Fighting malnutrition: strategies and programmes

Former Prime Minister Dr Manmohan Singh called malnutrition a matter of 'national shame'. POSHAN Abhiyaan, launched in Jhunjhunu, Rajasthan, in March 2018, targets stunting, undernutrition, anaemia and low birth weight, by bringing different ministries together (convergence). It is run by the Ministry of Women and Child Development.

Two kinds of strategies:

• Direct, short-term interventions: ICDS (for children aged 0-6 and mothers); fortification of foods (like iodised salt); low-cost, local nutritious foods made by women's groups; supplements of iron, vitamin A, folic acid and iodine.
• Indirect, long-term measures: food security; better diets; poverty alleviation through employment and the PDS; land reform; health care; preventing adulteration; improving the status of women; education; and community participation.

Food-based strategies (diet diversification, home gardens, nutrition education, fortification) are sustainable, cost-effective, and carry no risk of overdose. Nutrient-based supplementation works quickly, but it is costly, short-term, and hard to reach everyone. The goal is to shift towards food-based approaches.

Programmes: ICDS; deficiency control programmes for vitamin A, anaemia and iodine; the Mid-Day Meal scheme; food security schemes (PDS, Antyodaya Anna Yojana, Annapurna, Food for Work); and self-employment and wage-employment schemes. Food first; supplements to bridge the gap.