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Bridging the Malnutrition Gap The Bemetara Way

Context:

It is believed that simplicity represents the highest form of sophistication. Through our experiences, we have learned that simple concepts are not always easy to implement but frequently yield the most successful results. Given this perspective, providing guidance on dietary and feeding habits while tracking individuals’ progress can have a profound impact and significantly alter the outcome.

Relevance:

GS2-

  • Welfare Schemes for Vulnerable Sections of the population by the Centre and States and the Performance of these Schemes; Mechanisms, Laws, Institutions and Bodies constituted for the Protection and Betterment of these Vulnerable Sections.
  • Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources.
  • Issues relating to Poverty and Hunger.

Mains Question:

Nutrition Counseling can be a gamechanger in India’s fight against food insecurity. Comment. (10 marks, 150 words).

Current status of food security in India:

Throughout the years, the government has made diligent efforts to ensure food security:

  • Presently, students receive midday meals at their schools, and citizens obtain monthly rations through a continuously improving Public Distribution System.
  • Furthermore, mothers and children at Anganwadi Centers (AWCs) benefit from ready-to-eat packets and hot meals as part of the Prime Minister’s Overarching Scheme for Holistic Nourishment (POSHAN Abhiyaan).
  • Additional supplements like eggs, bananas, protein powders, peanut chikki, and jaggery are also distributed under various state-specific programs, exemplified by the Mukhyamantri Suposhan Yojana in Chhattisgarh.
  • Nevertheless, achieving nutrition security remains a distant aspiration. Many people lack knowledge about proper dietary and feeding practices, and misconceptions about food persist, exacerbated by increased access to highly processed foods. Nutrition counseling holds the potential to address this problem.

Nutrition Counselling and Jan Andolan:

  • The “Jan Andolan,” which is a part of the POSHAN Abhiyaan, encompasses various activities aimed at social and behavioral change communication (SBCC).
  • These activities include bicycle rallies, the establishment of Poshan Vatikas, the celebration of Poshan Maah, Poshan Pakhwaras, and Godh Bharaais.
  • Different states have organized diverse awareness programs as part of SBCC. However, the integration and consistent implementation of nutrition counseling have not been fully realized across states.
  • In fact, according to the POSHAN Abhiyaan Progress Report from 2018, it states that “A focused and coherent SBCC Action Plan is crucial to advance the objectives of the POSHAN Abhiyaan.”
  • Hence, there is a pressing need to ensure that field staff receives proper training in nutritional counseling, and it should be made mandatory and uniformly enforced by all states.

Case Study of Bemetara, Chhattisgarh in nutrition counselling:

About Bemetara:

Located in the fertile plains of Chhattisgarh, Bemetara remains untouched by Naxalite activities and boasts agricultural prosperity. In December 2022, the count of Severe Acute Malnutrition (SAM) cases here increased to 3,299. This statistic closely mirrors the situation observed in tribal-dominated and Naxal-affected districts like Bastar.

It highlights the issue of inadequate understanding regarding appropriate feeding practices. The primary challenge doesn’t revolve around access to food but rather the lack of knowledge regarding the timing, methods, and food choices for consumption. This is precisely why the approach of nutrition counseling coupled with vigilant monitoring was selected as the operating method for this area.

Nutrition Counseling in Bemetara:

  • The “Potth Laika Abhiyaan,” meaning “Healthy Child Mission” in the Chhattisgarhi language, is a nutritional counseling initiative currently underway in 72 of the most affected Anganwadi Centers (AWCs) within the Bemetara subdivision of Bemetara district.
  • This program receives technical support from UNICEF, Chhattisgarh. In this region, frontline staff from the Health and Women and Child Development departments have received comprehensive training on delivering nutrition counseling.
  • On a weekly basis, specifically every Friday, parents of children identified as Severely Acute Malnourished (SAM) and Medium Acute Malnourished (MAM) are invited and provided with counseling sessions.
  • They are educated in simple Chhattisgarhi language about the significance of a balanced diet known as “Tiranga Bhojan,” the importance of regular handwashing, and various other tips to lead a healthy lifestyle. Additionally, these sessions dispel harmful dietary myths and superstitions.
  • The progress of the targeted children is closely monitored, and local leaders such as sarpanchs, panchayat sachivs, and religious figures actively participate in these counseling sessions.
  • Furthermore, door-to-door visits are conducted to the homes of these identified children to track their development and well-being.

Success of the initiative:

  • Within a span of nine months, from December 2022 to July 2023, the Potth Laika Abhiyaan successfully lifted 53.77% of the targeted children out of malnutrition, equivalent to 599 out of 1,114 children.
  • Notably, this initiative resulted in 61.5% of Medium Acute Malnourished (MAM) children and 14.67% of Severely Acute Malnourished (SAM) children recovering from malnutrition.
  • In a comparative analysis with a randomly selected control group of 20 Anganwadi Centers where the mission was not implemented, only 30.6% of the children were able to overcome malnutrition. Specifically, 33.8% of MAM children and none of the SAM children improved in the control group. This demonstrates a substantial 23% increase in recovery rates compared to the control group, which is highly encouraging.
  • Furthermore, while providing meals often involves complex budgeting and the risk of resource misallocation, this mission operates at zero cost, necessitating no more than a few training sessions and regular monitoring. Consequently, it has proven to be not only effective but also cost-efficient.

Conclusion:

Based on the lessons learned from these experiences, it is clear that this approach should be expanded on a broader scale, encompassing multiple districts and states. Simply supplying food to those in need must be complemented by nutrition counseling and ongoing monitoring to effectively advance the goal of eliminating malnutrition. It is only when this straightforward yet potent strategy of nutrition counseling is fully embraced and implemented in both word and deed that India can make significant strides toward realizing the ambitious yet noble aspiration of a “Kuposhan Mukt Bharat,” or a Malnutrition-Free India.


July 2024
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