Ankita Choure, Public Policy Consultant, Chase India, shares her insights on tackling the malnutrition burden in India amidst the coronavirus times
The nation-wide lockdown announced on 24th March, 2020 which continues till today, for over a month has built government’s response to fight against COVID-19 strategically in many ways, but has also increased the pressure on healthcare systems and other essential services tremendously. While government schemes aimed at providing cash-transfer, healthcare and other benefits are trying to cope with the pressure of people’s needs in times of an emergency, it is not able to cater larger vulnerable groups across India.
Tackling malnutrition
Malnutrition has been a huge public health burden in India. In India, one in five children under five years is wasted. Percentage wise, the figure stands at 20.8 per cent, compared to Asia’s average of 9.4 per cent. This is further supported by India’s National Family Health Surveys (NFHS) data, as per the last two survey rounds; 21 per cent are wasted (too thin for height) and 7.5 per cent are severely wasted . The numbers have increased from 6.4 per cent to 7.5 percent in the last two decades, making our children weaker and susceptible to all infections, including COVID-19. India has been making conscious efforts to tackle malnutrition through various initiatives such as Poshan Abhiyaan (National Nutrition Mission) and Transformation of Aspirational Districts programme launched in January 2018, but the COVID-19 pandemic could reverse these gains.
As per the Global Nutrition Report 2020, the global prevalence of severe acute malnutrition (SAM), was 7.3 per cent in 2018, compared to 7.9 per cent in 2012, validating negligible progress towards the five per cent target set for 2025 in the 2012 World Health Assembly (WHA).
India is home to half of the wasted children globally. Even before COVID-19, one of the most impacted group when it comes to access to nutrition-related schemes have been the marginalised or vulnerable groups, especially the women and children in every village, district and state. This pandemic has only worsened the situation for them.
The COVID-19 impact
As per the Renke Commission report 2008, the number of de-notified, semi-nomadic and nomadic communities is approximately 15 crores. India has 1,500 nomadic and semi-nomadic tribes and 198 de-notified tribes scattered across the country who often migrate from one state to another, engaging in various livelihood occupations. Majority of them do not have access to many government schemes or are denied access from the Public Distribution System (PDS), leaving them further isolated and pushing them to poverty and malnutrition.
Amidst lockdown, these vulnerable communities are bound to face a severe socio-economic impact, putting lives and livelihood at stake. With shortage of food supply, disruption of supply chains triggered by the lockdown comes poor accessibility to healthy and sustainable food security.
Since shortened food supply and inaccessibility to healthy diets for days do not fulfil nutrient requirements of a mother and child at crucial phases of development, the lockdown will impact women and children in particular, the hardest. The World Bank has also highlighted in its latest communications that India is facing a dual burden of fighting undernutrition and COVID-19.
Furthermore, rules of social distancing and basic hygiene practices are difficult for them to follow as there is a poor availability of basic hygiene and sanitation facilities in their social environments. Their compromised dietary practices, low socio-economic status and overcrowded temporary homes leave them susceptible to faster transmissions of infections. The lockdown storm is steering them in tougher challenging situations than before.
Intensifying the battle
Coronavirus has exposed the weaknesses of our already fragile food systems and inequitable Health systems pushing India’s vulnerable groups with compromised immune systems further towards deadly infections and all forms of malnutrition. With this background and altered needs of the pandemic, it’s crucial to turn challenges into opportunities, re-strategise schemes to make them more inclusive with a strengthened workforce at the frontline to implement them. India’s battle against malnutrition needs to be intensified in order to reach its nutrition targets now more than ever.
Since post-COVID, social distancing will be the new normal, the effectiveness of the community-based management of acute malnutrition will be vital. For example, instead of distributing essential nutrient food packets which was earlier done in anganwadis/Nutritional Rehabilitation Centres (NRCs), will now be directly taken to the homes of the beneficiaries by the frontline Anganwadi workers equipped with a personal protective gear. This will ensure access to nutrition services thereby improving health outcomes for women and children.
The fight against this dual-threat of Malnutrition and COVID-19 seems overwhelming but not impossible with growing support coming in through international agencies, PM Cares fund, Tata Trusts and other Corporate Social Responsibility (CSR) projects and NGOs, all pitching in to work better together in these unprecedented times.
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