As per UNICEF report ‘Tracking Progress on Child and Maternal Nutrition’ in 2009, the proportion of India’s underweight children under five to the developing world is 42%. It is mentioned that these estimates are calculated on basis of data collected from 2001-02 or later and may not be comparable. However, as per the National Family Health Survey-3 (NFHS-3), 2005-06, 42.5% children under 5 years are underweight in the country.
The problem of malnutrition is complex, multi-dimensional and inter-generational in nature, and cannot be improved by a single sector alone. The approach in dealing with the nutrition challenges has been two pronged: First is the Multi-sectoral approach for accelerated action on the determinants of malnutrition in targeting nutrition in schemes/programmes of all the sectors. The second approach is the direct and specific interventions targeted towards the vulnerable groups such as children below 6 years, adolescent girls, pregnant and lactating mothers.
The Government has accorded high priority to the issue of malnutrition especially among children and women including young girls and is implementing several schemes/programmes through State Governments/UT Administrations. The schemes/programmes include the
Integrated Child Development Services (ICDS),
National Rural Health Mission (NRHM),
Mid-Day Meal Scheme, Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG) namely SABLA,
Indira Gandhi Matritva Sahyog Yojna (IGMSY)
as direct targeted interventions.
Besides, indirect multi-sectoral interventions include
Targeted Public Distribution System (TPDS),
National Horticulture Mission, National Food Security Mission,
Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), Nirmal Bharat Abhiyan,
National Rural Drinking Water Programme etc.
All these schemes have potential to address one or other aspect of Nutrition.
The main schemes/programmes of Ministry of Women and Child Development which have a bearing on the nutritional status includes the Integrated Child Development Services (ICDS) Scheme which provides a package of six services namely supplementary nutrition, pre-school non-formal education, nutrition & health education, immunization, health check-up and referral services. ICDS Scheme has since been universalised with effect from 2008-09. The total number of sanctioned Projects are 7076 and Anganwadi centres (including Mini AWCs and Anganwadi on demand) are 13.71 lakhs. Against this there are 7025 operational projects and 13.31 lakh operational AWCs as on January 2013. The services are currently availed by 927.66 lakh beneficiaries which include 746.81 lakh children (6 months to 6 years) and 180.85 lakh pregnant and lactating mothers.
Government has recently approved strengthening and restructuring of Integrated Child Development Services (ICDS) Scheme with a budget allocation of Rs. 1,23,580 crore during 12th Five Year Plan.
Another scheme, the Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG), or Sabla provides a package of services including health and nutrition to adolescent girls in the age 11- 18 years (with a focus on out-of-school AGs) in 205 districts on a pilot basis. The scheme has two major components i.e. Nutrition and Non Nutrition Component. The beneficiaries in 2011-12 were 100.77 lakhs and during 2012-13 are 88.49 lakhs so far.
Further, the Indira Gandhi Matritva Sahyog Yojana (IGMSY), introduced in 2010, is a Conditional Cash Transfer scheme for pregnant and lactating (P&L) women to contribute to better enabling environment by providing cash incentives for improved health and nutrition to pregnant and nursing mothers. The scheme is being implemented initially on pilot basis in 53 selected districts. The beneficiaries in 2011-12 were 3.05 lakhs and during 2012-13 are 3.76 lakhs so far.
The Mid Day Meal Scheme by Department of School Education and Literacy has a provision for providing hot cooked mid day meal to children studying in class I to VIII in Government, Government aided, local body schools as well as children studying in the National Child Labour Project (NCLP) schools and centres run under the Education Guarantee Scheme (EGS) / Alternative and Innovative Education (AIE) centres including Madarsas/ Maktabs supported under the Sarva Shiksha Abhiyan (SSA). During 2011-12, 10.54 crore children & in 2012-13, 10.43 crore children were covered under the Mid -Day Meal Scheme in the country.
The National Rural Health Mission (NRHM) and under its umbrella, the Reproductive and Child Health Programme, seeks to improve the availability and access to quality health care including Maternal and Child Health services particularly to rural population throughout the country. Some of the key steps undertaken through this programme are promotion of institutional deliveries through Janani Suraksha Yojana; capacity building of health care providers in basic and comprehensive obstetric care; antenatal and postnatal care including Iron and Folic Acid supplementation to pregnant & lactating women for prevention and treatment of anaemia; Janani Shishu Suraksha Karyakaram (JSSK) ( launched on 1st June, 2011) which entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section ; Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services ; operationalisation of Sub-centers, Primary Health Centers, Community Health Centres and District Hospitals for providing 24×7 basic and comprehensive obstetric care services.
Under NRHM, the Twelfth Plan strategy seeks to strengthen initiatives taken in the Eleventh Plan to expand the reach of health care and work towards the long term objective of establishing a system of Universal Health Coverage (UHC) in the country. Maternal and child care will continue to focus on reduction of IMR and MMR.
Government has also launched an Information, Education and Communication (IEC) Campaign against malnutrition for generating awareness on nutrition issues with the pro bono services of Shri Aamir Khan.