The Nutrition Month or Poshan Maah observed every September since the past three years as part of the the government’s efforts to ensure community mobilisation to curb malnutrition under the National Nutrition Mission came to a close earlier this week without any mention of COVID-19 and its impact on hunger and rising levels of malnutrition and policy measures being taken to address them.
The Ministry of Women and Child Development held a one-hour long closing ceremony on Wednesday which was broadcast on YouTube. A Joint Secretary-level official in-charge of the Nutrition Mission at the Centre described various activities undertaken by different stakeholders in the past one month, including “social media campaigns” and “meme competitions”, but made no mention of the challenges imposed by the pandemic in delivery of services or the urgent need to track and identify pregnant women, lactating mothers and children under the age of six years most vulnerable to the economic impact of COVID-19 or due to the failure in service delivery because of lockdowns.
According to a study brought out by the Standing Together for Nutrition consortium, and published in The Lancet in July, an additional 6.7 million children under the age of five could be severely wasted as the pandemic resulted in disruption of food systems and impeded access to healthcare services. This sparked world bodies such as UNICEF, the Food and Agriculture Organization (FAO), the World Food Programme (WFP) and the World Health Organization (WHO) to appeal to the governments around the world for an immediate response against malnutrition.
The government data on the Health Management Information System (HMIS) showed that services geared towards maternal and child health were impeded due to the lockdowns between April and July.
However, these concerns found no mention at Wednesday’s ceremony. In her concluding remarks, Minister of State for Women and Child Development Debasree Chaudhuri spoke about identification of Severe Acute Malnourished (SAM) children and setting up of nutrition gardens as the two broad focus areas of the Poshan Maah. The only policy decision announced by the Ministry in the past month was a Memorandum of Understanding signed with the Ministry of AYUSH in integrating principles of ayurveda and yoga with various services delivered at anganwadis. An important policy announcement on guidelines for supplementary nutrition distributed at anganwadis and management of SAM children remains pending for more than three years.
“The policy response from India’s perspective definitely needs to be strengthened multifold. If we unpack the multiple forms of malnutrition, we already know India’s undernutrition burden is still unacceptably high and the COVID-19 is expected to exacerbate it. We need disaster management integrated in social protection schemes, especially those pertaining to nutrition. We need procedures and protocols for feeding, providing rations and continuing with other important healthcare features like immunisation, management of severe acute malnutrition children, functional nutritional rehabilitation centres, operational “Poshan” centres where pregnant women and young children can be provided care and nourishment under proper supervision and precautions. Of course, efforts were being made but they were far and few between”, says Shweta Khandelwal, Head Nutrition Research and Additional Professor at Public Health Foundation of India.
“The Poshan Maah is an important and visible reminder of the nutrition mission and its goals, and several visible discussions were held. This was an important time to reflect on how nutrition could be better protected in the context of COVID-19 and the economic slowdown and what more would be needed. Second, on SAM itself, we know that community-wide efforts focused on prevention are more effective on changing population levels of wasting than a focus on curing individual malnourished children, even though individual children obviously need the attention. Making the preventive aspects of Poshan Abhiyaan work very well and delivering the take home rations, counselling, growth monitoring and other services in the first 1000 days to everyone can go a long way in addressing both stunting and wasting. Some of these need no new policy prescriptions — but they need a continued and sustained emphasis on doing the right things for every woman and every child, all 27 million of those born every year,” explained Purnima Menon, Senior Research Fellow at International Food Policy Research Institute (IFPRI).
While the Centre may have failed to show urgency, some States responded with alacrity.
“Several States have issued policies and guidelines related to nutrition, including on addressing SAM — e.g. Assam, MP, UP. Actually, I have been very impressed how these issues were taken on at State level in such a short time. Very few States had policies, guidelines, statements around these before and many do have them now. We expect that these will have a long-lasting and large impact beyond Poshan Maah. Not until the recent past did SAM receive so much attention. Also, it is great to see that most States did respond and recognise that prevention of SAM, identifying children with SAM and providing management and care for these children are as important. Of course, the future will tell us [the results], but I think this was a very successful Poshan Maah. Nutrition is back on the agenda,” Arjan de Wagt, Chief of UNICEF India (Nutrition) told The Hindu .
