While India’s malnutrition rates have improved over time, the country is still home to the largest number of stunted and wasted children in the world. To combat this, the Government of India launched POSHAN Abhiyaan in 2017, a flagship national nutrition mission that aims to provide a convergence mechanism for the country’s response to malnutrition. Under the POSHAN Abhiyaan (PM's Overarching Scheme for Holistic Nourishment),
‘Rashtriya Poshan Maah’ is celebrated during the month of September every year to bring focus on nutrition with the tagline of “
Har Ghar, Poshan Tyohar”. The initiative is about spreading behavioural change and communication (BCC) messages related to maternal, infant and young childcare and feeding practices. It also includes other related interventions such as growth monitoring, anaemia management, hygiene and sanitation, and so on. This year, we celebrate the fifth Poshan Maah to ‘trigger Poshan Maah through Gram Panchayats as Poshan Panchayats with a key focus on “
Mahila aur Swasthya” and “
Bacha aur Shiksha’ and to convert
‘Jan Andolan’ into ‘
Jan Bhagidari’ for a Suposhit Bharat—India that is free of stunting, wasting, and anaemia. To celebrate the Poshan Maah, Observer Research Foundation (ORF), in partnership with the National Commission for Protection of Child Rights (NCPCR), organised a webinar titled “Health and Nutrition of Children through Traditional Foods” on 28 September 2022.
The POSHAN Abhiyaan introduces a convergence platform where different ministries and departments that implement interventions impacting nutrition outcomes, come together to achieve a synergy of all interventions to effectively target undernutrition.
Priyank Kanoogo, Chairperson-NCPCR, in his welcome remarks highlighted the importance of Poshan Maah in creating awareness on nutrition for women and children—a key component of the POSHAN Abhiyaan/National Nutrition Mission. He emphasised the role of relevant stakeholders including the Ministry of Health and Family Welfare, the Indian Council of Agricultural Research, Public Health Foundation of India, etc. in achieving the goal set by the POSHAN Abhiyaan. In his address, he outlined the significance of including millets in the diet for improved dietary diversity and nutrient intake.
Dr Deb highlighted the way the Ministry of Health and Family Welfare is contributing to achieving the POSHAN Abhiyaan’s target on stunting, low-birth weight, and anaemia. She mentioned that the rise in anaemia in the National Family Health Survey-5 (NFHS-5) is a cause of concern. Poor implementation of the “Anemia Mukt Bharat” programme and the outbreak of the pandemic have pushed back any progress achieved in reducing anaemia. The non-nutritional causes including the supply of IFA tablets to pregnant women have been lagging as indicated in NFHS-5. Dr Deb highlighted a 360-degree approach to addressing the issue of anaemia, which includes the implementation of behaviour change strategies and IEC strategies that would bring awareness about nutrition amongst women. The Anemia Mukt Bharat Initiative (Anemia Control Programme), under the overarching scheme of POSHAN Abhiyaan, targets to reduce anaemia by 3 percent per year, higher than the historical trend of a 1-percent reduction from 2005 to 2015. Developed by the Ministry of Health and Family Welfare, it is a 6x6x6 strategy—six age groups, six interventions, and six institutional mechanisms (fig below). Monitoring to address both nutritional and non-nutritional causes of anaemia along with ensuring the supply chain is required. She reiterated the need for the convergence of different functionaries to help efficiently implement the policy.
Anaemia Mukt Bharat 6x6x6 Strategy
An important component of POSHAN Abhiyaan is reviving traditional food systems while involving multiple stakeholder strategies to strengthen nutrition. On this issue, Dr Agarwal emphasised the importance of plant-based system research to work towards biofortified crops. A recent review on plant biofortification to enhance nutritional quality indicates a positive impact on reducing the problem of malnutrition through nutrient enrichment of foods. He talked about the advantages of nutrition gardens for dietary diversity and enriching the foods at the Anganwadi centres and mid-day meals. Nutrition gardens have proven to be a sustainable model for food security and diversity. He mentioned model nutri-gardens established by ICAR to create awareness on growing locally available crops along with capacity building of women farmers. The need for sustainable and climate-resilient crops that have the potential to fulfil energy and nutrient requirements can be way ahead to nurture a healthy ecosystem along with ensuring food security.
