Mentors Comments:

• https://www.thehindu.com/news/national/obesity-and-undernutrition-coexist-finds-study/article29550673.ece
• Data from the first-ever national nutrition survey conducted by the Centre, yet to be made public, shows that obesity and undernutrition coexist in India, among children. Health experts have raised concerns over the delay in the release of the survey. 
• One has to explain the prevalence of the double whammy facing the country and the causes leading to it along with solutions to overcome the situation.
• In the intro, discuss the Comprehensive National Nutrition Survey and its findings.
• In the main body, bring out the key findings of the survey such as – Out of the children in the age group of 5-9 years and adolescents in the age group of 10-19 years are
  • 10% are pre-diabetic
  • 5% are overweight
  • 5% suffer from blood pressure.
• The study found the prevalence of indicators of non-communicable diseases alongside indicators of undernutrition shown by various NFHS surveys such as stunting, wasting and underweight.
• The survey provides for the first time hard evidence of the coexistence of obesity and undernutrition, among school-going children.
• Discuss the key role that India’s nutrition policy has to play to address the concerns.
• Conclude with the way forward and need for better nutritional access as well as better support at the primary level. Discuss the solutions for the inequality which is a major reason for the lack of nutrition access. Revamping national nutrition policy will also be a talking point here.

Answer:

The key findings of the first-ever national nutrition survey conducted by the Centre, yet to be made public, providing for the first time hard evidence of the coexistence of obesity and undernutrition, among school-going children. The survey recorded malnutrition that included micronutrient deficiencies and details of non-communicable diseases such as diabetes, hypertension, cholesterol and kidney function in children and adolescents.               

Key findings of the survey:

The National Nutrition Policy in 1993, with Women and Child Development (WCD ) ministry as the nodal department, was designed as a multi-sectoral strategy for eradicating malnutrition and achieving appropriate nutritional status for all. Alas, targets for 2000 AD could not be achieved as there is general consensus that among nearly 40% of under-five children deaths, malnutrition is a major contributor.

Key features of the National Nutrition Strategy include:

• The Strategy aims to reduce all forms of malnutrition by 2030, with a focus on the most vulnerable and critical age groups. The Strategy also aims to assist in achieving the targets identified as part of the Sustainable Development Goals related to nutrition and health.
• The Strategy aims to launch a National Nutrition Mission, similar to the National Health Mission. This is to enable integration of nutrition-related interventions cutting across sectors like women and child development, health, food and public distribution, sanitation, drinking water, and rural development.
• A decentralised approach will be promoted with greater flexibility and decision making at the state, district and local levels.
• Further, the Strategy aims to strengthen the ownership of Panchayati Raj institutions and urban local bodies over nutrition initiatives
• The Strategy proposes to launch interventions with a focus on improving healthcare and nutrition among children as well as mothers.
• Governance reforms envisaged in the Strategy include (i) convergence of state and district implementation plans for ICDS, NHM and Swachh Bharat, (ii) focus on the most vulnerable communities in districts with the highest levels of child malnutrition, and (iii) service delivery models based on evidence of impact.

The following steps must be taken in policy action across 6 key areas viz.

• creating sustainable, resilient food systems for healthy diets;
• providing social protection and nutrition-related education for all;
• aligning health systems to nutrition needs, and providing universal coverage of essential nutrition interventions;
• ensuring that trade and investment policies improve nutrition;
• building safe and supportive environments for nutrition at all ages; and
• Strengthening and promoting nutrition governance and accountability, everywhere.

According to M S Swaminathan, to promote nutrient value food production, a multi-pronged strategy involving academic institutions, government, scientists and farmers should be evolved. Boosting nutrition levels as well as tackling obesity across the country is one of the biggest low hanging fruit in the Indian public policy sphere.