ICMR to Conduct Study to Develop Solutions to Remedy Childhood Undernutrition

Relevance: Prelims, GS2 - Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources; Issues relating to poverty and hunger

(Source: Hindu, 10/10/2023)

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Why in the news?

• Childhood undernutrition remains a pressing concern in India, with alarming statistics reflecting the nation's ongoing battle with stunting, wasting, and underweight children. To tackle this critical issue, the Indian Council of Medical Research (ICMR) is embarking on a significant multi-centre research study.
• This initiative aims to assess the impact of providing take-home foods along with behavior change interventions to promote optimal complementary feeding practices for children aged six to 24 months.

Important Indices and Reports Showing the Nutritional Status

• According to the Global Food Security Index 2022, the prevalence of undernutrition in India is 16.3%.
• India is ranked 107th out of 121 countries in the Global Hunger Index (GHI) 2023, with a score of 29.1, indicating a serious level of hunger.

Current Situation of Child Nutrition in India

• Among children, 30.9% are stunted, 33.4% are underweight, and 3.8% are obese.
• As per Global Nutrition Report 2021, child malnutrition remains alarmingly high with:
  • 22.3% (148.1 million) children being stunted
  • 6.8% (45 million) being wasted
  • 5.6% (37 million) being overweight
• The cost of a healthy diet in India is the lowest among BRICS nations and its neighbours.
• Eg: In Mumbai, where the cost of meals increased by 65% in just five years, while salaries and wages only saw a rise of 28%-37% during the same period.

Types of Undernutrition

The various types of undernutrition prevalent in India include:

1. Stunting (Chronic Malnutrition)

• It represents the percentage of children aged 0-59 months who have a low height-for-age.
• Stunting reflects long-term nutritional deprivation and can result in delayed cognitive development and reduced productivity in adulthood.

2. Wasting (Acute Malnutrition)

• It represents the percentage of children aged 0-59 months who have a low weight-for-height.
• Wasting is a severe form of malnutrition that signifies acute weight loss, often due to recent illness or inadequate dietary intake.
• It increases the risk of morbidity and mortality in children.

3. Underweight

• It represents the percentage of children aged 0-59 months who have a low weight-for-age.
• Being underweight is a composite form of undernutrition that may be the result of either chronic (stunting) or acute (wasting) malnutrition.

4. Micronutrient Deficiencies

• It refers to the lack of essential vitamins and minerals in the diet.
• Common micronutrient deficiencies in India include:
  • Iron-Deficiency Anemia: A condition where there's a decrease in the number of red blood cells due to a lack of iron.
  • Vitamin A Deficiency: Can lead to blindness and increases the risk of disease and death from severe infections.
  • Iodine Deficiency: Can result in goiter (enlarged thyroid gland) and other thyroid-related issues, including intellectual impairments.
  • Zinc Deficiency: Essential for growth and development, immune function, and wound healing.
  • Vitamin D and Calcium Deficiencies: Can lead to rickets in children and osteoporosis in adults.

5. Edematous Malnutrition (Kwashiorkor)

• It is characterized by bilateral pitting edema (swelling), usually in the ankles and feet, extending upwards.
• It is often associated with a protein-poor and carbohydrate-rich diet.

6. Marasmus

• It represents severe undernutrition and manifests as a significant weight loss, often with no edema.
• It's characterized by extreme thinness.
• It results from prolonged calorie insufficiency.

7. Marasmic Kwashiorkor

• A combination of marasmus and kwashiorkor symptoms, where a child exhibits signs of severe wasting (like in marasmus) but also has edema.

Reasons for Undernutrition

• Lack of Access to Nutritious Food: Many families in impoverished regions can't afford a balanced diet, relying heavily on staple foods like rice, missing out on proteins and vitamins.
• Sanitation and Clean Water: Poor sanitation can lead to diseases like diarrhea which affects a child’s nutritional status. For instance, in areas with open defecation, children tend to suffer more from diarrhea and malnutrition.
• Low Awareness: Many communities, due to traditional practices or lack of education, might not be aware of the importance of a balanced diet. In some cultures, for instance, colostrum is discarded, depriving the newborn of vital nutrition.
• Economic Disparities: In economically backward regions, the priority is often to secure any food rather than nutritious food.

