Flourish to Nourish:

Reducing Malnutrition

(Theme 7)

“Malnutrition is a major health problem in India involving

under nutrition and over nutrition that are caused by imbalanced

consumption of nutrients.”

Scope of the problem:

Despite an impressive economic performance, with the gross domestic product (GDP)

rising 8.4 per cent in 2005-06 and 9.2 per cent in 2006-07,30 nutrition indicators

still reveal an unacceptable situation – contributing to India’s poor rank of 128

among 177 countries on the Human Development Index in 2007. The lack of

progress over the past decade and the current high levels of malnutrition have led to

India being recognised as having, perhaps, the worst malnutrition problem in the

world.

The data reveal an unacceptable prevalence of malnutrition in our children:

• 42.5 per cent of our children under the age of five years are underweight (low weight

for age)

• 48 per cent of our children are stunted (low height for age)

• 19.8 per cent of our children are wasted (low weight for height)

Determinants of Malnutrition:

Economic: Poor purchasing power, poverty, livelihood insecurity, major inequities in asset distribution and control.

Environmental: Lack of safe drinking water, poor sanitation, poor hygiene practices.

Figure: India, child weight-for-age and height-for-age, by age.

Health: Weak health service systems, inadequate human resources, especially in public health nutrition, weak health and nutrition educational systems.

Cultural: Inadequate knowledge of nutrition, cultural beliefs and practices that lead to poor nutrition e.g., (expelling colostrums, restricting food consumption during pregnancy or sickness), cultural shifts to prefer less micronutrient rich foods, discriminatory intra-familial food distribution, high workload for women, inadequate time available for infant and young child feeding and care.

Bringing the multi faceted programme “The Mid Day Meal Scheme” into practice that seeks to address issues of food security.

We will bring the incessant checking of the irregularity in serving meals in schools.

Caste based discrimination in serving food will be ceased. Nutritional impact of dry rations

are likely to be lower when compared to a cooked meal.

We will implant the need of providing cooked food to children among the running institutions.

To ensure that knowledge, research, education/training and public assessment systems strengthen the capacities of the organisations to participate in policy formulation and decision-making about food distribution in schools.

Implementation of “Hungry to be heard” Campaign

We will execute campaigns to tackle the scandal of people becoming malnourished while in hospital.

Ensure that hospital staff follow their own professional codes and guidance from other bodies.

We will introduce ‘protected mealtimes’

We will implement a ‘red tray’ system and ensure that it works in practice.

We will undertake thematic and comprehensive reviews to get an accurate picture of hospital mealtimes.

We will introduce compulsory monitory to tackle issues regarding the number of patients going into hospitals and coming out of them malnourished.

“Adulterated food is impure, unsafe and wholesome food”

Extent of the issue :

The Centre for Science and Environment(CSE) recently discovered our branded

edible oils are full of unhealthy trans fats. Trans fats are associated with a host of problems ranging from diabetes to heart

disease to cancer.

Consumption of fruit(ripened using carbide) can cause diarrhoea, mouth ulcers, dizziness and even cancer in the long run.

10 per cent milk samples across the country did not carry standards. Most Indians

are consuming detergents and other contamination through milk due to lack of hygiene in handling milk.

The Punjab Department of Health and Family Welfare seized 2,000 litres of synthetic milk in Patiala.

Proposition: Putting an end to adulteration

by broad array of enforcement tools

Sizing and condemning of the

products.

We will ensure detaining of

imported products.

Ensure regular sampling and

analysing.

We will bring conventional

methods of farming to practice.

We will have a regular check on

the sale of synthetic and

adulterated milk and various dairy

products.

0

20

40

60

80

100

120

% of Bad Milk Samples

% of BadMilkSamples

“Access to territories and natural wealth and associated agrarian and aquatic reforms”

The notion of territory involves the

political, economic, environmental,

cultural and social rights of food

producing communities in rural areas.

Territories are essential for diverse and

sustainable food production and to

reinforce local markets, build capacities to

support safe and decent jobs, and create

the conditions for the full implementation

of food sovereignty.

For the majority of local food

providing communities, natural wealth

means much more than ‘‘productive

or natural resource’’.

Proposals for policies :

Ensure Genuine agrarian and aquatic reforms that can put an end to the massive, forced exodus from the countryside to the city, which forces cities to grow at unsustainable rates and under inhumane conditions.

Establish a strategy where in small-scale food providers should be fully and genuinely involved in formulating policies related to agriculture, fisheries, forests, water, and the environment

Recognise that pastoralism is essential for food sovereignty and that pastoralists need to be mobile in order to survive.

Reverse and prevent the privatisation of fisheries resources, such as through individual transferable quotas (ITQs) and similar systems that promote private and market-friendly property rights.

B i o f o r t i f i c a t i o n a n d diversification a s s u s t a i n a b l e s o l u t i o n s .

We will look upon the improvement the

micronutrient content in high yielding rice varieties by support

and acceleration of the ongoing research

program.

We will incorporate micronutrient density as a quality parameter in the Super Rice(new

plant type).

Ensure inclusion of energy density and

consumer preferences (e.g., satiety) as quality

parameters for released rice varieties

in future breeding programs.

Promote homestead gardening with

vegetables and fruits in view of important deficient nutrients in

the diet, such as vitamin A, vitamin C,

iron and calcium.

Vitamin A deficiency has been recognized as a nutritional problem in India. Severe stages of vitamin A deficiency cause eye damage, leading to night blindness and ultimately to blindness. Milder stages of vitamin A deficiency cause impaired immune response and increased morbidity and mortality among children and pregnant women.

FAO stresses that nutrition education is a key for developing the skills and motivation needed to eat well, and is especially important in situations where families have limited resources.

Encourage pre-natal nutrition education to prevent mother raising her children with poor eating habits, and without balanced, healthy meals.

Improve the performance of primary care providers, teachers and counsellors to address the nutritional needs of adolescent girls, through improved training, communications materials, job aids, motivation and supportive supervision.

We insure teaching people how to grow crops and harvest them. We will also implement in teaching things that will help them get jobs for which they can earn money and help themselves

To encourage classroom learning linked with practical action, backed up by improvements in the school environment and family and community participation.

Policy and advocacy

Protocols and

guidelines

Human resource capacity

Outreach and

community ownership

Appendix:

• Howarth Bouis, IFPRI, “Effects on Nutrition of For-Profit Vegetable Production”

• Policies and actions to eradicate hunger and malnutrition by a Drafting Committee.

• A Leadership Agenda for Action

• Report of child nutrition survey of India

• Ministry of Consumer Affairs, Food and Public Distribution, Government of India, New Delhi, ‘The National Food Security Bill, 2011 (Bill No.132 of 2011)’

• Social Views of Food Adulteration and Its Legal Provision

• Food and Agriculture Organisation: Helping to build a world without hunger