Increase in joblessness and poverty due to the pandemic will lead to a rise in hunger as well as malnutrition in the country, cautions UNICEF’s India Chief for Nutrition Arjan De Wagt, adding that the extended lockdown has hit many nutritional services. He stressed that COVID-19 sensitive strategies must be developed to continue them.
What has been the impact of COVID-19 on nutritional services?
We know that in March and April many services were affected, but some such as take home ration delivery did take place because it is a legal entitlement under the National Food Security Act, 2013. There was quick adaptability and there was door-to door delivery of take home ration, but at the same time there were people on the move who could not be reached.
The limited data we have from making phone calls, not scientific data, we know that restoration of services started to happen and improved in the months of May and June but the reach and coverage is still lagging behind. During the pandemic it is important to make health and nutrition services COVID-19 sensitive. We need the same essential services, but need to deliver them through new platforms such that they do not contribute to possible spread of COVID-19.
What are the challenges India is facing vis-a-vis nutrition
There is COVID-19 induced food insecurity, there are job losses and incomes have reduced which will lead to an increase in malnutrition. These are the secondary impacts of COVID-19.
According to a Lancet study last year, of the 10.4 lakh under-5 deaths in India in 2017, as many as 7,06,000 deaths could be attributed to malnutrition. In other words, two in three under-5 deaths were due to malnutrition. So on an average, every day 1,934 children under five die with malnutrition as underlying cause; they could all be alive if there was no malnutrition. But due to COVID-19 induced food security and malnutrition these figures will go up.
We need to go back to January/ February levels of investment of resources, community engagement and energies and work on the additional nutritional challenges posed by COVID-19. The leadership needs to continue.
Were there increased admissions in Nutrition Rehabilitation Centres (NRCs) where severe acute malnourished children are brought for treatment ?
In the beginning, some of these NRCs were declared COVID-19 centres or staff members were diverted to support the COVID-19 response. But in many States, they have reopened and the staff have undergone reorientation and training to treat children who test positive for COVID-19 and have severe acute malnutrition. We noticed though that there was a fall in the numbers of children being admitted to NRCs because of several reasons — either parents were reluctant to bring their children to these centres due to fears about them getting infected, or due to these facilities being poorly equipped or community screening to identify malnourished children in need of management not taking place and affecting the uptake of services at NRCs.
The government has been distributing mobile phones to anganwadis to improve tracking and monitoring of nutrition delivery. What does the data from these devices show about service delivery during the lockdown.
There are many sources of data. Ministry of Women and Child Development has invested a lot in rolling out the ICDS-CAS system whereby all angandwadi workers have a mobile phone and enter information about their clients. Towards the end of last year this had not yet reached all anganwadis and more needs to be done on training, collecting, analysing and disseminating the data at various levels. While the data is very promising, it is not yet clear how it is being shared and used at the various levels in the system.
