and can become an agent of change.
• Various studies highlight a strong link between mothers’ education and improved access and compliance with nutrition interventions among children.
• We must ensure our young population has a competitive advantage; nutrition and health are foundational to that outcome.

Steps taken by Government for nutritional enhancement

• POSHAN Abhiyaan or National Nutrition Mission: It is Government of India’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers.
• Under it the Anemia Mukt Bharat (AMB) Strategy was launched in 2018 with efforts to improve Iron and Folic Acid (IFA) supplementation, behaviour change and anaemia-related care and treatment across six target groups including pregnant women, lactating mothers, and children.
• Integrated Child Development Scheme (ICDS): It aims to improve the nutritional and health status of children in the age-group 0-6 years and reduce the incidence of mortality, morbidity, malnutrition and school dropout.
• Public Distribution System: It provides coverage to upto 75% of rural population and upto 50% of urban population for receiving highly subsidized food grains under Targeted Public Distribution System.
• Midday meal scheme: The scheme provides meals for all school children studying in Classes I-VIII of Government, Government-Aided Schools.

Road ahead

• There should be a process to monitor and evaluate programmes and address systemic and on the ground challenges.
• A new or existing committee or the relevant standing committees meet and deliberate over effective policy decisions, monitor the implementation of schemes, and review nutritional status across States.
• The country’s response to malnutrition and its growing anaemia burden should be practical and innovative. This is critical to make an India that is malnutrition-free and anaemia-free a reality, and not just an aspiration. Every one is a stakeholder and should contribute towards ending malnutrition and anaemia. We should not become part of a tragedy that is preventable.