Malnutrition continues to be a significant problem that India has been facing from a long time and is the cause of deaths of many children between the age group of 1 to 6 years. Last year, when 17,000 deaths were reported in the tribal area of Maharashtra, the issue of malnutrition again came to light. According to World Health Organisation (WHO), malnutrition, in all its forms, includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related non-communicable diseases.
According to the National Family Health Survey-4 2015-2016 in Maharashtra, 40 per cent children were underweight in rural area of Maharashtra and in the urban area, it was 30.7 per cent. And infant mortality rate (per 1,000 live births) was recorded at 23 in urban area and 27 in the rural area. Also, the under-five mortality rate was 27 and 30 respectively in the urban and rural area.
To address the issue of malnutrition, the government is implementing various schemes. The Women Child Development Ministry has implemented Integrated Child Development Services (ICDS) Scheme and Rajiv Gandhi Scheme for Adolescent Girls. While ICDS covers the nutritional needs of children of 6 months to 6 years of age, pregnant and lactating mothers, RGSAG Scheme covers the nutritional and non-nutritional components for adolescent girls.
Under these schemes, age-appropriate supplementary nutrition is provided to beneficiaries at the Anganwadi centres spread across the country. But most of the time, the schemes of the government look good only on paper, points out Pournima Gadiya, social worker, who runs an NGO for children and is involved in various welfare activities for children, women and senior citizens. There is no proper implementation and planning of the various schemes, which the government introduces from time to time. For example, the mid-day scheme for children in schools.
The contract of providing meals to schools is given to local bachat gats (self-help groups of women) or a contractor. But after that, it just becomes a business. The raw material, which is used to cook food is of the lowest quality. There are no proper guidelines, which are followed so that children get nutrition through food. If suppose khichadi is provided to children as lunch, it should include some vegetables so that children get proper nutrition but that factor is completely ignored. If supplementary tablets of iron, calcium and necessary vitamins are given to children, it should be given on a regular basis but that is not strictly followed in Anganwadi or schools, which add to the increasing deficiency of vitamins and minerals among children. So the government should plan simultaneous diet in all schools and keep a regular check on the quality of food and the Anganwadi workers should be well-trained to get proper results of the implementation of the various schemes.
Also, we always keep reading about news of mass food poisoning of children due to mid-day meals or children falling sick after having mid-day meals. This is because they are no proper quality checks of the raw food items, which is used to cook the meals or no proper attention is given to the method in which the food is prepared, so the nutritive value of the food is also lost. She also points out that there is a need among masses not only in rural areas but also in urban areas about the process in which the food should be cooked so that it doesn’t lose its nutritive values.
Another factor, which adds to the growing malnutrition among kids, is the malnutrition among women. It affects more women due to specific nutritional needs during adolescence, pregnancy and lactation. And in many cases, we see that the nutritional needs of girls are ignored because of the preference of male child in the family so undernourished girls grow up to become undernourished women who give birth to a new generation of undernourished children. Other factors, which cause malnutrition among children, include poverty, lack of education among women, cultural taboos, lack of healthcare facilities, etc.
So there are three basic factors, which decide the reasons for malnutrition among children - economic status, lack of education and awareness. So the government needs to not only introduce new schemes to reduce malnutrition among children but take proper steps to implement these schemes.
