NATIONAL CONFERENCE ON MISSION MODE TO ADDRESS UNDERNUTRITION SEPTEMBER 19, 2017 VIGYAN BHAWAN ADDRESSING INDIA'S STUNTING AND ANEMIA IN HIGH BURDEN DISTRICTS
INDIA S COMMITMENT : A WILL TO DELIVER AND TRANSFORM Poverty, lack of education & malnutrition - these are big challenges our nation faces. We need to bring a positive change in this regard': Hon ble Prime Minister, Shri Narendra Modi Food Commissions and Nutrition Missions have been established in a number of states Legislation like NFSA-2013 mandates food and nutrition security in a life cycle approach India being a signatory to Sustainable Development Goals(SDGs) and World Health Assembly (WHA) targets is committed to achieve key targets National Nutrition Mission and numerous policies are in the agenda. India s Judiciary and Quasi- Judicial Bodies are taking up issues on malnutrition
THE CURRENT LANDSCAPE Source: Global Nutrition Report, 2016: From promise to impact: Ending Malnutrition by 2030
STUNTING AMONG UNDER-FIVE CHILDREN & ANEMIA AMONG WOMEN OF REPRODUCTIVE AGE, BY DISTRICT, 2016 48.0 % --- 38.4 % 55.3 % --- 53.0 %
INDIA S FUTURE PRODUCTIVE WORKFORCE (15 TO 59 YEARS- IN MILLIONS) 100% 117 139 164 191 220 253 291 330 368 405 440 471 494 515 533 548 559 566 75% 817 877 930 972 1007 1033 1046 1049 1044 1032 1014 994 975 951 926 899 874 850 50% 25% 377 373 368 365 358 348 337 326 317 308 298 289 280 271 264 257 250 244 0% 2015 2020 2025 2030 2035 2040 2045 2050 2055 2060 2065 2070 2075 2080 2085 2090 2095 2100 0-14 15-59 60+ Source : Probabilistic Population Projections based on the World Population Prospects: The 2015 Revision, UN Population Division, 2015
Stunting And Anaemia Affecting India s Demographic Dividend NFHS-II(1998-99). Stunting- Children 0 35 months: 45.5% Anaemia -Children 6 35 months: 74.3% Anaemia -Women: 51.8% 0 to 59 months in 2006 (115 million) 5 to 9 years in 2011 (113 million) 10 to 14 years in 2016 (113 million) In 2005-06, India had over 50 million stunted children = 40 million years of lost schooling = INR 14,400 lost in annual income per child = INR 313 billion lost in future earnings per year 15 to 19 years in 2021 (112 million) 20 to 24 years in 2026 (112 million) Being Stunted as a child Source:The total population of each age group has been taken from the projected population (2006-2026) from the Population Projections for India and States (2001-2026); RGI, GoI; GNR = 22% of Adult Income Lost Micronutrient deficiencies (including Anaemia) cost India INR 165 billion each year NFHS III(2005-6)- Stunting 48% Anemia-55.2% NFHS-IV(15-16)- Stunting -38.4% Anemia-53%
UNDERNUTRITION- CONSEQUENCES & THE POWER OF NUTRITION PROBLEM MANIFESTATIONS CONSEQUENCES IMPACT Undernourishment Stunting Micronutrient Deficiency Sub-optimal Breastfeeding Wasting Small for gestational Age 01 02 03 04 05 Under five and maternal deaths Impaired Physical and Cognitive Development Decreased Economic Productivity Compromised Adult Health High risk of Intergenerational Perpetuation 45% of Underfive Mortality IQ loss (e.g. 5-11 points by stunting) 22% of adult income loss Every Rs. Invested in Nutrition gives an average return of Rs. 16 Annual GDP loss of 11%
OUR MANDATE AND COMMITMENT TO ACHIEVE WHA TARGETS In 2012 the World Health Assembly (WHA) unanimously agreed to a set of SIX GLOBAL NUTRITION TARGETS THAT BY 2025 India being a signatory to SDG has to achieve WHA targets by 2025. This requires ownership and accountability from each state to contribute towards India achieving these targets. 1. Reduce by 40 per cent the number of children under 5 who are stunted; 2. Achieve a 50 per cent reduction in the rate of anaemia in women of reproductive age; 3. Achieve a 30 per cent reduction in the rate of infants born low birth weight; 4. Ensure that there is no increase in the rate of children who are overweight; 5. Increase to at least 50 per cent the rate of exclusive breastfeeding in the first six months; and 6. Reduce childhood wasting to less than 5 per
KEY FOCUS AREAS: MISSION MODE TO ADDRESS UNDERNUTRITION Focus on first 1000 days Supplementary Nutrition IT enabled monitoring SBCC/Media Campaign PMMVY and JSY Comprehensive regulation for large scale food fortification Focus on Deworming + Open Defecation Free society Strengthening Supply Chain Composite incentives Using life cycle approach with a focus on pregnancy and first two years of life Take Home Ration and Hot Cooked Meals Aadhaar based tracking and monitoring of beneficiaries of ICDS and Health Implementing a comprehensive Social Behaviour Change Communication Plan (SBCC) (including media campaign) Convergence to provide Maternity Benefit Using regulation for fortification of Oil, Salt, Milk and staples in food distribution systems (TPDS, THR, MDM) for anaemia & various micronutrient deficiencies Reduce the impact of poor sanitation for addressing anemia and undernutrition Ensuring access to health services IFA, Deworming, Vitamin-A, ANC Recognition of excellent work of Field Level Workers (AWWs + ASHAs + ANMs) in improving nutritional status
SOLUTIONS TO COMBAT MICRONUTRIENT DEFICIENCIES Solutions Dietary diversification Supplementation Bio Fortification Food Fortification Bio fortification is breeding crops to increase their nutritional value, which can include both conventional selective breeding, and modern genetic modification. Food fortification involves addition of nutrients to the staples and food products Control of vitamin and mineral deficiencies is an essential part of the overall effort to fight hunger and malnutrition
PRIORITISE DISTRICT LEVEL ACTIONS ON NUTRITION Setting ambitious goal for Malnutrition Free India by 2022 (75 years of India s independence) High Burden districts, Hunger and Malnutrition hotspots identified and Multi-sectoral RESULT based district plans in : 113 high burden stunting districts Plus one most backward district in each state Village wise community based and community owned planning and monitoring as the bedrock of district plans. Focus on convergence, review reviews and accountable mechanisms: Regular Data-driven Quality Knowledge Management: Gather evidences and best practices for scale up and replication Multi-stakeholder partnerships District Magistrates and the district level officials of Health & Family Welfare, ICDS/Social Welfare and Water & Sanitation Departments should play a pivotal role. Engage and revitalise Local Government Bodies and District Grievances Authority mandated under NFSA
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