India is unlikely to meet targets set under the ambitious Poshan Abhiyaan or National Nutrition Mission (NNM) for reduction in prevalence of stunting, underweight, low birth weight and anaemia in women and children by 2022 if there is no progress achieved in improving the rate of decline observed between 1990 and 2017, according to a new study published in The Lancet .
The study points out that India will miss its target for stunting levels of 25% by 9.6%; underweight target of 22.7% by 4.8%; desired low birth level of 11.4% by 8.9%; anaemia level among women of 39.4% by 13.8%; and anaemia level among children of 44.7% by 11.7%, according to the Global Burden of Disease Study 1990-2017, released on Wednesday.
Joint initiative
The report is a joint initiative of Indian Council of Medical Research, Public Health Foundation of India (PHFI) and the Ministry of Health and Family Welfare.
Poshan Abhiyaan, the world’s largest nutrition programme, expected to benefit 10 crore people and launched in 2018 by Prime Minister Narendra Modi, aims to reduce stunting, underweight, and low birth weight, each by 2% per year; and anaemia among young children, adolescents and women each by 3% per year until 2022. A special target for stunting is set at 25% by 2022.
A senior official at government think-tank NITI Aayog, which is spearheading the programme, says that the findings are not worrisome.
“Poshan Abhiyaan has doubled the rate [of decline]. For example, it sets a target of 2% reduction per year for underweight, but the percentage of reduction for this indicator typically is 1%. So, we are not worried. We knew the prevalent levels were slow; the country aspires to make them faster and is making extra efforts to achieve that. Under Poshan Abhiyaan, we will make a change,” Dr. Vinod K. Paul, Member, NITI Aayog told The Hindu .
‘Needs acceleration’
The study, however, points out that the rates of improvement desired under the Poshan Abhiyaan are aspirational.
“Our findings suggest that the malnutrition indicator targets set by NNM for 2022 are aspirational, and the rate of improvement needed to achieve these targets is much higher than the rate observed in this study, which might be difficult to reach in a short period. This slow pace of improvement needs to be accelerated, so that future prevalence of the malnutrition indicators is better than our projections based on trends so far.”
“We anticipate that the ambitious efforts of the Poshan Abhiyaan which started in 2018 will accelerate the rate of improvement in the malnutrition indicators above that has been possible previously in India, which would likely lead to future prevalence of these indicators to be better than our projections based on the trends up to 2017,” said Professor Lalit Dandona, PHFI.
Gaps shown
He added that the gaps shown in the study highlight how much more of these efforts are needed in different States to reach the targets set by the government.
According to the National Family Health Survey-4 (2015-2016), 38.4% of children under the age of five are stunted; 35.7% are underweight; 18% of children were born underweight (less than 2.5 kg); and 58% of children between the age of 6-59 months and 53% of women in the age of 14-49 years have anaemia.
While the base for NNM targets is NFHS-4 data, the study considers prevalence levels determined in 2017 as the base level, which are comparable with the former.
The study used all accessible data sources from India, including national household surveys, a variety of dietary and nutrition surveys, and other epidemiological studies, to arrive at its findings.
