In 2017, India ranked 100 out of 119 countries on the Global Hunger Index, performing worse than Myanmar, Bangladesh and Iraq. Among adults, malnutrition directly impacts adult productivity and hampers the cognitive development of children. Simply put, it is only natural that an individual who is unwell and undernourished is unable to function at her peak physical or mental capacities.
As a member of the Citizens Alliance against Malnutrition, I, along with a number of Members of Parliament cutting across party lines, have advocated solutions to help alleviate malnutrition, for over a decade. Various initiatives have been taken up by government and non-governmental organisations towards this effort. For instance, recently, rice fortified with iron has been introduced in the mid-day meal scheme in Gajapati, Odisha, to reduce anaemia among primary school students — from 73% to 5%. Although innovations such as rice fortification should be encouraged, they must be reinforced with proper monitoring and implementation. As we have seen in a study in another State, leakages from the government’s Integrated Child Development Services (ICDS) programme, which provides food, pre-school education, and primary health care to mothers and children, have not only been costly but also compromised the effectiveness of the government scheme. To curb leakages, information and communications technology solutions that track last mile delivery to cover both top-down and bottom-up channels of information are essential for the timely delivery of services to beneficiaries.
Malnutrition is often a symptom of underlying problems such as poor maternal health which may lead to low weight at birth, stunting and susceptibility to diseases in childhood. Based on the fourth National Family Health Survey (NFHS) (2015- 16), 38% children below 5 years are stunted and 58.4% are anaemic. Not surprisingly, we also found that 54% women between 15 and 49 years to be anaemic while 22.9% have a low maternal body mass index.
Returns are high
The economic returns to investing in health and nutrition can be very high. Introducing specific interventions to tackle malnutrition among children born in 2015 in India can lead to 20% reduction in stunting and a consequent increase in incomes by 11%. This is an incredibly high return on investment. The government can strengthen existing schemes and programmes such as the ICDS and the Public Distribution System (PDS) to make available diverse, nutritious and micro-nutrient fortified foods. Another option the government can explore is cash transfers supplemented with counselling to ensure behavioural change among people and to generate demand for such diverse dietary choices.
In Odisha, the State government has been implementing nutrition-specific interventions through the years; the number of Anganwadi centres in the State has been doubled, and self-help groups (SHG) developed under ‘Mission Shakti’, a women’s empowerment initiative. These SHGs have also helped strengthen programmes such as ICDS. Between 2005-6 and 2011, stunting rates improved among vulnerable sections. Establishing nutrition rehabilitation centres, identifying children suffering from severely-acute malnutrition, and fixing a day for monitoring such children through Pustikar Divas were among other action steps that have been recognised and adopted.
These interventions have worked well; mobilising communities and SHGs can initiate change across the country. As a member of the Lok Sabha, I am working to improve the health status of the people in my constituency through the Saansad Adarsh Gram Yojana, which aims to equip people with quality access to basic amenities and opportunities to help them shape their own destiny. Improving the health and nutrition status of people is fundamental to achieving this objective. A well-implemented mass media communication campaign, involving trained health workers, will have a strong impact. In Madhya Pradesh, there is a nutrition project which aims to reduce severe malnutrition among by creating community awareness around these issues. It aims to strengthen governance, accountability and mutual responsibility of service providers and communities to foster the programme’s success. Providing people quality health care and living conditions will empower them and complement their personal goals and development. No citizen deserves less than a shot at a healthy, prolonged and quality life in a prosperous economy. Moreover, no nation can achieve its true potential without it.
Baijayant ‘Jay’ Panda is a BJD Lok Sabha MP. The views expressed are personal