Monday, September 17, 2012

NUTRITION POLICY AND STRATEGY STATUS OF MALNUTRITION IN INDIA

It is critical to detect and prevent under-nutrition, as early as possible, across the life cycle, to avert irreversible cumulative growth and development deficits that compromise maternal and child health and survival, achievement of optimal learning outcomes in primary education and gender equality. The national plan of action on nutrition will be centered on the following critical facts related to malnutrition

[1] Every fifth child in the world lives in India
[2] 22% babies are born with low birth weight
[3] 42.5% of children 0-5 years are underweight
[4] 53 out of 1000 live births do not complete their first year of life
[5] 79% children (6-35 months) are anemic
[6] Declining female / male ratio in children under -6 yrs – from 945 to 927/1000
[7] 35.6 % women with low BMI.


Nutrition challenges: Some facts

Some nutrition challenges include:

[1] Maternal and child under – nutrition is the underlying cause of more than one third of the mortality of children under five years.
[2] One fifth of maternal mortality can be averted by addressing maternal stunting and iron deficiency anemia.
[3] One fifth of neonatal mortality be prevented by ensuring the universal practice of early initiation of exclusive breastfeeding (around 22% neonatal mortality can be averted by this).
[4] One fifth of child mortality (Under 5 years ) in India can be prevented by ensuring universal exclusive breastfeeding for the first six months and appropriate complementary feeding practices after 6 months (along with continued breastfeeding till 2 years and beyond).
[5]Over one in the short term, by available nutrition interventions, implemented at scale.

The Policy Frame work and Key Interventions:

Priorities, process indicator and need for convergent action:

The Eleventh Five year plan positions the development of children at its cent re and recognizes nutrition as critical for ensuring child survival and development. It accords high priority to addressing maternal and child undernutrition through multi and child undernutrition through multi sector interventions by different sectors.
The nutrition status f the population is the outcome of complex and inter-related set of factors and cannot be improved by the efforts of single sector or action alone. The national Plan of action on Nutrition 1995 lays down a systematic framework for collaboration among national government agencies, state government, NGOs , the private sector and the iinternational community. It is a multi-sectrol framework for implementation of the national nutrition goals too be reached by 2000 AD. The multi-sectrol plan states the objectives and tasks of 14 different sector namely, Agriculture, Food ,Civil supplies & public Distribution, Education, Forestry, Maternal & child Health, Food Processing Industries, Health, Information & Broadcasting, Labour , Rural Developmwnt, Urban Development, Welfare, Women & child Development

[1]. National Nutrition Policy (NNP):

The National Nutrition Policy (NNP) 1993 identified key areas of action in various areas like agriculture, food production, food supply, education, information, health care, social justice, tribal welfare, urban development, rural development, labour, women and child development, people with special needs and monitoring and surveillance. The core strategy envisaged under NNP is to tackle the problem of nutrition through direct nutrition interventions for vulnerable groups as well as through various development policy instruments which will improve access and create conditions for improved nutrition. The National plan of Action on Nutrition (NPAN) 1995 laid down the frame work for systematic collaboration among national government ministries / departments, State Government, NGOs, the private sector and the international community. Specific implementation arrangement suggested by NPAN included National Nutrition Council headed by the prime ministers, special working groups in concerned ministries/ departments, committees, Nutrition council etc. at the state and district levels by the State Governments, among others. The interventions to address nutrition challenges in India mainly stem from the National nutrition policy and the National plan of Action o Nutrition and policies of related sector such as health, food and agriculture.

The Government of India has over the past few years, expanded the coverage under a number of programmes, which have the potential to improve the current nutrition security situation of the country . These programmes include the National Rural Heath Mission (NRHM), Integrated Child Development Services (ICDS) Scheme, Mid Day Meal Scheme , National Food Security Mission Horticulture Mission, Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), Jawaharlal Nehru National Urban Renewal Mission and the National Rural Drinking Water Programme. The table below discusses the existing government schemes/ interventions listed by life cycle focus area.

Schemes like, National Rural Health Mission (2005-06), National Horticulture Mission(2005-06), Mahatma Gandhi National Rural Employment Guarantee Scheme (2005-2006), Janani Suraksha Yojana (2006-07) , Total sanitation Campaign , Mid Day Meal (2008-09), Integrated child Development services (ICDS) scheme (2008-09) and National Rural Livelihood Mission (2010-11) have been expanded / universalized in the recent past, and hence better result could be awaited in the years to come . All these schemes address one or the other aspect of nutrition.

