The Peculiarities Of Malnutrition Among Children In India

Introduction

Malnutrition means deficiency of proper nutrition in diet due to not having enough food. It mainly involves calories, protein, vitamins and carbohydrates. It has also divided into different types of under nutrition such as stunting, wasting, underweight and no proper vitamins and minerals (Pathak & Singh., 2011).

My essay topic area is malnutrition among children of India. In India, there is highest number of children at world level suffering from malnutrition (Pathak & Singh., 2011). Poverty is the main causative factor of malnutrition. There are several programs designed to provide children proper nutrition and for their growth and development for example Integrated Child Development Scheme, Mid-Day meal program and Special Nutrition Program (Upadhyay et al., 2011).

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This essay will analyze previous existing intervention that is Special Nutrition Program and the advocacy strategy for implementing malnutrition control program for development and health promotion. It is also focused to reduce hunger among poor and to make base for poverty eradication that is constant along with paying attention to sustainable development goals, social determinants of health such as poverty, theory of change and communication tactics. In my advocacy strategy, I will start with a social awareness campaign in which recruit people from grassroots. Furthermore, I will make alliance other organizations having same views towards reducing malnutrition and then set up short term and long term goals. Thus, to achieve my target there will be proper planning for putting pressure on decision making powers.

Previous intervention description

Special nutrition program was started in the year of 1970. It was launched by Social Welfare Ministry. It is operating among the people who are in serious need of it which includes urban slum area, tribal area and backward rural areas. This program was aimed at improvement of nutritional status among the targeted group (Planning Commission., 2001). During the year of 1970-71 it was limited among the age group of 0-3 years and nutritious food was supplied to 6.8 lakh (million) children. However, in 1971-72 it was extended to children age group 0-6 years and pregnant and nursing mothers also included. Furthermore, periodic check-up of children scheme was also proposed (NIHFW). Proper nutrition such as rice, lentils, vegetable or eggs, iodized salt is provided to children and also micronutrient powder having iron, folic acid and vitamin A is provided to nursing women. There are several social determinants associated with malnutrition such as low income, no sanitation, no education and lack of adequate awareness about healthy and nutritious food (Deshmukh et al., 2013).

Grass root community mobilization is present in this program. The program was initiated from grassroots only that is Anganwadi workers are playing vital role. It has proper prenatal and post natal care for mothers. New-born are provided with immunization. Children are having check-up on regular basis. Pregnant women during her last trimester is prioritized and emphasis on institutional deliveries. Lactating mothers are educated about initiation of breast feed soon after birth to focus colostrums feeding (Saxena., 2018).

Ministry of Women and child development and government of India run this program. The program was limited due to financial and lack of leadership efforts among such huge population. However, four national level organizations for example Indian Council of Child Welfare are providing grants for program implementation. There was need to monitor the program at district and block level. There should be number of outreach camps. Regular supply and monitoring of immunization material and also micronutrient powder was required. Attendance of mothers and children having nutritional services was also important for progress in management of malnutrition. Panchayats did not focus to construct Anganwadi centres. Along with these services awareness should be provided to mothers regarding child marriage, importance of education (Balarajan et al., 2016).

There was no specific theory of change was adopted in previous intervention program. The good part of this program is that services are provided in Anganwadi centres but on the other hand it is clear that some of villages are not having any Anganwadi centres and also panchayats are not focusing to construct. Then, there are some regional areas where people are lacking of services (Balarajan et al., 2016). However, it is clear in previous intervention that why change is required in malnutrition among children. Theory of change provided by Shiffman is focused on strengthen the organization (Shiffman & Smith., 2007).

The main activity of this program is to provide supplementary food to children, pregnant women and lactating mothers for 300 days throughout a year. Moreover, some initiatives were made at individual level in some states India. Program is focused to provide every child 300 calories and 8 to 15b grams of protein and for expectant and nursing mother is provided with 500 calories along with 25 grams of protein per day. Micronutrient is also given to expectant and nursing mothers such as iron, vitamin A and folic acid (Gulati et al., 2012).

Strategy plan

In my strategy plan for health advocacy implementation for issue of malnutrition among children is aimed to start with creating awareness among people regarding malnutrition. Furthermore, after involving people in malnutrition campaign, short term and long term goals should set. In short term goals home grown solutions will be there to tackle malnutrition. Long term goals will be focused to eliminate hunger and poverty. In addition to it, organizations sharing same ideas regarding reducing malnutrition will be contacted to make alliances. When several organizations will be together and aiming at same view towards malnutrition, it will be easy to target decision making powers with the help of effective communication tactics.

Link between problem and goal of advocacy to Sustainable Development Goals

Vulnerability to malnutrition among children is due inadequate knowledge about causes of malnutrition. There is no proper drinking resource which results in dehydration, lack of sanitation results in diarrhea and cholera outbreaks. There are several poverty eradication program but still have not reached to the centre of country. Mothers are illiterate which leads to several health issues due to lack of knowledge. It is commonly seen that if an illiterate mother is trying to cure diarrhea she removes solids from child diet (Gulati et al., 2012).

