Covid-19 has been a difficult time and the lock-down limited outreach. However, there is limited evidence from some organizations that conducted some telephonic surveys in few states. In one of the studies conducted in UP and Bihar, demand for nutrition services in rural areas was highest followed by child immunization and family planning services.
Another study conducted four rounds of surveys across 27 districts in 9 states to provide regular district-level updates on the rapidly evolving situation across some of the India’s most vulnerable populations due to Covid-19. The survey topics covered in the first round were Covid-19 awareness, migration impacts, food insecurity and economic impacts. Around 43% respondents reported that they or someone in their household reduced portions or gave up a meal altogether since the lock-down, whereas around 55% of respondents reported that they stopped eating certain food items during the same period. A telephonic survey of around 700 anganwadis in Jharkhand revealed that more than 80% anganwadi workers had distributed take home ration, however, less than 50% provided additional ration to severely wasted and underweight children.
Govt. of India has taken many initiatives in a mission-mode. However, across the states there are gaps that require immediate attention to strengthen the inputs and the pillars of Poshan Abhiyaan. The binding constraints in implementation are gaps in human resources, particularly at the supervisory level, procurement of growth monitoring devices and smartphones, and likelihood of attrition in the quality of data collected through Integrated Child Development Services- Common Application Software, fund utilization, convergence at grassroots level, capacity building etc.
Possible impact would be a reduction in the number of meals per day leading to inadequate dietary intake and diseases. The impact of malnutrition, especially among severe acute malnourished (SAM) children, is extremely high as health and nutrition services are reduced, the caring structures have broken down, and trauma is increasing. Screening of children to identify acute malnutrition has been long halted, posing a likely scenario of the increased burden of malnutrition. Also, immunization was at a halt for some time. According to Global Nutrition Report 2020, no country is on course to meet all eight global nutrition targets.
Apart from the pandemic, India also has to deal with already existing problems of unemployment, low incomes, rural distress, malnutrition and widespread inequality which are aggravating further. Pandemic has caused food and nutrition shortages and driven governments to reduce social services, such as school nutrition programmes that the most marginalised rely upon. hunger and malnutrition could double within the space of just a few weeks, which is likely to increase load on Nutrition Rehabilitation Centres to serve SAM children. Under nutrition and micronutrient deficiencies cost up to $ 2.1 trillion per year as per the Comprehensive National Nutrition Survey, 2016-18. This is likely to increase further due to Covid-19.
Civil Society Organizations, including self help groups, can play an active role in supporting solutions at a local level, such as promotion of nutrition garden to generate self-reliant populations, support capacity building efforts, nutrition security, technology innovations in agriculture, data collection and monitoring mechanisms. The role of Panchayati Raj Institutions (PRIs) can facilitate availability, accessibility and counselling for proper utilization of services, and build awareness on locally available foods, and promotion of appropriate dietary habits. Private sector plays a significant role in social development. This is a right time to explore public-private-partnership opportunities for creating a sustainable public health ecosystem.
Community-based management of acute malnutrition is the best way to tackle malnutrition in the present scenario. It can be leveraged for ensuring many services related maternal and child health such as use of mobile phones for counselling by front line workers, use of remote health advisory and intervention services like dial 104 helpline for getting all the necessary health information and guidance, strengthening mother and child tracking system. Poshan helpline number for ensuring health care, immunization services, and regular counselling through nutrition specialists.
Matter referenced:
Sujeet Ranjan, Executive Director of Coalition of Food and Nutrition Security, Times of India, Ahmedabad, Monday, 8th June, 2020.
By: Dr. Bhawana Asnani.
Happy to see Reviews, Additions, Suggestions and Comments, further.
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