The policy aims to map various schemes that address malnutrition and set up a robust convergence mechanism, and an information and communications technology-based real-time monitoring system, besides incentivising states and Union territories to meet the targets. It will also incentivise Anganwadi Workers (AWWs) for using IT-based tools, social audits and setting up of nutrition resource centres involving the masses. The intent of the policy is clear, but implementation could be a challenge.
“The programme is very ambitious, but before we achieve what we want to, we have to work on various issues ranging from sustainability and utilization of funds, and ground level work. The sustenance of the programme will totally depend on political will and investment in nutrition. Since states will handle the programme, accountability becomes a problem," said Alok Kumar, adviser, health, NITI Aayog.
“Moreover, real-time data is also missing about stunted and wasted children in India. We have to strengthen our monitoring and delivery systems," he said.
The scheme also suffers from under-utilisation of allocated funds, just like many other government programmes. The minutes of the national council meeting on India’s nutrition challenges held in February, highlighted concerns over dismal utilisation of funds by states and Union territories, which stood at 16% of allocated resources for 2018-19.
Malnutrition is a complex and multi-dimensional issue, primarily caused by several generic factors, including poverty, inadequate food consumption, inequitable food distribution, improper maternal, infant and child feeding, and care practices, inequity and gender imbalances, poor sanitary and environmental conditions, and restricted access to quality health, education and social care services.
Malnutrition statistics are also dismal. As many as 35.7% children under 5 years were underweight and 38.4% were stunted, according to the National Family Health Survey (NFHS-4) conducted by the ministry of health and family welfare in 2015-16.
“India grapples with a malnutrition crisis despite having more than 30 government programmes and schemes for maternal and child health, and nutrition, under various ministries and departments that often operate in isolation," said Shweta Khandelwal, head, nutrition research, Public Health Foundation of India.
“NNM requires a huge human resource input. In a low-and-middle-income-country with challenges around power supply, literacy, handling technology sensitively and sensibly may require a long period of hand-holding and capacity building. Motivating people to report and collect data ethically also have to be emphasised," she said.
NNM is backed by a National Nutrition Strategy prepared by the NITI Aayog with the goal of attaining “Kuposhan Mukt Bharat" or malnutrition-free India, by 2022.
More than 100 million people are expected to benefit from NNM, according to the government. The policy aims to reduce stunting, under-nutrition, and anemia among young children, women and adolescent girls, besides reducing low birth weight. The minimum target to reduce stunting is 2% every year, but the mission will strive to bring it down from 38.4% in 2016 to 25% by 2022, by ensuring convergence, implementation and monitoring other nutrition-related schemes. NNM will work with several entities, such as the women and child development ministry, health ministry and department of biotechnology, besides exploring public-private partnership. Tata Trusts, among others, are working with the government to support the NNM mission, with programmes such as Nutrition Dashboard, a pan-India rapid surveyance tool for effective nutrition-related programming and planning, besides a portal to access nutrition data and fortification of milk and oil.
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