The National Family Health Survey (NFHS)-5 shows negligible gains in nutritional outcomes in under five children which needs urgent focus.
What does the NFHS-5 say?
Malnutrition- There has been sluggish progress in reducing undernutrition, wasting and stunting.
Even now 35.5% of under-five children are stunted, 19.3% are wasted and 32% are underweight.
There is also increase in the proportion of overweight children, women and men with serious health consequences in the form of non-communicable diseases.
Anaemia- The incidence of anaemia has increased from 58.6 to 67% in under-5 children, from 53.1 to 57% in women and from 22.7 to 25% in men.
Anaemia is characterised as a serious public health concern by WHO and has to be focussed as it is as worsening as the COVID-19 effect.
Breastfeeding- Though institutional delivery has gone up, early initiation of breastfeeding is static.
Data- There is a need to monitor data and process indicators for programmatic evaluation and correction.
Data generated quickly can lead to mid-course corrections and data-driven planning and strategies can lead to good governance with accountability.
Exclusive breastfeeding- Anganwadi workers, ASHA workers and Auxiliary Nurse Midwives must continue to monitor exclusive breastfeeding till the infant is six months old.
They must record the timely initiation of complementary feeding with soft gruel as this is the critical period of growth that cannot be compromised.
Rations- It must be ensured that there is take-home ration for under-three children through the regular supply of supplementary nutrition from the Integrated Child Development Services.
There is a need to know the regularity and quantity of dry rations supplied to anganwadis and schools, preparation of menu and procuring locally available vegetables for dietary diversification.
Dietary supplement in the family- What goes into the family pot depends on what parents can earn and their purchasing capacity.
As the National Nutrition Monitoring Bureau was shut down some years ago, there is no data on what families can cook and their affordability.
It is important to monitor the MGNREG Scheme wages earned in areas where droughts frequently occur, where there is mass migration and where there is prevalence of high malnutrition.
Monitoring PDS- PDS is a hunger-mitigation mechanism that does not enable nutrition security.
The wheat and rice procured through the Food Corporation of India fill the stomach and hunger is averted but not malnutrition.
Many established surveys seem to have methodological errors and the Consumer Expenditure Survey results of 2017-18 were withheld.
Both Poshan Abhiyan and the Pradhan Mantri Garib Kalyan Anna Yojana need to be monitored with the help of the community to ensure sustainable nutrition security.
