Malnutrition:How to Tackle It Effectively…
Malnutrition refers to defiencies or excesses in nutrient intake,imbalance of essential nutrients or impaired nutrient utilization.
News jungal media: Tha double burden of malnutrition consists of both undernutrition and overweight and obesity,also diet related non communicable diseases.
Undernutrition manifests in four broad forms, wasting, stunting,underweight and micronutrient deficiencies.
Wasting:
It is defined as low weight-for- height.
It indicates severe weight loss.It can also persist for a long time.
It usually occures when a person has not,had adequate food quality and quantity or they have, had frequent or prolonged illnesses.
Stunting:
It is defined as low height-for- age.
It is a result of chronic or recurrent undernutrition, usually assiciated with poverty,poor maternal health and nutrition, frequent or prolonged illnesses,inappropriate feeding and care in early life.
Stunting prevents children from reaching their physical and cognitive potential.
Underweight:
It is defined as low weight-for- age.
A child who is underweight may be stunted or wasted or both.
India has world’s largest undernourished people, with around 14.3% of its population is not receiving enough nutrition.
According to National Family Health Survey (NFHS-5)
36% children under age 5 are stunted
19% are wasted
32% are underweight
3% are overweight.
Anemia(low hemoglobin), affects a staggering 67% of children below age 5.
Anemia is much more prevalent in women, with around 57% of Indian women suffer from it, as compared to men with 30%.
What are Primary Causes behind Prevailing Malnutrition in India?
Lack of Primary Health Infrastructure: Many Indian people do not have access to basic health services, such as immunization, antenatal care, infection treatment that further worsen malnutrition condition.
World Health Organisation(WHO) recommends, a doctor to population rato should be 1 per 1000people and ideal nurse density should be 3 per 1000 people.
In India there are .7 doctors and 1.7 nurses per 1000 people.
Lack of Awareness and Illiteracy:Many people in India are not aware of the importance of nutrition or the best practices to ensure it.They don’t know how to prepare balanced meals,what food to avoid during pregnancy or breastfeeding, or how to prevent micronutrient deficiencies.Illiteracy also limits their access to information and education on nutrition.
Weak Public Distribution System: PDS is a government scheme that provide subsidized food grains and other essential commodities to poor households.However, PDS suffers from many problems, such as corruption, diversion, leakages, poor quality and inadequate coverage. As a result, many people who need food assistance do not receive it or receive insufficient amounts.
According to CAG Report, Only the 49% of the food grains allocated under PDS scheme reached the intended beneficiaries in 2012-13.
Weak Integrated Child Development Scheme: ICDS is another government scheme which improves the nutrition and health of children under six year old and pregnant and lactating women.It provides supplementary food, health check-ups, immunization and pre school education through Anganwadi centres(community based mother and child care centres).
However, ICDS also faces many challenges, such as inadequate funding,staff shortages,low quality of services and low participation rates.
According to NFHS-5 only 50% of children under age six years received any services from an anganwadi centres from last six months.
Government measures have been taken to curb Malnutrition:
Pradhan Mantri Matru Vandana Yojana(PMMVY)
Mid Day Meal Scheme
Mother’s Absolute Affection(MAA)
Mission Poshan 2.0
What more should be done:
Nutrition counseling: Nutrition counseling should be institutionalized as a fundamental component of existing health infrastructure, such as in primary health centres and community health centres.
Bemetara Village Case Study:
Bemetara is a district in Chhattisgarh where the number of Severe Acute Malnutrition(SAM) children were 3299 in December 2022.
There was a lack of proper knowledge about feeding practices.This is why nutrition counseling combined with robust monitoring was chosen as prime method for this area.
Poth Laika Abhiyan( Healthy Child Misssion) is anutrition counseling programme that is being implemented in 72 most of the affected Anganwadi centres.
Every Friday, the parents of the targeted SAM and MAM (Medium Acute Malnutrition) children are summoned and counseled.
Local leaders, such as Sarpanch, Panchayat sachivs and religious heads have also participated in counseling sessions.
They are taught in simple chhattisgarhi language, the importance and constituents of Tiranga Bhojan( a balance diet), the need to wash hands regularly and many other tips for healthy lifestyle.
Door to Door visits to houses of targeted children also done to monitor their progress.
As a result, as many as 53.7% of targeted children were brought out of malnutrition in a span of nine months.
This mission is zero cost one, requiring only few training sessions and regular monitoring.
Antenatal and Postnatal Breastfeeding counseling: Provide breastfeeding counseling to pregnant women during antenatal check ups and continue this support through frequent home visits after delivery.Evidence suggests that such counseling significantly improves breastfeeding practices and reduce undernutrition.
Utilize Mass Media: Levarage mass media and television shows to organize informative discussions on caring for infants and young children during the first 1000 days.This can reach mother and caregivers beyond the public health system.
SBCC Action Plan: States should develop Social Behaviour Change Communication action plan.It should outline the objectives, target audience, key messages and strategies for effective communication.
Conclusion: India is still afflicted by public health issue like Malnutrition.Poor nutrition adversely impact health and survival also leads to diminish learning capacity and poor school performance.And in adulthood, it means reduced earnings, increased risks of chronic diseases, such as diabetes, hupertension and obesity.
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