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Developmental Issues

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Last year, the Centre launched the National Nutrition Mission (NNM) to ensure a “malnutrition free India” by 2022. The Global Hunger Index (GHI), released on Tuesday, has sobering figures for this inter-ministerial mission. India is one of the 47 countries that have “serious levels of hunger”, according to the study. Though the country’s position has gone up a notch since last year, this is not an improvement since this year’s GHI mapped two more countries. It is particularly worrying that India is among the worst-performing countries on the acute under-nutrition parameter. “India’s wasting rate (indicative of acute under-nutrition) is extremely high at 20.8 per cent — the highest wasting rate of any country for which data or estimates were available,” the report states.

Malnutrition is most often a product of several factors including poverty, inadequate availability of food, genetic predisposition, environmental factors and poor health and sanitation services. And, the oft-repeated complaint of policymakers that there is no real-time data that brings all these factors together to show the extent of India’s malnutrition problem is valid to an extent. However, it is also clear that providing nutritious food to the country’s children is more a matter of political will and effective policy implementation at the grass roots level than solving a difficult puzzle. For example, in May-June, the Acute Encephalitis Syndrome (AES) outbreak in Bihar bared the failure of the Integrated Child Development Scheme (ICDS) in the state. Moreover, by its own admission, the state government did not have any special nutritional programme to combat a disease that has been a scourge for at least 10 years.

The ICDS has also been vexed by disagreements over the constituents of the mid-day meal programme. In the past four years, the Centre has increasingly laid emphasis on the use of “fortified varieties” of salt, wheat flour and edible oil. A section of policymakers have also advocated the use of Ready To Use Therapeutic Food (RTUF). The debate on the nutritional quality of “fortified food” is far from settled. But the emphasis on such food has led to the increasing centralisation of the mid-day meal scheme and moreover, has not addressed local food sensitivities and tastes. Also, as a study published, this week, in PLOS Medicine shows, long-term investments in health, sanitation and nutrition are far more effective in preventing deaths due to severe acute malnutrition than measures such as RTUF. The NNM would do well to keep such studies in mind. But most of all, it should be bear in mind that the GHI figures are too stark for any further prevarication.

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