Reference to theory of change

In this strategy, people from the grassroots will be recruited for the development of social campaign. People from community will involve mothers, older people and community health nurses to create awareness among people regarding malnutrition and its risks to health. Community people will be taught about nutrition importance. Furthermore, educate and train community people about kitchen garden in which how to grow green vegetables and fruits rather than getting expensive and fortified food from market. Local people will be trained and then they will be sent to the isolated regions to spread information. There is continuous increase in use of artificial additives and preservatives in food that also affects health of population. Thus to limit these preservatives demonstration will be organized with the help of local community people against the companies. Community development and engagement will be helpful to address the root cause by raising awareness and also reflect on the SDGs such as no poverty and no hunger.

Alliance with other organizations

There will be continuous efforts to make alliance with other organizations. Engage with Right of Food and Nutrition Watch because it is an organization advocating for eliminating malnutrition at global level. For the development of policies this organization will play vital role in food policy to eradicate food companies’ influence. Organization is working to improve the access of food, social protection and providing people nutritionally adequate diet. In their 2015 report, the organization reveals the subtle but frightening violations of the human right to food by international corporations. The conclusion of the report indicated that the problem needs human rights-based solutions that are independent of commercial/business interests to ensure a diverse, healthy, sustainable, and culturally appropriate diet (Right to food and nutrition, 2015).

Another organization is FIAN (First Food Information and Action Network) is working to ensure that everyone should have food to feed themselves. Furthermore, this organization is present in some states of India as well (Windfuhr & Jonsén 2005). Moreover, FIAN is working on empowering starving people along with political support.

Communication tactics and building citizen power

To create awareness, it is very important to make partnership with the media. To fulfill our purpose, I will contact some reputed media partners. Furthermore, proper television programs providing information regarding malnutrition will be telecasted. In addition to it, online websites will be created with the help of organizations and NGOs working on same at world level to pressurize decision making powers. The prime minister of India Shri Narendra Modi will be aimed for my advocacy as he is leading Ministry of Agriculture & Farmers' Welfare (MAFW). MAFW is focused to get more and more yield from farmers. Peaceful demonstrations will be organized against the MAFW and ministry of health to persuade them to limit the use of unnatural additives on food by commercial companies.

My advocacy strategy will be having following activities:

• Educate the target audience on the importance of nutrition.
• Promote the adoption of indigenous approaches to farming on the selected media outlets.
• Train target personnel who will be sent on different target regions in India to educate the affected person on how to approach indigenous farming.
• Organize peaceful demonstrations against companies promoting unnatural food as a measure against malnutrition.
• Organize a peaceful protest against the MAFW to persuade them to limit the influence of commercial companies on food policy.
• Contact representatives of ERFNW, FIAN, and other nonprofits to join the cause.
• Enquire from the Ministry of Social Justice and Empowerment of India on how far the country is towards achieving the “no poverty” goal of the SDGs.

If the progress is not impressive, hold a public exchange forum to discuss ways of engaging the target SDGs. Create an online forum for the same. Create an emergency hotline for “save a child from hunger” initiative.

References

1. Balarajan, Y., & Reich, M. R. (2016). Political economy of child nutrition policy: A qualitative study of Inadia’s Integrated Child Development Services (ICDS) scheme. Food Policy, 62, 88-98.
2. Deshmukh, P. R., Sinha, N., & Dongre, A. R. (2013). Social determinants of stunting in rural area of Wardha, Central India. medical journal armed forces india, 69(3), 213-217.
3. Gulati, A., Kumar, A. G., Shreedhar, G., & Nandakumar, T. (2012). Agriculture and malnutrition in India. Food and nutrition bulletin, 33(1), 74-86.
4. NIHFW. Special Nutrition Programme (SNP). Retrieved from http://www.nihfw.org/NationalHealthProgramme/SNP.html
5. Planning Commission. (2001). Report of the Steering Committee on Empowerment of Women and Development of Children for the Tenth Five Year Plan (2002-07).
6. Pathak, P. K., & Singh, A. (2011). Trends in malnutrition among children in India: growing inequalities across different economic groups. Social science & medicine, 7 3(4), 576-585.
7. Right to food and nutrition (2015). The Right to Food and Nutrition Watch 2015: “Peoples' Nutrition Is Not a Business”.
8. Saxena, N. C. (2018). Hunger, under-nutrition and food security in India. In Poverty, Chronic Poverty and Poverty Dynamics (pp. 55-92). Springer, Singapore.
9. Shiffman, J., & Smith, S. (2007). Generation of political priority for global health initiatives: a framework and case study of maternal mortality. The Lancet, 370(9595), 1370-1379. doi:10.1016/S0140-6736(07)61579-7
10. Upadhyay , R. P., & Palanivel, C. (2011). Challenges in achieving food security in India. Iranian journal of public health, 40(4), 31.
11. Windfuhr, M., & Jonsén, J. (2005). Food Sovereignty: Towards democracy in localized food systems. FIAN-International.