Nutritional deficiencies

September will be observed in the country as the nutrition month to raise awareness on the importance of nutrition and proper nourishment of children, pregnant women, and lactating mothers. Poor utilization of central fund released under the national flagship programme of POSHAN Abhiyan by Assam reflects that the actual achievement on the ground is not the mirror image of the awareness drive in the state. The nutrition support and other nourishment in the first 1,000 days of every child is critical to achieving the national target of reducing child stunting, underweight and low birtPOSHAN Abhiyan by Assam rdrive with aggressive push for improvement in institutional mechanism right up to the village levels. State-wise data of funds released and utilised under POSHAN Abhiyaan tabled in the Rajya Sabha in February show that nearly 64 per cent of the central fund remained unutilized till 2019-end in Assam. The state could utilise only Rs. 115.92 crore of the total central fund of Rs. 319.62 crore released to the state since launch of the scheme in 2017. A report of the NITI Aayog titled "Transforming Nutrition in India: POSHAN Abhiyan" published in September 2019 revealed Assam scored zero ranking on a scale of 0 to 6 and for not taking initial steps towards cross-sectoral convergence. The POSHAN Abhiyan being an over- arching mission of leveraging funds, functionaries, technical resources and information education and communication activities under existing schemes and programmes contributing towards addressing malnutrition, the convergence is critical to aligning the efforts of all stakeholders. The report also brought to light that more than 50 per cent of District Programme Officers were not filled up in the state. A recent advertisement for filling up 37 vacancies at the district and block level indicates the human resource gap existing in the state. Data from the Round 5 of the National Family Health Survey (NFHS) are still awaited as works under it have been disrupted and delayed by COVID-19 pandemic and therefore the governments and other agencies will have to depend data from NFHS-4 and the Comprehensive National Nutritional Survey (CNNS) (2016- 2018) for identifying the gaps and articulating the strategies. The CNNS data show that less than 50 per cent mother or caregivers of children aged 0-4 years are exposed to any mass media (read newspaper or magazine, listen to radio, or watch television at least weekly) in Assam. The campaign strategy for building awareness during the POSHAN month, therefore, requires a focus on alternative communication channels in addition to the traditional mass media. Only 6.5 per cent children aged 6-23 months are fed a minimum acceptable diet. Among the children in the 2-4 years only 19.4 per cent are fed eggs, 49.2 per cent get Vitamin-A rich foods and vegetables, 31.9 per cent receive other fruits and vegetables. Comparison of some of these data with those of Meghalaya points towards the gap Assam needs to bridge to improve nutritional support to targeted beneficiaries. The CNNS data show that Meghalaya tops the chart in feeding Vitamin-A rich food and vegetables to children aged 2-4 years with coverage of 93.8 per cent and in feeding eggs with 70.8 per cent. An estimated 67.7 per cent children in this category in the hill state are fed other fruits and vegetables ranking third in the list against 25th rank of Assam. Meghalaya also tops the chart in feeding flesh foods to children in this age group with 77.2 per cent against 49.1 per cent in Assam. Consumption of dairy products in the neighbouring state among this age group is 71.8 per cent compared to 39.3 per cent in Assam. The NFHS-4 data show that 29.8 per cent of children under 5 years are underweight (30.8 per cent in rural areas and 21.4 per cent in urban areas) while 36.4 per cent of children are stunted. Rural areas account for 38 per cent of stunted children against 22.3 per cent in urban areas which calls for special focus of the awareness drive in rural Assam. In his latest address of Mann Ki Baat Prime Minister Narendra Modi has underlined the need for schools having a Nutrition Monitor like a Class Monitor and introducing a Nutrition Card like a Report Card. There is no likelihood of classes reopening in the month of September due to rising number of COVID-19 cases in the state, campaign strategies will have to look beyond the classrooms in order to reach out to the children to raise awareness among them as suggested by the Prime Minister. Panchayats and Angwanwadi centres can be effective alternative channels for taking the campaign to mass audience. Clubbing the POSHAN campaign with awareness drive on COVID-19 can be one of the options.