Author : Sheila C. Vir

Occasional PapersPublished on Aug 24, 2017 PDF Download
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Re-examining and Re-positioning India’s Nutrition Programme for Accelerating Improvements in Maternal and Child Nutrition

  • Sheila C. Vir

    India's progress in reducing the prevalent stunting rate in under-five children has been slow, and it must work hard to double the current annual rate of decline if it hopes to meet its sustainable development goals. Among others, this target requires ninety-percent coverage of women and children in the first one thousand days of life with evidence-based Essential Nutrition Interventions (ENIs) and maternal-child health services. Such coverage of ENIs must be complemented with selected nutritionsensitive interventions including improving access to diversified food, improved sanitation and ODF, and women's empowerment. This paper argues for the redesigning of the country's nutrition programmes.

Malnutrition, defined to encompass both undernutrition and overnutrition, have serious adverse impacts not only on mortality and morbidity. It hampers overall brain development, school performance, and productivity, and inf luences the onset of various noncommunicable diseases. In India, the undernutrition situation has improved over the past several years, though the progress has been slow: Today, four of every ten children are stunted and almost every third mother is undernourished. Meanwhile, the problem of overnutrition is increasing, with some of the more affluent states having over 40 percent of women being overweight or obese. With the current evidence of which strategies are more effective for addressing undernutrition, there is a need to redesign the country’s nutrition programme and move away from the ‘ICDS-centric’ strategy for accelerating nutrition improvement in maternal, infant and young child nutrition (MIYCN). The mismatch in the delivery of the evidence-based essential nutrition interventions and the designated implementing system needs to be understood and addressed. It is time that the complex and fragmented approach of implementing essential direct nutrition actions through ICDS and health is examined, redefined and re-organised. Moreover, there is an urgent need to address nutrition-sensitive issues such as accessibility to diverse diets, rapid improvement in sanitation, and making substantial improvements in the socio-economic and education status of women. This working paper presents an overview of the nutrition situation in the country, its determinants and implications, tracks the history of emergence of ICDS, and argues for the urgent need to correctly position the nutrition programme within the National Health Mission, under the Ministry of Health and Family Welfare. Further, the paper emphasises the issue of the first 1,000 days of life being the window of oppor tunity, and the significance of complementing the universal coverage of direct nutrition interventions with nutrition-sensitive actions being implemented by the Ministry of Rural Development and a number of other vertical programmes under the various ministries.

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Author

Sheila C. Vir

Sheila C. Vir

Dr. Sheila C. Vir is Director Public Health Nutrition and Development Centre.

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Sheila C. Vir

Sheila C. Vir