Adequate nutrition for productive society

Thingbaijam Dhamen *

Good nutrition is fundamental for optimal health and growth. Through its effect on health and cognitive development it is also vital for academic performance and productivity, and therefore for healthy economies and socioeconomic development.

Almost two-thirds of the deaths of children around the world are directly or indirectly associated with nutritional deficiencies. Both protein-energy malnutrition and micronutrient deficiencies increase the risk of death from common diseases such as acute gastroenteritis, pneumonia and measles.

Marginal nutrient deficiencies in the developed world are increasingly accepted as risk factors for the development of chronic disease such as cardiovascular disease or some cancers.

Globally, every year the lives of around 50 million children are put at risk because they are dangerously thin from acute under-nutrition, while the long term health of more than 40 million children is threatened because they are overweight.

Two billion people suffer from vitamin and mineral deficiencies, but overweight and obesity are key contributors to the non-communicable diseases that account for almost two thirds (63%) of adult deaths globally. These different forms of malnutrition—undernutrition, overweight and obesity, and micronutrient deficiencies— now affect people across the same communities and harm people of all ages.

Improving nutrition therefore presents a key opportunity to improve health. As the UN secretary general launches his second Global Strategy for Women's, Children's and Adolescents' Health in September 2015 a strengthened focus on nutrition is warranted, with special attention to the first 1000 days of life (from pregnancy to the child's second birthday), pregnant and lactating women, women of reproductive age, and adolescent girls.

According to 'The State of Food Security and Nutrition in the World, 2020' report, 14 per cent of India's population is undernourished. As per the report states that 189.2 million people are undernourished in India and 34.7 per cent of the children aged under five in India are stunted. It further reports that 20 per cent of India's children under the age of five suffer from wasting, meaning their weight is too low for their height.

In fact, India is home to the most number of malnourished children all across the world. In the country, 35 percent of malnourished children are below the age of five years.

In addition to all this, as per Global Hunger Index (GHI) 2019, India has been ranked 102 out of the qualifying 117 countries that were assessed. The Global Hunger Index comprehensively tracks and measures hunger across the world and India's rating in the 2019 year has been poor with a score of 30.3 which according to their guidelines, falls in the 'serious' category. The data certainly shows that malnutrition is indeed one of the most underrated problems faced by the country.

Even as India's malnutrition rates have improved over the recent years, the country is still home to the largest number of stunted and wasted children in the world.

Various government data reveal that the percentage of women with low body mass index (BMI) has remained almost stagnant in the last two decades despite improvement in provision of maternal health services, including institutional delivery which has increased significantly. As per national data, over a third of women are reported to have low BMI and the undernutrition situation is almost stagnant.

The prevalence rate of undernutrition in women is much higher in rural areas (40.6 %) compared to urban regions (25 %). The undernutrition rates in women in low wealth index is almost three fold higher compared to highest wealth index.

In respect of Manipur, National Family Health Survey (NFHS 4) 2015–2016 shows that among the children below 5 year old, 30% were stunted, 7% wasted, 2% severely wasted and 14% underweight. Even though these statistics are better than the national data, there has been an increase of overweight and obesity in adult women (26%). At the same time, 26% of the adult women are affected by anaemia.

Over the course of time, various governments have initiated several large scale supplementary feeding programmes aimed at overcoming specific deficiency diseases to combat malnutrition. This includes programmes such as the distribution of prophylaxis against nutritional anaemia, Special Nutrition Programme, Balwadi Nutrition Programme, ICDS programme, and Mid-day meal programmes.

Even though most of these programmes which are aimed at children, lactating mothers, pregnant women, and women in reproductive age groups have brought in results, its large scale implementation is still a distant dream for the nation.

The crisis brought about by the COVID-19 pandemic has further worsened the nutritional status of the country and the poor and hungry are being affected the most. Children are not getting their share of mid-day meals from the schools as every educational institution in the country has been closed. Further, the Supplementary Nutrition for ICDS projects in rural areas through Anganwadi Centres has also been disrupted to a great extent.

To combat the dismal state of nutrition in the country, the government launched the Prime Minister's Overarching Scheme for Holistic Nourishment (POSHAN) Abhiyaan ('movement') in 2017, a flagship mission that aims at a convergence mechanism for the country's response to malnutrition.

The mission aims to improve nutritional outcomes for children, pregnant women and lactating mothers. Continuing the thrust on Jan Andolan, this year POSHAN Pakhwada is being celebrated during 16th- 31st March 2021 with addressing nutritional challenges through food forestry and POSHAN Panchayat as key focus areas.

In Manipur too, state social welfare launched the mission on March 16. On the occasion, state social welfare minister Okram Henry Singh sought full cooperation from stakeholders in the successful conduct of fortnight long POSHAN Pakhwada, 2021.

Foods from forests have much potential to address needs of nutrition and food security. Forest foods, including products from trees, herbs, mushrooms and animals, contribute in many ways to improving food security by providing ready accessibility to affordable and often highly nutritious food.

India relies mostly on agriculture, but that is subject to vagaries of weather. Forests can complement the agriculture-based strategy. Most of the forest foods are not in commercial production systems, but can be vital with sustainable harvesting.

At the same time, the principal cause of undernutrition is lack of accessibility to food with dietary diversification where poverty and other socio economic factors are decisive for accessibility to food.

Therefore, to sustain nutrition intake, nutri-garden will ensure accessibility and availability of diversified food. It is a cost effective model as well with locally available seeds of fruits, vegetables. We can also promote local manure in this model. So, there is the need for giving special emphasis to nutri-gardens.

By successful conduct of the fortnight long event, it should not mean conducting the charted activity calendar successfully but focus on what progress has been made in tackling malnutrition and better understanding of the challenges and solutions to the targeted section of people.

While creating awareness, they should be educated that good health is a key criterion, which contributes to human wellbeing and economic growth and adequate nutrition for women would help them to serve as productive members of the society to develop the consequent health generations.