Experts peg community participation, grassroots awareness as key drivers for malnutrition-free India

New Delhi (IANSlife) Bringing into sharp nation-wide focus the indispensable role nutrition plays in the development of not just a child, but communities and the nation at large, September 2020 has been announced as POSHAN Maah, or National Nutrition Month, as a key milestone for ‘Kuposhan-mukt Bharat’ (Malnutrition-free India), across the life cycle. A strong Panchayat-level focus forms a major highlight of this month, tracing the under-nutrition problem to India’s hinterland for a grassroots-up resolution, say experts.

Under the POSHAN Maah 2020, focus areas are early identification, tracking and management of children suffering Severe Acute Malnutrition (SAM), and plantation drives for promotion of POSHAN-Vatika or nutri-gardens.

Children with SAM are at higher risk of mortality if they develop illnesses like diarrhoea, pneumonia, malaria etc. Due to Covid-19, closure of Anganwadi Centres (AWCs) had an acute impact on growth monitoring and promotion activities. The identification of probable children suffering from SAM will entail house-to-house visits by Anganwadi workers, making mothers informed and aware and via other platforms like Village Health Sanitation and Nutrition Day (VHSND), health facilities and hospitals, and Poshan application.

Organising four POSHAN Panchayats with discussion on malnutrition situation within the Panchayat – i.e. status update on detection of SAM children, measures taken for their referral and management, provision of nutrition to them, and required physical, infrastructural and social support for mothers and acknowledgment or appreciation of frontline workers – Triple A’s – Anganwadi Worker (AWW), Accredited Social Health Activist (ASHA), Auxillary Nurse Midwife (ANM) — is one of the key component of the POSHAN Maah.

A unique POSHAN-Vatika initiative includes creating a micro-nutri environment in every village. The space available at AWCs, panchayat area, and vacant lands of village will be used in the cultivation of vegetables, fruits, and important herbs.

According to Rachna Sujay, Senior Technical Advisor, Alive & Thrive, “to improve the health and nutrition status of a gram panchayat, the sarpanch or mukhiya and the PRI members, are the first responders to a large grassroots population.”

She says that adoption of four steps can improve the situation of the gram panchayat and make them ‘suposhit’ (well-nourished). The first is to review the health and nutrition services being provided by all departments especially to pregnant women and infants & young children and provide necessary support and corrective action. The second is community awareness campaign by panchayat leaders on right messages on health and nutrition practices. Third, on-site visits to community based service delivery points by the leader of the Panchayat to ensure everything is in place, and to boost community’s faith into these services. The fourth is how to prioritize, plan and budget health and nutrition activities in the annual Gram Panchayat Development Plans.

Surabhi Jain, chief nutritionist and lactation consultant, Nutriwell India, places breast milk as a boon for infants which protect them from infections and other diseases. Mother’s optimum nutrition status and exclusive breastfeeding for initial six months followed by nutritious complementary feeding helps in decreasing infant mortality and ensuring the infant’s optimal growth and development. Educated and aware mothers and elderly women of the family can play pivotal role in a child’s overall development, she says.

“With regard to complementary feeding, apart from providing nutrient-dense foods under the supplementary nutrition program through Anganwadi centres it is essential that Anganwadi workers promote use of locally available affordable and safe nutrient rich foods to prepare complementary food at home and feeding the child the same in adequate quantity the right number of times.”

Under-nutrition is both a cause as well as consequence of chronic, perpetuating poverty, eroding human capital through irreversible and inter-generational effects on cognitive and physical development. Poor birth weight, stunted development and a lifelong effect on the mind and brain and body, are only some consequences of malnutrition. As per The State of the World’s Children report submitted by UNICEF in 2019, malnutrition is the main reason behind 69 per cent deaths among children below 5 years in India. The best and smart start to life through early initiation of breastfeeding is received by only 42 percent new-borns and only 55 percent are exclusively breastfed for 6 months. Early initiation of breastfeeding is one of the lead interventions which has major impact on reducing neonatal mortality and improving survival and well-being.

For a developing country like India, fighting malnutrition in children is a major challenge, since it has multiple factors associated with it. The primary reasons may include lack of adequate nutrition among the mothers during pregnancy, delayed initiation of breastfeeding, suboptimal exclusive breastfeeding, restricted access to diverse and nutrient-rich food due to social or economic factors, lack of age appropriate complementary feeding of young infants & children, and care giving practices. Other factors which make addressing malnutrition more complex are household food security and diversity, optimum food environment, economic condition of parents, awareness and educational resources access to and availability of reach of health care.

Giving the challenge at-hand due importance, the Government of India in its flagship programme the National Nutrition Mission (‘POSHAN Abhiyaan’) – is working towards improving nutritional status for children, pregnant women and lactating mothers. The Mission was launched in 2018 to make malnutrition-free India a reality. It targets to reduce stunting, under-nutrition, anemia (among young children, women and adolescent girls), and low birth weight. Additionally, the Ministry of Health & Family Welfare has launched ‘Anemia Mukt Bharat’ programme to reduce the prevalence of anaemia among infants, children, adolescents, women of reproductive age, pregnant women and lactating women.

As PM Modi said in his address to the nation in the radio programme Mann Ki Baat, ‘Yatha Annam Tatha Mannam’ – our mental and intellectual development is directly related to the quality of our food intake.

Along with helping India get closer to meeting the national nutrition goals, the POSHAN Abhiyaan makes systemic attempts to break the cycle of impoverishment and help develop a well-nourished, capable citizenry for tomorrow. The POSHAN Maah, a step in this direction, will help in creating digital mobilization across the country for improving health and nutrition indicators.

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