Is Malnutrition a Proverbial ‘Elephant in the Room’?

India to achieve UN’s ‘Zero Hunger’ Sustained Development Goal by 2030.

K Dhanush, an eighth-grade student from a government school in Ballari, Karnataka is a typical example of how a perfectly healthy boy has become undernourished after being deprived of the nutritious midday meals that were served during school days. His mother has a heart-rending tale to tell. She says, “The children were very healthy when they were going to school. Now due to the lockdown, I have no salary and no mid-day meals. The children have lost weight and are looking weak.” And here is some food for thought - lack of availability of nutritious food for needy children is probably the largest casualty of Covid-19 and its aftermath.

A staggering 115 million children in India are at risk of malnutrition or ‘hidden hunger’, which is today getting aggravated due to the disruption in some key initiatives like the mid-day meal program as a result of the coronavirus pandemic. Consequently, malnutrition is becoming a further bigger issue as the loss of livelihoods threaten to push families into poverty. Therefore, it needs to be addressed on a war footing and it just cannot be the elephant in the room. While this crisis is like a Damocles’ Sword hanging on our nation, the narrative has to shift beyond platitudes and statistics.

Good nutrition allows children to survive, thrive, develop, learn, play, participate, and contribute—whereas malnutrition robs children of their future and cuts short young lives. The benefits of good health are perceived not only at the individual level but also at the level of society and country. The health of an individual is determined by interplay of various factors like social, economic, dietary, lifestyle-related, environmental, government policies, and political commitment, etc.

It is a well-known fact that in few of the developing nations, India included, nearly half of the children under 5 years of age succumb to death every year due to under nutrition. The irony is, India is the world’s second-largest food producer, the stark reality is that it has a very large number of undernourished children in the world!

Malnutrition was the primary reason behind 69% of deaths among children below the age of five in India, according to a UNICEF’s The State of the World’s Children 2019 report. The report further clarifies that every second child in India, belonging to that age group is affected by some form of malnutrition. This includes stunting (low height for age) with 35%, wasting (low weight for height) with 17% and 2% overweight.

UN’s Sustainable Development Goal 2 wants to ensure Zero Hunger, while Goal 3 is good health and well-being for all; both of which goals are expected to be met by India by 2030.

There have been various schemes launched by the government to abolish malnutrition. Some of the schemes include:

· Integrated Child Development Services (ICDS) – A government programme operational in India since 1975, which provides food, preschool education, primary healthcare, immunization, health check-up and referral services to children under 6 years of age as well as their mothers.

· National Health Mission (NHM) initially launched in 2013 to address the health needs of 18 states, identified as having weak public health indicators, which was later scaled up to the entire nation.

· Mid-Day Meal Scheme which has been implemented since 1995, where a nutritious meal is provided by the school to better the nutritional standing of school-age children nationwide and prevent school dropouts.

With the world still reeling under a series of unprecedented, unexpected, and rapid disruptions triggered by the COVID-19 pandemic and its biggest impact happening on the human life and within that more specifically on the overall quality of life index. As a major food company, we acknowledge the depth of the issue that despite sincere efforts being taken by both the private and the government sectors one of the most vulnerable TG (Indian children 1-4 years), about 40% are anemic, 14% have vit B12 deficiency, 13.7% have hypovitaminosis D, 23.4% have folate deficiency, 19% are Zinc deficient and 17.5% are vitamin as per the CNNS 2016-18 data). Even today the household consumption of some of the key micronutrients are grossly inadequate when compared to their recommended dietary intakes eg. For Iron & Vit A. At ITC, the spirit which has always guided our philosophy of responsible nutrition practices towards supporting the health of the nation is embodied in our credo of Nation First - Sab Saath Badhein.

We believe that food security together with nutrition security is an extremely critical vector in order to overcome this problem. Food fortification is one of the most effective & efficient way of decreasing the nutrition gap. We whole heartedly support FSSAI’s fortification of staples (+F) initiative and have launched fortified Atta (with Iron, Folic Acid & Vit B12) & Fortified Milk (with Vit A & D) which reaches thousands of households daily. We are also working on double fortified salt (with Iodine & Iron). We have fortified products as a part of our foods portfolio which are a source of many vital minerals & vitamins along with other value added ingredients (prebiotics, fiber, protein etc.) which will have a positive impact on the overall nutrition status of the consumers. We are also working towards supporting the local communities to develop products from various ancient grains like millets, fruits, jaggery etc. which can be sourced locally and hence not only bring more fresh, nutritious foods to the consumers in a comparatively short period of time but also help the communities at large.

We continuously engage with various academic institutes, government & other like-minded organisations, to closely work together in the field of generating & disseminating knowledge in the field of nutrition science & health research to further amplify the need for developing a more sustainable way of making nutritious products which can have a positive impact on the health of our nation & the planet. This has resulted in some significant outcomes and has further encouraged us to continue this journey towards developing nutritious offerings.

Along with direct nutritional interventions, our Social Investment Programme - Mission Sunehra Kal (MSK) aims to transform the lives of even the most marginalised amongst its stakeholder groups to live a life of dignity. Our way of grassroots empowerment, based on knowledge and technology transfer, confronts livelihood challenges of today and tomorrow through a holistic approach to create healthy, educated, and skilled communities which look to the future with confidence and determination.

Both central and state governments agree that public-private partnership is the best way forward to deliver nutrition. When we speak about NGOs and corporate organizations collaborations, The Akshaya Patra Foundation (TAPF), the world’s largest not-for-profit organization is top of mind recall. Presently on their way to celebrate the 20th anniversary of the mid-day meal program, they have come a long way. Incidentally, by February 2019, they had served the 3 billionth meal. Having set a goal of feeding 5 million children daily by 2025, is what I call commitment, and an outcome driven by the mission and passion.

There is no questioning the fact that despite numerous schemes directly and indirectly targeting the nutritional status of children (0-6 years age), pregnant women and lactating mothers, the level of malnutrition and related problems in the country still remain high and continue through birth, puberty to adulthood. The only way it can be improved is by continuing with the on-going schemes, and simultaneously, implementing and introducing new schemes and initiatives, which can help tackle the problem of malnutrition in a more judicious manner. Let us take time to stop, think and act so that we don’t allow malnutrition to be the proverbial ‘elephant in the room’.

A Healthy Child is a Happy Child!

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