India is dealing with a severe health and nutritional crisis, the Women and Child Development Ministry has reported. The country has more than 9.2 lakh children, ranging from six months to six years in age, who are ‘severely acute malnourished.’ This situation has been further accentuated by the Covid-19 pandemic, affecting mostly the poorest of the poor.
Understanding Severe Acute Malnutrition (SAM)
The World Health Organisation (WHO) describes ‘severe acute malnutrition’ (SAM) as very low weight-for-height, or a mid-upper arm circumference less than 115 mm, or by the presence of nutritional oedema. Conditions like these make children suffering from SAM nine times more likely to die from diseases, due to a weakened immune system.
Nutritional Oedema
Nutritional oedema refers to abnormal fluid retention in body tissues, especially when there’s a deficiency of protein, usually occurring in states of starvation or malnutrition. However, it’s important to note that oedema can occur even without a drop in blood levels of albumin during starvation.
Assessing the Scale of Malnutrition in India
According to official figures up to November 2020, an estimated 9,27,606 severely malnourished children were identified across India. The highest numbers were recorded in Uttar Pradesh (3,98,359), followed by Bihar (2,79,427). Interestingly, no cases of severe malnutrition were reported in Ladakh, Lakshadweep, Nagaland, Manipur, and Madhya Pradesh.
Findings from the National Family Health Survey (NFHS)
The National Family Health Survey-4 (NFHS-4), 2015-16 suggests that prevalence of severe acute malnutrition among children was at 7.4%. The survey further showed that malnutrition rose among children in 22 states and Union Territories in 2019-20 from 2015-16.
Stunted and Wasted: The State of India’s Children
The NFHS-4 reported that around 13 out of 22 surveyed states and Union Territories recorded a rise in the percentage of children under five years who are stunted compared to 2015-16. Stunting is when a child has a low height for their age, usually due to malnutrition, repeated infections, and/or poor social stimulation. Furthermore, 12 states and Union Territories saw a rise in the percentage of children under five years who are wasted. Wasting depicts low weight for their height among children, reflecting acute undernutrition.
The Impact of Covid-19 on Malnutrition
Covid-19 has pushed uncountable people into poverty, reducing incomes and affecting those economically disadvantaged disproportionately. These vulnerable individuals are also the most susceptible to malnutrition and food insecurities.
Government Initiatives to Address Malnutrition
Several initiatives have been launched to tackle this crisis, including the National Nutrition Mission (NNM) or POSHAN Abhiyaan, Anemia Mukt Bharat Abhiyan, Mid-day Meal (MDM) scheme, The National Food Security Act (NFSA), Pradhan Mantri Matru Vandana Yojana (PMMVY), and Integrated Child Development Services (ICDS) Scheme.
A Way Forward to Tackle Malnutrition
Moving forward, the apparent solutions to alleviate this situation include home-based care, facility-based care, building linkages with government systems for better food availability, utilisation, awareness, strengthening Nutrition Rehabilitation Centres (NRCs), designing customised menus for SAM cases, and enhancing the role of Anganwadi Centres.
The road to a malnutrition-free India is a long one, but with adequate steps and attention, can be achieved in the near future.