Talking of sustainable and climate-smart crops, millets, for example, are significant for improving nutrition for consumers, but are also for the farmers and the environment. Dr Ronanki talked of millets as naturally bio-fortified and can be grown in marginal weather conditions, with fewer input costs and fertilizers. They are also climate resilient as they can withstand different vagaries of weather conditions, also known as ‘food medicine’. A recent report asserts the role of millets in attaining sustainable development goals.
Even with these benefits, more attention is on growing wheat and rice, the post-green revolution leading to a fall in cultivation, distribution and consumption of millets and millet products. The reasons for the lack of remunerative prices, input subsidies, price incentives, and low shelf life have led to the decline in the production and consumption of millets. To boost millet production, the government has been taking various steps like providing farmers with subsidies and quality seeds. Millets have also entered the public distribution system with the Poshan Abhiyaan mission, leading to better distribution practices. Many states like Karnataka, Andhra Pradesh, and Odisha have implemented millets as part of the public distribution system and supplementary nutrition programme.
The POSHAN Abhiyaan promises to revive traditional food systems across the country to improve dietary diversity and increase consumption of locally grown fruits and vegetables. The NFHS-5 shows gaps in dietary diversity and minimum adequate diets consumed by children. Dr Khandelwal addressed this concern by identifying three major gaps quality, quantity, and sustainability. With respect to quality, she highlighted the significance of quality food for developing nutrition in children, and that an emphasis should be laid on nutrition security, rather than food security. In terms of quantity, she outlined the local food diets by bringing in state-specific traditional foods. There is a need for overall dietary diversity to fill the nutrition gap that cannot be fulfilled by one meal provided through the Mid-day Meal Scheme or Supplementary nutrition programme. We need to focus on 1,000 days, a crucial period for better health and an opportunity to reduce the burden of non-communicable diseases.
Lastly, environmental growth should be linked to dietary diversity rooted in sustainability.
Refocusing the discussion on climate resilience, smart breeding practices could be adopted to overcome broad-spectrum stress like drought, floods etc. Dr Mishra outlined the importance of alternate strategies for food production and alternate varieties of food consumption which will lead to further nutritional diversity. There is also an immense need for acceptance of certain foods that actually provide nutrition. Strategies related to climate resilience in convergence with high yield and nutrient efficiency need to be adopted. Crop biofortification can prevent malnutrition. This calls for creating awareness to promote crop fortification to enhance the availability of nutritious food.
To sum up, the discussion reiterated the need for renewed commitment for a malnutrition-free India. Strengthening convergence can be one way of achieving better nutrition outcomes during these challenging times. We must diversify our food plate, and eat what is available locally. The way forward lies in being BOLD: Building a resilient food system; optimal nutrition across life course and one-health; leadership at all levels, and high-quality disaggregated data in research for decision-making in real-time.
Annex
Digital Webinar on ‘Health and Nutrition of Children through Traditional Foods’
28 September 2022
Participants
- Priyank Kanoogo, Chairperson, National Commission for Protection of Child Rights
- Dr Sila Deb, In-Charge-Nutrition, Ministry of Health & Family Welfare, Government of India
- DrRakesh Chandra Agarwal, Deputy Director General (Agriculture Education) and National Director, National Agricultural Higher Education Project (NAHEP), Indian Council of Agricultural Research (ICAR)
- Dr Swarna Ronanki, Scientist, Indian Institute of Millets Research, Hyderabad
- Dr Shweta Khandelwal, Head, Nutrition Research at the Public Health Foundation of India
- Dr Stuti Mishra, Assistant Professor, Department of Plant Breeding & Genetics, Jawaharlal Nehru Krishi Vishwa Vidyalaya, Jabalpur
- Dr Shoba Suri, Senior Fellow, Health Initiative, Observer Research Foundation (moderator)
This report has been compiled by Shoba Suri, Senior Fellow, ORF Health Initiative with help from Shivangi Sharma, research intern
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