EXPERTS CALL FOR CONVERGENCE OF WORK, POLICY CHANGES TO
ENSURE SUCCESS OF NATIONAL NUTRITION MISSION
Jaipur, Feb. 19: Rajasthan is set to emerge as a “nutrition state” with the formulation of a State Vision Document for 2022 with the convergence of work by stakeholders, such as Anganwadi workers, ASHAs, ANMs, and healthcare personnel. The desert state will make rapid strides with the implementation of the National Nutrition Mission (NNM), which has been approved by the Union Cabinet, in 24 of its 33 districts.
A multi-sectoral state consultation, organized by the Department of Women and Child Development, Government of Rajasthan, here today threw light on the strategies for addressing the under-nutrition issues in an efficient and systematic manner as well as the plan of action to implement NNM and ensure its success.
While sustained efforts should be made to take the policies and programmes in the nutrition sector to each household of the poor and downtrodden, there is a need to review the policies to bring them in sync with the changing needs of the society. This was the view of Dr. M. K. Bhan, Member, National Technical Board on Nutrition, who delivered the keynote address at the day-long consultation at Hilton Hotel here.
“A lot more still needs to be done on the quality front. The targets can be achieved by taking up new initiatives and adopting new strategies to improve the nutrition levels of women and children belonging to vulnerable sections,” Dr. Bhan said.
The Rajasthan Chief Secretary, Mr. N. C. Goyal, who presided over the consultation, delivered a speech on the state’s perspective and commitment to address under-nutrition. He said the NNM framework would come handy for the officials in Rajasthan to ensure proper development of human capital, which was earlier considered a burden with each Census showing an increase in population.
Mr. Goyal said the human capital should be healthy, efficient and able to perform in the desired manner, for which the work should be taken up at the cutting edge level with the emphasis on the concept of convergence. He cited the example of the Mukhya Mantri Jal Swavalamban Yojana, in which different departments have come together to ensure availability of water. The NNM's guidelines would enable the state functionaries to formulate plans of action at the state and district levels, he said.
The NNM has set the target to benefit ten crore people. It aims at reducing malnutrition among the children of the age of 0-6 years from 38.5% to 25% by 2022. The NNM will cover 235 districts of the country in 2018-19 and all the districts in the next two years and will address the issues related to underweight, stunting and wasting in the country with a budget of Rs. 9,046 crore for three years.
Ms. Roli Singh, Secretary, Department of Women and Child Development, Government of Rajasthan, threw light on the strategies to be adopted for execution of NNM. The UNICEF-Rajasthan Field Office Chief, Dr. Isabelle Bardem, said UNICEF would all extend help and render assistance at all levels to make NNM a success.
Mr. Arjan De Wagt, Chief of Nutrition, UNICEF India Country Office, Mr. Sunil Mehra, Executive Director, MAMTA, Ms. Shuchi Sharma Commissioner, ICDS, Mr. Adesh Chaturvedi, Senior Technical Consultant, World Bank, Ms. Manjula Singh, Ms. Manjaree Pant from UNICEF, and the Collector of Banswara, Mr. Bhagwati Prasad Kalal, addressed the gathering on different aspects of nutrition.
Later, the group works undertaken for developing a convergent plan by the participants from different departments and districts. The 24 districts of Rajasthan have been selected by their previous track record and a number of indicators as well as empirical evidence which depicts a high degree of malnutrition among women and children.
The causal framework for nutrition highlights the immediate and underlying determinants of nutrition, calling for both direct (nutrition specific) and indirect (nutrition sensitive) interventions, as envisaged in the National Nutrition Policy 1993. These involve several factors such as women and child development, health, food and public distribution, sanitation, drinking water, rural development, livelihoods, education and agriculture, among others.
The convergent State Plan of Action to be developed during the consultation will be based on the provisions and directions laid down by Niti Ayog in the National Nutrition Mission. The key system-level barriers in the state have been identified as lack of knowledge of frontline health workers on complementary feeding, absence or poor use of communication and counseling aids, limited efforts by frontline health workers to counsel women on complementary feeding and lack of knowledge among the village-level private practitioners.
