Because India faces a double-burden of malnutrition, (over-nutrition and under-nutrition), there is need to adopt a multi-sectoral nutritional approach
India has witnessed noteworthy improvement in health and nutrition in the last decade, especially among children. The recently released fourth round of National Family Health Survey (NFHS) 2015-16 data, compared to the third round of NFHS (2004-05) data shows that stunting (low height-for-age) levels have reduced by seven per cent (from 45 to 38); underweight (low weight-for-age) by five per cent (from 40 to 35) and wasting (low weight-for-height) by two per cent (from 23 to 21). These declines are encouraging but not substantial. More than a quarter of the children in the country continue to suffer from one or the other type of malnutrition.
Further, anaemia continues to affect 50 per cent of women, including pregnant women, and 60 per cent of children in the country. While anaemia prevalence has decreased in children by 20 per cent points, from 79 per cent to 59 per cent, the change is not so significant in women (three per cent decline) or in pregnant women (eight per cent decline). Anaemia is also on rise among men, currently at 22 per cent.
The problem of malnutrition and undernutrition on one hand, is compounded by the rising trend of obesity among Indians. Latest NHFS data show an upward increase in the levels of obesity among both men (seven per cent) increase from 12 to 19) and women (six per cent increase from 15 to 21). Furthermore, around six per cent of women and eight per cent of men suffer from diabetes; seven per cent and 10 per cent of women and men suffer from hypertension respectively. This double burden of undernutrition and growing percentage of obesity, hypertension and diabetes puts a dent on the country's growing asset (healthy human resource).
Another indicator highlighting malnutrition in India, is its ranking in the Global Hunger Index (GHI). India ranks lower than other developing countries from the region on global indexes measuring hunger and malnutrition. It ranked 97 out of 118 countries (scoring 28.5 falling under serious category) in the GHI 2016. Though this score has improved from the earlier score of 36 in 2008, the nation is still one of the worst performers in the region. Out of a total of four components for calculating GHI, three are nutrition parameters (underweight population, wasting and stunting in children) indicating the highly unsatisfactory state of nutrition in the country. As per the Global Nutrition Report (2016), India ranks 114th out of 132 countries on under-five stunting and 120th out of 130 countries on under-five wasting and 170th out of 185 countries on prevalence of anaemia.
To address the problem of malnutrition and under-nutrition, the Indian Government has taken important steps, such as the release of fortification standards for five staples by the Food Safety and Standards Authority of India (FSSAI) to fight micronutrient malnutrition, release of food composition tables by the National Institute of Nutrition to increase focus on dietary diversity, and now, the release of nutrition data to address the issue of malnutrition more holistically.
The Sustainable Development Goal (SDG)-2 goal, which aims to “end hunger, achieve food security and improved nutrition and promote sustainable agriculture”, is a priority area for India, which can offer key solutions for hunger and poverty eradication and also tackle the issue of malnutrition and undernourishment in the country. To achieve the SDG target, a number of steps are being taken globally and in the country by the Food and Agriculture Organisation of the United Nations (FAO). One of FAO's strategic objective is to help eliminate hunger, food insecurity and malnutrition globally. The FAO looks at nutrition from the perspective of food and agriculture-based approaches as the sustainable long-term solution to hunger and malnutrition. A pilot harnessing the power of modern day technology for improving the health and nutrition behaviours among tribal populations in the state of Odisha has just been initiated.
Because India is facing a double-burden of malnutrition: Over-nutrition and under-nutrition existing simultaneously, there is a pressing need for a multi-sectoral approach along with nutrition-sensitive and nutrition-specific interventions to address the problems holistically. For this, there is a need to reiterate the priorities which may include, spreading of knowledge and awareness regarding safe food, diversifying food baskets, putting women and children at the centre of any nutritional intervention and leverage on modern technologies to impart nutrition-linked messages and sustainable agricultural practices.
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