India has been making consistent and speedy progress in reducing the prevalence of malnutrition over the past decade. However, the pace needs to improve to meet the targets of Sustainable Development Goal (SDG) 2.
These main targets of SDG-2 include, by 2030, to end hunger and ensure access by all people, including infants, to safe, nutritious and sufficient food; and end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons.
It is important to implement the existing nutrition schemes and programmes with quality, intensity, coverage and consistency. Yet, in more specific terms, here are a few recommendations or suggestions to address persistent malnutrition.
First, concentrate on the first 1,000 days from pregnancy to two years, making sure children and women receive nutritious food, with adequate vitamins, minerals, protein and calcium. This means ensuring continuous supply through Integrated Child Development Scheme (ICDS) and running the programme well and reaching all needy children and mothers.
The time spanning between conception and the second birthday is a unique period of opportunity when the foundations of optimum health, growth and neurodevelopment across the lifespan are established. Yet, too, frequently in developing countries, poverty and its attendant conditions and malnutrition weaken this foundation, leading to earlier mortality and significant morbidities such as poor health and, more insidiously, substantial loss of neuro-developmental potential.
Studies show that countries that fail to invest in the well-being of women and children in the first 1,000 days lose billions of dollars to lower economic productivity and higher health costs.
Secondly, it is necessary to ensure that those not receiving food support are included in Targeted Public Distribution System (TPDS) and continue with Mid-Day Meals.
Thirdly, it is necessary to complement food distribution with fortification and ensure that it reaches underserved populations in tribal areas.
Looking at nutrition from a cross-cutting or cross-sectoral lens would need realignment and integration of several activities ranging from health to livelihoods and agriculture to climate change.
Nutrition-specific interventions can only prevent child mortality, but 80 percent of nutrition-related child mortality can be prevented through nutrition-sensitive interventions. It is important to apply the nutrition lens to all interventions being planned and implemented.
Thus, it is important to continue the prioritization of nutrition in development efforts, with comprehensive approaches to access to food, health, water and sanitation and, if possible, to also provide cash support to complement the intake of diversified food with vitamins and minerals and proteins for children and mothers.
To just cite an example, climate change impacts are not only reducing food and crop production, but also reducing nutritional components of the food making them less beneficial. This will need to be addressed through adaptation strategies, like shifting to millet crops.
India has some of the most robust and progressive policies and programmes in the world both to address malnutrition and strengthen food security. India’s three flagship schemes – TDPS, Mid-Day Meals and ICDS – serve over a billion people. India has a lot to offer in terms of learning on availability, access and inclusion. It is doing a lot of this already.
It may be prudent to also look at a few observations from global experiences, specifically from the perspective of a social protection outlook.
Nutrition plays a key role in maximizing social protection outcomes, including health and nutrition, but requires clear nutrition-related objectives.
Nutrition sensitive social protection services (for example, cash transfers, integrated microcredit, and nutrition education) improve household food security, dietary diversity and caregiver empowerment.
Social protection interventions beneficiaries tend to increase the number of meals per day, diversify their diets and reduce negative coping mechanisms that affect nutrition and health in times of crisis.
Platforms to deliver social protection services can be used to encourage greater uptake of health services by caregivers of young children and with opportunities to deliver counselling and education.
Nutrition-sensitive social protection programmes can be targeted to reach the most vulnerable by strengthening food systems and promoting healthier diets through dietary diversity using a life-cycle approach.
Nutrition specific and nutrition sensitive initiatives both can be strengthened with learnings from global good practices.
(Bishow Parajuli is the Representative and the Country Director, United Nations World Food Programme, to India.)