National Nutrition Strategy, 2017

NITI Aayog has released the National Nutrition Strategy, 2017.

Why the Strategy has been Released?

• Over the years, various government initiatives have been launched which seek to improve the nutrition status in the country.
• These include the Integrated Child Development Services (ICDS), the National Health Mission (NHM), and the Janani Suraksha Yojana, among others.
• The Strategy notes that despite improvements over the years, concerns regarding malnutrition have persisted.

Reduction of Undernutrition

• The Strategy aims to reduce all forms of undernutrition by 2030, with a focus on the most vulnerable and critical age groups.
• It also aims to assist in achieving the targets under the Sustainable Development Goals related to nutrition and health.

Decentralised Approach

• Greater flexibility and decision making at the state, district, and local levels will be promoted.
• Further, the Strategy aims to strengthen the ownership of Panchayati Raj institutions and urban local bodies over nutrition initiatives.
• This is to enable decentralised planning and local innovation along with accountability for nutrition outcomes.

Healthcare and Nutrition among Children

• The Strategy proposes to launch interventions with a focus on improving healthcare and nutrition among children under the age of three years.
• These interventions will include:
  1. promotion of breastfeeding for the first six months after birth
  2. universal access to infant and young child care (including ICDS and crèches)
  3. enhanced care, patient referrals, and management of severely undernourished and sick children
  4. micronutrient supplements and biannual de-worming for young children

Governance Reforms

Governance reforms proposed include

1. Convergence of state/district implementation plans for ICDS, NHM and Swachh Bharat Mission,
2. Service delivery models based on the evidence of their impact
3. Focus on the most vulnerable communities in districts with the highest levels of recorded child malnutrition

Malnutrition in India

In the recent past, there has been a renewed discussion around nutrition in India.A few months ago, the Ministry of Health and Family Welfare had released the National Health Policy, 2017. It highlighted the negative impact of malnutrition on the population’s productivity, and its contribution to mortality rates in the country.In light of the long-term effects of malnutrition, across generations, the NITI Aayog released the National Nutrition Strategy in September, 2017.

What is the Extent of Malnutrition in India?

• India’s performance on key malnutrition indicators is poor according to national and international studies.
• According to UNICEF, India was at the 10th spot among countries with the highest number of underweight children, and at the 17th spot for the highest number of stunted children in the world.
• Malnutrition affects chances of survival for children, increases their susceptibility to illness, reduces their ability to learn, and makes them less productive in later life. It is estimated that malnutrition is a contributing factor in about one-third of all deaths of children under the age of 5.
• Over the decade between 2005 and 2015, there has been an overall reduction in the proportion of underweight children in India, mainly on account of an improvement in stunting.

Is Malnutrition Witnessed only Among Children?

• No.Among adults, 23% of women and 20% of men are considered undernourished in India.
• On the other hand, 21% of women and 19% of men are overweight or obese.
• The simultaneous occurrence of over nutrition and under-nutrition indicates that adults in India are suffering from a dual burden of malnutrition (abnormal thinness and obesity).
• This implies that about 56% of women and 61% of men are at normal weight for their height.

What does the National Nutrition Strategy Propose?

• Various government initiatives have been launched over the years which seek to improve the nutrition status in the country.
• These include the Integrated Child Development Services (ICDS), the National Health Mission, the Janani Suraksha Yojana, the MatritvaSahyog Yojana, the Mid-Day Meal Scheme, and the National Food Security Mission, among others.
• However, concerns regarding malnutrition have persisted despite improvements over the years.It is in this context that the National Nutrition Strategy has been released.
• The Strategy aims to reduce all forms of malnutrition by 2030, with a focus on the most vulnerable and critical age groups. The Strategy also aims to assist in achieving the targets identified as part of the Sustainable Development Goals related to nutrition and health.
• The Strategy aims to launch a National Nutrition Mission, similar to the National Health Mission. This is to enable integration of nutrition-related interventions cutting across sectors like women and child development, health, food and public distribution, sanitation, drinking water, and rural development.

Interventions

The Strategy proposes to launch interventions with a focus on improving healthcare and nutrition among children.

These interventions will include

1. Promotion of breastfeeding for the first six months after birth
2. Universal access to infant and young child care (including ICDS and crèches)
3. Enhanced care, referrals and management of severely undernourished and sick children,
4. Bi-annual vitamin A supplements for children in the age group of 9 months to 5 years
5. Micro-nutrient supplements and bi-annual de-worming for children.

Measures to improve maternal care and nutrition include:

1. Supplementary nutritional support during pregnancy and lactation
2. Health and nutrition counselling
3. Adequate consumption of iodised salt and screening of severe anaemia
4. Institutional childbirth, lactation management and improved post-natal care

Governance reforms envisaged in the Strategy include:

1. Convergence of state and district implementation plans for ICDS, NHM and Swachh Bharat;
2. Focus on the most vulnerable communities in districts with the highest levels of child malnutrition; and
3. Service delivery models based on evidence of impact.