State Of Nutrition In States: NITI Aayog's Numbers Reveal India Is Losing The Battle Against Anaemia

Government think tank NITI Aayog, in a joint effort with International Food Policy Research Institute (IFPRI), Indian Institute of Population Sciences (IIPS), UNICEF and Institute of Economic Growth (IEG) launched ‘The State Nutrition Profiles’ for 19 states and Union territories on 30 September 2021.

Back in 2017, NITI Aayog published the National Health Strategy, which laid out a mission 2022 “Kuposhan Mukt Bharat”. The strategy had two objectives:

1. three-point percentage/year reduction in underweight prevalence in children (0-3 years) by 2022 from NFHS-4 levels

2. 33 per cent reduction in anaemia in children, adolescent and Women of Reproductive Age (WRA)

The recently released data factsheet, published on the last day of September, or Poshan Maah, compares the improvements in state performances under various health parameters. The factsheet shows mixed results — some states show marginal improvement while others show decline in important nutrition parameters over five years. The datasheet compares survey results of the National Family Health Surveys (NFHS) of 2015-16 and 2019-20 (NFHS-4 and NFHS-5).

The rise is acute for prevalence of anaemia in women as well as children over the last five years in all states. Goa was the only state which showed a decline in prevalence of anaemia among children. Andhra Pradesh, Meghalaya and Himachal Pradesh showed decline in incidence of anaemia among women.

Out of the 18 states, Meghalaya was the only state which showed improvements in at least five out of the six parameters selected. Among the larger states, Andhra Pradesh saw the greatest improvement among the six nutrition indicators, but it still saw an increase in incidence of anaemia among children by 4 per cent.

A comparison of the recently released datasheet and the objectives shows us the daunting task that lies ahead. There has been an average increase in incidence as opposed to the decline preferred.

So, What Is The Government Doing?

Although tackling malnutrition involves various ministries such as the Education Ministry and the Ministry of Food and Public Distribution, the two main ministries involved with alleviating malnutrition are the Ministry of Health and Family Welfare (MoHWF) and Ministry of Women Child Development (MWCD).

MoHWF under the National Health Mission undertakes various schemes such as supplementation of Vitamin A, Iron and Folic Acid (IFA), Mission Indradhanush (children immunisation drive), etc.

MWCD, on the other hand, undertakes two main schemes namely — Poshan Abhiyan (National Nutrition Mission) and the Integrated Child Development Scheme (ICDS).

Poshan Maah

Since 2018, September of every year is dedicated to nutrition by the government and hence designated as Poshan Maah. The Ministry of Women and Child Development conducts various activities throughout the month to spread awareness about the importance of nutrition.

This year, the activities conducted included plantation drive for nutrition gardens (Poshan Vatikas), sensitisation/awareness drive for Covid-19 vaccination, drive for height and weight measurement for children (under six years of age), distribution of nutrition kits comprising of regional nutritious food, anaemia camps, drive for block wise identification of severe acute malnutrition (SAM) children, supervised supplementary feeding programme for SAM children as an initiative to tackle prevalence of SAM in children up to the age of five years, sensitisation for community management of acute malnutrition and distribution of nutritious food for SAM children, etc.

Recent Actions

On 29 September, the government revamped the mid-day meal scheme and relaunched it as PM Poshan. The new scheme will cover an additional 24 lakh children studying in government aided pre-primary schools across the country. It also includes the development of nutrition gardens and regular audit by students of local colleges and universities.

The government also recently decided to fortify rice, to supplement its nutrition programmes. The new standards for fortification of rice was published in September.

According to an answer given by the government in the Lok Sabha, the funds for Poshan Abhiyan remained underutilised because the scheme could not be implemented as it is a community driven initiative.

As fears of Covid decline and as schools and economy reopen, it is extremely vital for the government to ensure textbook implementation of the schemes. Moreover, states which have not performed well should learn from the states which have performed well such as Andhra Pradesh. Finally, to gauge the progress of such schemes, data must be collected and analysed regularly.