Pandemic will increase India’s malnutrition burden, says Unicef

The covid-19 pandemic has disrupted optimal care for children, especially those who are malnourished, a Unicef report said. This may increase the overall severe and acute vburden and massive disruptions in continuity of food availability and livelihood, said the report, titled Community based programme for children below 5 years of age with severe acute malnutrition in India—Progress so far and lessons learned 2020.
The report took into account the malnutrition programmes running in 12 states. States were using their funds to roll out such programmes in select areas even as they were awaiting guidelines from the ministry of women and child development on community-based management of children with severe acute malnutrition (SAM), it said.

The report identified barriers in the state-level Community Management of Acute Malnutrition (CMAM) Programme. “Though community mobilisation strategies are developed, activities are rarely implemented as planned due to a lack of convergence between government departments, with proposed actors engaged in other activities,” it said.

“List of children developed by Anganwadi workers are often used to identify children who need to be screened, yet they are often not complete, which means not all children are screened. As a result, children living in more remote and hard-to-reach areas of the block can be excluded from routine screening,” the report said. Screening equipment is often faulty and, therefore, unusable, it said.

Weight and height measurements by Anganwadi workers and auxiliary nurse midwifes are of poor quality, leading to inaccurate classification of children’s nutrition status, it said.

As far as human resource for handling the nutrition programme goes, many areas with fewer frontline worker vacancies have been chosen to ensure high quality service delivery. However, to scale up, vacancies will become a challenge, the report said.

There is an urgent need to bring SAM management under essential health and nutrition services and to ensure continuity of services for the management of child wasting, Unicef said.

“One key mandate for Poshan Abhiyaan is to propel the convergence lever forward to positively integrate and influence maternal child nutrition and well-being,” said Dr Shweta Khandelwal, head, nutrition research and additional professor, Public Health Foundation of India (PHFI), a public-private participation initiative.

“Coherent policy action, right from sectors such as health, nutrition, environment, urban and rural development, to education and finance, needs to be implemented at all levels with participatory approach. For this awareness and sensitization of local masses are extremely critical,” she said.

Malnutrition is still one of India’s biggest challenges and is the predominant risk factor for death in children younger than five years in every state in 2017, accounting for 68.2% of the total under-5 deaths, according to the Global Nutrition Report, 2020, released on 12 May.

There were 706,000 deaths because malnutrition, according to the statewide data on malnutrition by the Indian Council of Medical Research, PHFI, and National Institute of Nutrition released in 2019.

As much as 35.7% children under 5 years of age are underweight, 38.4% are stunted, and 21% are wasted, according to the National Family Health Survey-4 in 2015-16, conducted by the ministry of health and family welfare. – Livemint