While the ICDS scheme continues to cater to the supplementary nutritional needs of children below six years and pregnant and lactating mothers, and the Mid-day Meal scheme take care of the school going children (6-14 years ) ,
the recently introduced

Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG), namely , SABLA would provide a package of services including health and nutrition to adolescent girls in the age group of 11-14 years for out of school girls and 15-18 years for all girls for nutrition in 200 districts as a pilot. Additionally, a new scheme, the Indira Gandhi Matritva Sahyog Yojana (IGMSY)- The CMB Scheme would provide a better enabling environment for improved health and nutrition to pregnant and lactating mothers and support for providing early & exclusive breastfeeding for the first six months of life on pilot basis in 52 districts initially. In order to address the India’s nutrition challenges every State Government and UT Administration has a crucial role to play. The National Nutrition Policy 1993 and the National plan of Action on nutrition 1995 specify clear institutional structure from national to grassroots level. Although some States / UTs have taken a few initiatives in this regard, the implementation of provisions and structure laid down in the National Policy and plan of Action have largely not been put in place or made effective. Most of these programmes are being implemented by the State Government / UT Administrations.

[2] Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (SABLA):

The Rajiv Gandhi Scheme for empowerment of Adolescent Girls (SABLA) was launched in November 2010.The objective of the scheme are to address nutritional problems and improving the health status of adolescent girls in the age group of 11-18 years, equipping them with knowledge on family welfare, health and hygiene providing information and guidance on existing public services and mainstream out of school girls into formal or non-formal education . The major activities that would take place in the next five years from 2011 till 2016 would mainly be implementation in 200 districts to begin with, followed by evaluation and further expansion across the country . The deliverables envisaged for the Scheme, in line with major activities to be performed between 2011 till 2016, are to ensure that nutrition and non-nutrition components of Scheme are delivered to adolescent girls, utilization of fund takes place as per norms and evaluation of pilot is conducted


[3] Indira Gandhi Matritva Sahyog Yojana (IGMSY)

Indira Gandhi Matritva Sahyog Yojana (IGMSY) has been approved the health and nutrition status of pregnant, lactating women and infants by the promotion of appropriate practices, care and services utilization during pregnancy, safe delivery and lactation; encouragement of women to follow (optimal) Infant and young Child Feeding (IYCF) practices including early and exclusive breast feeding for the first six months; and by contributing to better enabling environment by providing cash incentives for improved health and nutrition to pregnant and lactating mothers.

[3] National commission for protection of Child Rights (NCPCR):

The National Commission for Protection of child Right (NCPCR) was set up in March 2007 under the commission for Protection of Child Rights Act, 2005. The Commission’s mandate is to ensure better protection of the rights of the Child through the monitoring of constitutional and legal rights of children, review of safeguards, review of existing laws, looking into violations of the constitutional and legal rights of children, and monitoring programmes relating to the survival, protection, participation and development of children. The Commission also has to ensure that all National laws, policies, programmes, and administrative mechanisms are informed by a “right-based” emphasis and are in consonance with the child-rights perspective as enshrined in the Constitution of India and the UN Convention on the Rights of the child.

[4] National Institute of Public Cooperation and child Development (NIPCCD):

National Institute of public cooperation and child Development (NIPCCD) is an autonomous organization under the Ministry of women and child Development. The objectives of the Institute are to develop and documentation in the overall domain of women and child development. NIPCCD takes a comprehensive view of child development and promotes programmes in pursuance of National Policy for Children and evolves a framework and perspective for Organizing children’s programmes through governmental and voluntary efforts.

The current thrust areas of the institute relating to child development are maternal and child health, nutrition, early childhood education, positive mental health in children and child care support services. The institute conducts research and evaluation studies; organizes training programmes, seminars,, workshops and conferences; and provides documentation and information services in priority areas in public cooperation and child development .The Institute functions as an apex body for training of functionaries of the Integrated Child Development services (ICDS) programme. The Institute entrusted with the responsibility of training and capacity building of functionaries at the national and regional level, under the Integrated Child Protection Scheme (ICPS).


Source: KURUKSHETRA

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