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Insights into Editorial: Why Poshan 2.0 needs more power after Covid

 

Introduction:

Children are the future of our country. Well-being of children is essential for the country’s development as they contribute to the future human resource of the country.

To strengthen nutritional content, delivery, outreach, and outcomes, Government is merging the Supplementary Nutrition Programme and Poshan Abhiyan to launch Mission POSHAN 2.0.

The Ministry of Women and Child Development has taken many initiatives to ensure safety and well-being of children.

Ministry of Women and Child Development strives to ensure well-nourished and happy children growing in a safe and secure environment and empower women by providing them with an environment which is accessible, affordable, reliable and free from all forms of discrimination and violence.

 

Context:

Recently, the Ministry for Women and Child Development inaugurated Poshan 2.0 and urged all Aspirational Districts to establish a Poshan Vatika (nutrition garden) during the Nutrition Month (Poshan Mah) from 1st September.

For effective implementation of various schemes and programmes of the Ministry of Women and Child Development, all major schemes of the Ministry have been classified under 3 umbrella schemes viz. Mission Poshan 2.0, Mission Vatsalya and Mission Shakti.

A month-long celebration of the POSHAN Abhiyan mission places special attention on Severe Acute Malnourished (SAM) children.

 

Background:

In 2008, when distinguished international economists including many Nobel laureates were asked by the Copenhagen Center to build consensus on the most important development agenda in which policymakers and philanthropists should invest, ‘battling malnutrition’ emerged as the top priority.

It took time for this to sink in our country. For generations, malnutrition and undernutrition remained an all-pervasive but largely invisible issue in India and it didn’t receive the attention it deserved.

 

What is POSHAN Abhiyaan?

  1. The POSHAN (Prime Minister’s Overarching Scheme for Holistic Nutrition) Abhiyaan was launched by PM Narendra Modi on March 8, 2018, in Rajasthan.
  2. The Abhiyaan is India’s flagship programme to improve nutritional outcomes for children, pregnant, women, and lactating mothers.
  3. The POSHAN Abhiyaan aims to make India a malnutrition-free country by 2022. The Abhiyaan aims to reduce stunting in children from 38.4 per cent to 25 per cent by 2022.
  4. Under the POSHAN Abhiyaan, the 1st POSHAN Maah was celebrated in September 2018 with a special focus on Social Behavioural Change and Communication (SBCC).
  5. Themes included eating healthy – food fortification, hygiene and sanitation, right age of marriage, antenatal care, optimal breastfeeding, anaemia, and education of girls.

 

Malnutrition in India:

  1. About 68% of the deaths of children under the age of five in India can be attributed to child and maternal malnutrition, said Lancet in 2019.
  2. This basically means that tackling malnutrition as a whole, instead of addressing one disease at a time, will keep our children much safer and make their futures brighter.
  3. As per the Global Nutrition Report 2020, India is among 88 countries that are likely to miss global nutrition targets by 2025.
  4. Over half of our children under five years were found to be either stunted (too short for their age) or wasted (too thin for their age) or both, reckoned this Comprehensive National Nutrition Survey, released in 2019.
  5. The Food and Agriculture Organization (FAO) estimates that 194.4 million people in India (about 14.5% of the total population) are undernourished.
  6. Covid-19 has posed serious threats to children and their health and nutritional rights.
  7. According to recent estimates, even in the best possible scenario and accounting for changes in the provision of essential health and nutrition services due to COVID-19, India could have around additional 60,000 child deaths (around 3,00,000 in the worst-case scenario) in the next six months.
  8. The results were alarming for what it meant for the future of our children, but they were broadly in sync with other independent estimates on malnutrition’s prevalence.
  9. Malnutrition adversely affects the physical and mental growth of the child and is the single most important risk for acquiring other diseases.
  10. Research also shows malnourished children are less likely to go to school and more likely to drop out.
  11. This meant half of our children were silently falling behind, and no development can be truly meaningful without ensuring that our children and mothers are better fed and healthy.

How Poshan scheme affected by Covid-19?

  1. Covid-related shocks could lead to an additional 9 million children under the age of five suffering from wasting, of which two-thirds will be in South Asia, predicted research in Nature.
  2. So, it is important to not only renew but multiply our efforts towards Poshan 2.0 with full vigour while practising physical distancing, mask wearing and hand hygiene.
  3. Under Poshan 2.0, several related schemes have been merged to tap the synergies, malnutrition hotspots are being identified and 112 aspiring districts will receive extra attention.
  4. Under the current Poshan Maah, the drive to identify children suffering from severe acute malnutrition has been intensified and Anganwadi workers have been asked to refer those having medical complications to health institutions and NRCs.
  5. For those facing severe acute malnutrition without medical complications, community management protocols should be strengthened, so that they do not go on to develop medical complications in times of the pandemic.
  6. Fresh waves of Covid cannot be ruled out in the near future, and we must adapt our nutrition interventions to the possibility of such repeated shocks.
  7. The momentum set by this entire nutrition movement was disturbed once Covid lockdowns led to the shutting of schools, Anganwadi centres, Nutritional Rehabilitation Centres;
  8. Further, frontline workers had to be engaged in Covid-related work that took precedence over their daily duties, which entailed identifying, referring and monitoring children suffering from severe acute malnutrition and moderate acute malnutrition among other nutrition-strengthening activities.

States tried to cope to the best of their abilities by replacing hot-cooked meals with dry ration or cash transfers.

 

Way Forward steps for make India free of malnutrition by 2022:

Poshan Abhiyan, which vowed to make India free of malnutrition by 2022, repositioned nutrition as central to development and emphasised its multi-factorial and multi-sectoral nature.

  1. First, the movement built in its approach that, on top of direct interventions, nutrition can be improved in many ways, including:
    1. Better sanitation that addresses intestinal diseases and
    2. Allows people to absorb more nutrients;
    3. Increasing dietary diversity;
    4. Vaccinating children against diseases;
    5. Counselling more women to breastfeed babies for longer, which in turn improves immunity.
  2. Second, by involving many ministries and departments outside the nodal ones, along with bringing on board other stakeholders including communities, Poshan Abhiyan helped to build a comprehensive nutrition response, never seen before in this country’s history.
  3. Given that the damage malnutrition does in the first 1,000 days of life is irreversible, it beamed intense focus on nutrition-related intervention to improve maternal and child health in that window since conception.
  4. The nutrition mission also measured and monitored indicators real-time during the programme using technology, so that timely course corrections could be made in different contexts.
  5. However, what really stood out as a stellar achievement of Poshan Abhiyan was the way the senior political leadership committed itself to eradicating malnutrition and galvanised it into a people’s movement, with the celebration of Poshan Maah in September and Poshan Pakhwara in March, along with several other activities.

 

Conclusion:

A safe and bright future for our children will translate into a safe and bright future for the country.

And that’s the message we want every fellow citizen to internalise—Sahi Poshan, Desh Roshan.

Other activities, such as making new mothers breastfeed for longer, managing childhood diarrhoea, distributing deworming tablets and iron and folic acid diligently while convincing target groups to take these diligently will go a long way in improving the nutrition status of children and new mothers.

It is important to document and learn from states like Gujarat, Madhya Pradesh and Rajasthan, which have scaled up Community-based Management of Malnutrition practices in recent times, so that best practices can be adopted and incorporated.