Nutrition targets and community participation

Theme-based observation of POSHAN (Prime Minister's Overarching Scheme for Holistic Nutrition) month throughout September is aimed at a focused and assimilated approach for improving the nutritional status of children in the 0-6 year age group. Data from National Family Health Survey (NFHS) round-5 implies that Assam has to go beyond the routine programmes to achieve the objectives of the mission. The flagship mission of the Central government aims to reduce malnutrition in children of this age group in a phased manner. A key target set under the mission is to reduce the stunting of the children in this age group to 25% by 2022. NFHS-5 data reveal that percentage of children below 5 years who are stunted reduced marginally from 36.4 in 2015-16 to 35.3 2019-20 while the percentage of children who are wasted (weight is too less for his or her height due to undernutrition) increased from 17 in 2015-16 to 21.7 in the state. The percentage of children who are underweight increased to 32.8 from 29.8, and the percentage of overweight children increased from 2.3 to 4.9. The percentage of overweight children in urban areas in the state is as high as 8 while it is 4.5 in rural areas which are indicative of the rise in junk food consumption among children in urban Assam. NFHS-5, the latest available data of the series, also show that percentage of children aged 6 to 59 months who are anaemic increased from 35.7 in 2015-16 to a whopping 68.4 in 2019-20 which is a matter of grave concern and call for urgent intervention. The percentage of pregnant women in the age group 15-49 years who are anaemic increased from 46 to 65.9 which increases the risk of both maternal mortality and infant mortality. Percentage of teenage girls (15 to 19 years) who are anaemic also recorded an increase from 46 to 65.9. As the prevalence of teenage pregnancy is high in some areas of the state, a high incidence of anaemia puts them at high risk of maternal mortality and the risk of mortality of children born to them also increases manifold. A closer look at NFHS-5 data for some other parameters like child feeding practices reveals a gloomier picture of the nutritional status of children in the state. The percentage of children under three years of age breastfed within one hour of birth decreased from 64.4 to 49.1 per cent of children who are exclusively breastfed remained almost static at 63.5. Data from NFHS-5 emphasise the importance of POSHAN Abhiyan, earlier known as National Nutrition Mission to achieve improvement in the nutritional status of children from 0-6 years, adolescent girls, pregnant women and lactating mothers in a time-bound manner to reduce the level of stunting, under-nutrition, anaemia and low birthweight babies. Four weekly themes for this POSHAN month includes Poshan Vatika for plantation activities in the first week followed by yoga and AYUSH nutrition in the second week, distribution of 'Regional Nutrition Kit' to Anganwadi beneficiaries of High Burdened Districts in the third week and identification of the severely malnourished children and distribution of food in the last week. Plantation activities include the planting of saplings of fruit trees, local vegetables and medicinal plants and herbs in the space available at Anganwadi Centres, school premises and offices of panchayats and other places. Fruit-bearing trees and varieties of local vegetables are available in abundance in the state while climatic and soil conditions are also suitable for growing these in the state. Such favourable condition generates the expectation that the state will lead the country in observation of the Poshan Vatika so that children, as well as targeted women, are benefited immensely through improved nutritional support from natural sources available around them. Given the high incidence of malnutrition, thematic observation of the fourth week bears special significance for the state and is also crucial to intensify identification of the severely malnourished children in every nook and corner. Building awareness on the nutritional status of children and women plays a critical role in communities lending support to identify such children. The idea of observation of the POSHAN month is to generate awareness among Angwanwadi workers and among the communities to inculcate the practices of taking nutritional care of children, pregnant women, and lactating mothers as routine activities, which are not to be confined to official scheme implementations or limited to awareness campaigns. The prevailing pandemic situation has disrupted the normal functioning of the Anganwadi centres triggering apprehension of an increase in the number of malnourished children and women. As the state is gradually unlocking, implementation of the POSHAN mission can be expected to gain momentum in the coming days. Participation of the communities moving beyond the attendance in awareness programmes to their homestead gardens, kitchens, and menus on the food table for children and womenfolk of the household will be an indicator if POSHAN Abhiyan has turned into Jan Andolan or People's Movement in true sense in the state.