Background: National Family Health Survey (NFHS)-4 conducted in the year 2015-16 shows that in Rajasthan,
- 39.1 % children under 5 years are stunted (height-for-age),
- 23 % Children under five years are wasted (weight-for-height),
- 8.6 % Children under five years are severely wasted (weight-for-height)
- 36.7 % Children under 5 years are underweight (weight-for-age).
- 60.3 % Children in the age group of 6-59 months are anemic (<11.0 g/dl),
- 46.8% Non-pregnant women in the age group of 15-49 years are anemic (<12.0 g/dl) 46.6 % Pregnant women in the age group of 15-49 years are anemic (<11.0 g/dl)
- 46.8 % of all women in the age group of 15-49 years are anemic.
Nutrition-related deficiencies not only has immediate and long-term consequences on the health of individuals but also has a long-term effect on the overall development of the state and the country.
The government of India has put Nutrition and Health issues at the forefront and has approved the launch of the National Nutrition Mission (NNM) to tackle the problems of under-nutrition, low birth weight, and stunting, with a budget of Rs. 9,046 crore for three years. The mission has a target to reduce under-nutrition and low birth weight by 2 percent each year. It will strive to achieve a reduction in stunting from 38.4 percent as per the National Family Health Survey-4 to 25 percent by 2022. It also aims to bring down anemia among young children, women and adolescent girls by three percent per year.
More than ten crore people are expected to benefit from the programme. All the districts will be covered under the mission in a phased manner: districts in the current year, 235 districts in 2018-19 and remaining districts in 2019-20.
At the heart of the mission is the use of information communication technology to monitor the implementation of the scheme as well as to check pilferage in a distribution of supplementary nutrition at Anganwadi under the Integrated Child Development Scheme, according to the statement. Anganwadi workers will also be offered incentives for using IT-based tools such as smartphones.
Since functions of the new NNM, are cutting across line Ministries/Departments, the Mission is authorized and empowered to
carry out these functions for bringing out effective results through Executive Committee, an Apex body for nutrition-related activities at the National level under the Chairpersonship of Secretary, MWCD, GoI.
The mission aims to bring down stunting of the children in the age group of 0-6 years from 38.4% to 25% at National level [Mission 25] by the year 2022.
At the State too, convergence with various programmes is planned thus Integrated Child Development Services, Pradhan Mantri Matru Vandana Yojana (PMMVY) and Scheme for Adolescent Girls of this Ministry; Janani Suraksha Yojana (JSY) and National Health Mission (NHM) of MoH&FW; Swachh Bharat Mission of Ministry of Drinking Water & Sanitation (DW&S); Public Distribution System (PDS) of Ministry of Consumer Affairs, Food & Public Distribution (CAF&PD); Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) of Ministry of Rural Development (MoRD); Drinking Water & Toilets with Ministry of Panchayati Raj and Urban Local Bodies through Ministry of Urban Development and other key departments of the state are being contacted.
The goals of NNM are to achieve improvement in nutritional status of Children from 0-6 years, Pregnant Women and Lactating Mothers in a time-bound manner during the next three years beginning 2017-18 with fixed targets as under:
1. Prevent and reduce stunting in children (0- 6 years) by 6% at the rate of 2% p.a.
2. Prevent and reduce under-nutrition (underweight prevalence) in children (0-6 years) by 6% at the rate of 2 % per year.
3. Reduce the prevalence of anemia among young children (6-59 months) by 9 % at the rate of 3% per year.
4. Reduce the prevalence of anemia among women and adolescent girls in the age group of 15-49 years by 9% at the rate of 3 % per year and
5. Reduce Low Birth Weight by 6 % at the rate of 2% per year.
Concerted efforts of all the departments and support of the community are envisaged to achieve these targets.
For more information, please contact:
Kalyan Singh Kothari