The National Nutrition Mission or the Poshan Abhiyaan — the world’s largest nutrition programme for children and mothers — must be stepped up in order to meet the targets set by the Centre to reduce stunting, wasting, and anaemia by 2022, warns a report by NITI Aayog with only a little over a year left to reach its goals.
Significantly, the review report was drafted in March and does not factor worsening poverty and hunger levels over the past seven months, which is expected to dent strides made since 2018 to achieve nutritional targets.
The government’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers was launched in 2018 with specific targets to be achieved by 2022. It aims to reduce stunting and wasting by 2% per year (total 6% until 2022) among children and anaemia by 3% per year (total 9% until 2022) among children, adolescent girls and pregnant women and lactating mothers. More than a third of children under five suffer from stunting and wasting and 40% of children between one and four are anaemic. Over 50% of pregnant and non-pregnant women were found to be anaemic , according to the National Family Health Survey-4 released in 2016.
The government’s policy think tank warns, “we need to now accelerate actions on multiple fronts. We need to quickly graduate to a POSHAN-plus strategy which apart from continued strengthening the four pillars of the Abhiyaan also requires renewed focus on other social determinants in addition to addressing the governance challenges of NHM/ ICDS delivery mechanisms,” notes the NITI Aayog’s third progress report on the Nutrition Mission.
The report calls for a need to lay as much emphasis on complementary feeding as it does on breastfeeding, which it points out can help avert 60% of the total stunting cases in India. It also recommends improved “water, sanitation, hand washing with soap and hygienic disposal of children’s stools” as other interventions which could help avert a quarter of the stunting cases.
On stunting, the review says that India's targets are conservative as compared to the global target defined by the World Health Assembly (WHA), which is a prevalence rate of 5% of stunting as opposed to India’s goal of reducing stunting levels to 13.3% by 2022. “Additional preventive nutrition and health sensitive strategies are required to achieve further reductions in wasting to meet WHA target for India,” says the report.
The target of reducing prevalence levels of anaemia among pregnant women from 50.3% in 2016 to 34.4% in 2022 and among adolescent girls from 52.9% in 2016 to 39.66%, is also considered to be conservative as compared to the WHA's target of halving prevalence levels.
It notes that the government must implement interventions beyond the health sector and its focus on distribution of IFA tablets, and must include efforts to improve socio-economic conditions, else India will “achieve modest improvements in anaemia” among women of reproductive age.
Significantly, the report was prepared before COVID-19 spread rapidly across the country, but was released only last month. Experts warn that deepening poverty and hunger may delay achieving the goals defined under the Nutrition Mission.
“The projections are optimistic, and will need to be re-adjusted for the COVID-19 disruptions to health and nutrition services,” cautions Purnima Menon, Senior Research Fellow at International Food Policy Research Institute, which provided technical support and data to NITI Aayog for the report.
“When Poshan Abhiyaan was announced there was potential for surpassing the targets laid down. I think we can still achieve the targets,” UNICEF's Nutrition Chief for India told The Hindu .