Solutions for Combating Undernutrition

• Community Education: Grassroot programs educating families about nutrition.
  • The 'Poshan Maah' (Nutrition Month) campaign in India focuses on grassroots activities to create awareness about nutritional needs and healthy eating habits.
  • NGOs like 'PRADAN' have promoted kitchen gardens in rural areas, allowing families to grow a variety of nutritious vegetables and fruits.
• Improving Sanitation: Building toilets and providing clean drinking water can directly reduce undernutrition. The Swachh Bharat Abhiyan aims to create a clean India, indirectly impacting nutrition.
• Supplementary Nutrition Programs: Offering nutrient-rich meals to children in vulnerable regions. The Mid-Day Meal program in schools is a step in this direction.
• Empowering Women: Educated women tend to have healthier children.
  • The 'MAA' (Mothers’ Absolute Affection) Programme launched by the Indian government aims to promote breastfeeding and improve infant and young child feeding practices.
  • The 'Sahi Poshan, Desh Roshan' campaign educates mothers about age-appropriate complementary feeding practices.
• Community-based Management of Acute Malnutrition (CMAM): The UNICEF-supported CMAM program in Bihar and Jharkhand identifies and treats children with severe acute malnutrition in their communities.

Significance of Complementary Feeding:

1. Critical Growth Phase: The period from six to 24 months is crucial for a child's growth and development.
2. Determining Future Potential: Proper complementary feeding practices during this phase significantly influence a child's future potential.
3. Transition from Breast Milk: Complementary feeding begins when breast milk alone can no longer meet a child's nutritional needs.
4. Challenges in India: India faces various challenges related to complementary feeding, including:
   • Inadequate quality and quantity of foods.
   • Poor feeding practices.
   • Incorrect timing of initiation.
   • Insufficient quantities of complementary foods.
5. Take Home Ration (THR) Program: The Indian government's THR program aims to improve child nutrition.
6. Persisting Challenges: Despite the THR program's efforts, suboptimal complementary feeding practices continue to be a concern.
7. ICMR's Recognition: The Indian Council of Medical Research (ICMR) acknowledges the need for strategic adaptations to enhance the THR program.
8. Improving Quality and Nutrition: ICMR seeks to improve the quality and nutritional content of take-home rations under the THR program.
9. Promoting Behavioral Change: Behavioral change within communities is crucial to ensure that infants and young children not only receive the right food but also consume it effectively.

The Research Initiative

1. Inviting Researchers: ICMR is inviting researchers from across India to participate in a multi-centre research project.
2. Collaborative Effort: Researchers will collaborate to develop a comprehensive research proposal.
3. Independent Oversight: An independent expert committee will oversee the development of the research proposal and the implementation of the initiative.
4. Overarching Goal: The primary objective of this research initiative is to develop interventions that:
   • Promote proper complementary feeding practices.
   • Provide optimal nutrition to young children.
5. Reducing Childhood Undernutrition: The ultimate aim is to reduce childhood undernutrition in India.

Government Schemes to Tackle Undernutrition

• Integrated Child Development Services (ICDS): Aims to provide food, preschool education, and primary healthcare to children under 6 years and their mothers.
• Mid-Day Meal Scheme: Provides free lunch to school-aged children to enhance nutrition and increase school attendance.
• POSHAN Abhiyaan (National Nutrition Mission): Launched in 2018, it aims to reduce stunting, underweight, and low birth weight by 2% annually and anemia by 3%.
• Janani Suraksha Yojana (JSY): Promotes institutional deliveries to ensure better post-natal practices and infant nutrition.

By comprehensively addressing childhood undernutrition through multi-pronged interventions and robust policy frameworks, India can ensure a healthier future for its youngest citizens.

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FAQs

MCQs

Question: Which of the following are the objectives of 'National Nutrition Mission'? (UPSC 2017)

1. To create awareness relating to malnutrition among pregnant women and lactating mothers.
2. To reduce the incidence of anemia among young children, adolescent girls and women.
3. To promote the consumption of millets, coarse cereals and unpolished rice.
4. To promote the consumption of poultry eggs.

Select the correct answer using the code given below:

(a) 1 and 2 only

(b) 1, 2 and 3 only

(c) 1, 2 and 4 only

(d) 3 and 4 only

Question: Consider the following statements:

1. The Integrated Child Development Services (ICDS) primarily focuses on providing medical care to children under 6 years.
2. Stunting is a representation of acute malnutrition in children, reflecting rapid weight loss.
3. The Mid-Day Meal Scheme aims to enhance school attendance and simultaneously improve the nutritional status of school-aged children.

How many of the statements given above are correct?

(a) Only one

(b) Only two

(c) All three

(d) None