How India can lead the way in innovation for nutrition program

According to the World Health Organization (WHO), malnutrition refers to deficiencies, excesses, or imbalances in a person's energy and nutrient intake. It is well-known that maternal, infant, and child nutrition play significant roles in the proper growth and development, including the future socio-economic status of the child. National Health & Family Survey reports United Nations International Children's Emergency Fund and WHO have highlighted that rates of malnutrition among adolescent girls, pregnant and lactating women, and children are alarmingly high in India.

These affect children in several ways, including stunting, childhood illness, and retarded growth. Although India has nominally reduced malnutrition over the last decade, India has been implementing several programs with innovative strategies to address issues related to nutrition and healthcare.

Since the late 1960s, India has made considerable progress in reducing hunger in terms of calories. Still, many people remain undernourished, and now the country is also facing rising rates of obesity.

With the country assuming the G20 presidency this year, it will continue to focus on health and nutrition and learn from previous presidencies, even as it highlights critical areas that require the mobilization of resources. During the G20 Sherpa meeting, India's Shri Amitabh Kant spotlighted the numerous initiatives India has successfully implemented, especially those aimed at strengthening the health system and reducing hunger and malnutrition. His statement particularly resonated with global leaders, who agreed that India had made large-scale strides within the healthcare sector, especially with community programs.

The G20 Action Plan on agriculture and food security is one of the core initiatives driven by India's presidency and assumes importance with the ongoing global food crisis. This aligns with the programs India has implemented for its citizens to negate the harsh effect of hunger and malnutrition.

One of the first notable strides in upholding nutritional standards and food security for its citizens was the Government of India's flagship health program, the National Health Mission (NHM). The NHM has two sub-missions: the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM). The NHM, NRHM, and NUHM seek to improve access to quality healthcare services in India, with underserved and disadvantaged populations at the initiative's core. They aim to strengthen the healthcare system and address health inequities in the country by providing financial and technical assistance to States and local governments to improve the delivery of healthcare services.

The NHM has also intensely focused on reducing the prevalence of anaemia across India. The Anemia Mukt Bharat (AMB) mission intensified the Iron-Plus Initiative program to strengthen existing mechanisms and foster new strategies to tackle the problem. This program is based on a 6*6*6 strategy (six beneficiaries, six interventions, and six institutional mechanisms). The six interventions are prophylactic iron and folic acid (IFA) supplementation, deworming, intensified year-round behaviour change communication campaign, testing of anaemia using digital methods and point-of-care treatment, mandatory provision of IFA-fortified foods in government-funded health programs, and addressing non-nutritional causes of anaemia in endemic pockets, with a particular focus on malaria, haemoglobinopathies, and fluorosis. Its partial success has paved the way to establish and implement several supplemental nutritional programs.

This has helped reduce the prevalence of malnutrition in the long term by promoting healthy eating habits and increasing access to nutritious food. The most significant feature of this scheme is to improve parents' capabilities to take care of their children, involving the community by encouraging self-help in improving the family's quality of life and well-being.

The most successful implementation of a nutritional program in a developing nation, however, has been the Mid-Day Meal Scheme which outlines a good approach that G20 member countries can follow. The scheme provides free cooked meals to schoolchildren with a minimum energy content of 450 calories and protein of 12 grams per child per day. The initiative has been credited with increasing enrollment and retention in schools, particularly among girls and children from disadvantaged backgrounds, thereby

having a positive impact on nutritional and educational outcomes.

Role Dairy Can Play in Fighting Malnourishment:

In central and eastern India's economically lagging and less agriculturally productive states, 63% of dietary calories come from cereal grains. This leads to stunting and wasting of bodies due to nutrient deficiencies in diets, especially for the impoverished. In contrast, in northwestern and southern India's more developed and more agriculturally productive states, access to processed foods and edible fats has had the opposite effect. In the last ten years, the rate of obesity doubled for men and increased by 62% for women, bringing with it a rise in diabetes and heart disease.

The proven health benefits of dairy products are loaded with essential vitamins and minerals, including carbohydrates, protein, calcium, phosphorus, potassium, vitamins A, D, B12, riboflavin and niacin. Just one 8-ounce serving of milk has 8 grams of protein, which builds and repairs muscle tissue (an equal serving of almond beverage has only 1 gram of protein). Enhancing agricultural and dairy productivity is particularly important in the lagging states. States that failed to invest in agriculture during the Green Revolution of the 1960s were left with weak agricultural sectors and high levels of poverty. Since the lagging states are unlikely to match the productivity of staple-grain agriculture in developed states, the researchers recommend focusing efforts on adding more diverse crops like pulses, coarse grains, fruits and vegetables. With public and private sector investments, farmers could take advantage of the growing demand for these crops, which can be sold at higher prices than staple crops.