Experts lay focus on POSHAN 2.0 to address gaps in Under-5 child nutrition

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Need for increased focus on promoting complementary or young child feeding practices by reaching and working with families of Under-2 children

A rapid trend analysis report, published by the Observer Research Foundation (ORF), compares findings of the National Family Health Survey (NFHS-4 2015-16) and NFHS-5. The report, authored by Dr Sheila C Vir and Dr Shoba Suri, finds a reversal in the progress made on some of the key nutrition indicators in the country.

These include an increased trend in chronic undernutrition (measured as stunting or height for age) in 13 States, as well as a rising trend in the percentage of overweight under-5 children in every State with the exception of one UT. The unexpected increasing trend in undernutrition in States such as Kerala, Goa and Himachal Pradesh where over 60 per cent women are reported to having completed at least 10 years of education is intriguing and has been analysed.

Data reveals that the underlying determinants that are most crucial for preventing chronic child undernutrition or stunting are women’s education, height not less than 145 cms and right age of conception as well as improved antenatal care services and water-sanitation-hygiene (WASH) situation. The percentage coverage of nutrition-sensitive interventions focusing on underlying determinants – comprising the status of women’s empowerment, health care of women, and WASH practices – has seen positive trends in four years, between 20154 and 2019.

As per the latest NFHS-5 data, relatively more women today have access to safe and clean sanitation facilities, maternal health services and institutional delivery, possess their own personal mobile phones and bank accounts, and are able to stay in school for longer and delay conception till after they turn 18.

Why are child nutrition indicators not reflective of this progress?

The progress noted in underlying determinants in themselves are insufficient to address the problems of undernutrition. IYCF comprises breastfeeding and complementary feeding (CF). CF refers to shifting from exclusive breastfeeding for the first six months of life to introduction of semi- solid food items to a child along with the continuation of breastfeeding.

The ORF report highlights that CF practices continue to be insufficient, possibly contributing to the child undernutrition situation.

What are the policy needs?

Upcoming POSHAN 2.0 creates an enabling environment for the adoption of appropriate IYCF practices and moving beyond mere supply of supplementary nutrition or Take Home Ration (THR).

The ORF report identifies the need to employ effective social and behavior change communication (SBCC) to address misinformation and empower women and families to make the right affordable and locally applicable food choices to address all the three primary problems of child malnutrition –undernutrition, overweight or obesity and micronutrient deficiencies.

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