Addressing Malnutrition in Jharkhand: Progress, Challenges, and the Path Forward

By
Dr. MD Tabrez Alam
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Doctors Without Borders: Undernutrition Is a Community — Malnutrition Deeply

by Md Tabrez Alam   6 October 2023

Abstract:

Malnutrition remains a significant public health concern in India, and the state of Jharkhand faces unique challenges in combating this issue. This academic article explores the prevalence of malnutrition in Jharkhand, explicitly focusing on chronic malnutrition in infants, healthcare infrastructure, government initiatives, and the Strategic Action for Alleviation of Malnutrition and Anemia Reduction (SAAMAR) program. While progress has been made, much work still needs to be done to improve the nutritional status of the state’s children, pregnant women, and lactating mothers. Malnutrition continues to be a critical health challenge globally, affecting millions of individuals, particularly children and women. In India, the state of Jharkhand grapples with the persistent issue of malnutrition, including chronic malnutrition among infants. This article delves into the nutritional statistics, healthcare infrastructure, government initiatives, and the specific program to address malnutrition in Jharkhand.

JME 2023 Report: Reflections on Progress and Challenges

The 2023 edition of the ‘Joint Malnutrition Estimates’ (JME) report, jointly released by UNICEF, WHO, and the World Bank, brings both encouraging and concerning news regarding child malnutrition in India. The report highlights a significant improvement in addressing stunting among children, with 16 million fewer stunted children in 2022 compared to 2012. Stunting, a consequence of poor nutrition in early childhood, can affect a child’s height and cognitive development. While this progress is commendable, the report also underscores the persistent challenge of wasting among children under five. Despite the gains in addressing stunting, destroying remains a critical issue that demands further attention due to its adverse impacts on child health and development. The overall prevalence of stunting in India in 2022 was estimated at 31.7%, slightly lower than national estimates, reflecting positive trends. Child wasting, attributed to insufficient nutrient intake and recurrent illnesses, poses grave risks to children, including weakened immunity, developmental delays, and increased mortality, particularly in severe cases. Addressing waste necessitates heightened awareness and improved access to healthy diets for vulnerable children. While the JME data indicates promising progress in tackling stunting in India, it also calls for intensified efforts to combat wasting effectively. In addition, Unicef India attributes this progress in addressing stunting to the multi-sectoral responses initiated under programs like Poshan Abhiyaan in 2018 and continued through Poshan 2.0 in 2022. These initiatives have contributed positively to improving nutritional indicators and reflect the importance of promoting nutrition literacy and supporting healthy eating habits among families. Unicef’s emphasis on the need for a people’s movement, the Poshan Jan Andolan, underscores the critical role of community engagement in addressing malnutrition.

Furthermore, the JME data reveals a marginal increase in the prevalence of overweight children in India, rising from 2.2% in 2012 to 2.8% in 2022. While the numbers indicate a boost, it’s important to note that India’s classification for overweight children remains low, significantly below the global prevalence of 5.6%. These findings highlight the need for balanced efforts to address undernutrition and overnutrition, emphasizing the importance of maintaining a holistic approach to child health and nutrition. The JME 2023 report showcases India’s significant progress in reducing stunting among children, signalling the effectiveness of ongoing nutritional programs. However, the persistence of child wasting as a concern calls for intensified efforts to increase awareness and access to nutritious diets. Additionally, the marginal rise in overweight children underscores the importance of comprehensive nutrition policies that address the diverse nutritional needs of India’s children. While there has been progress in addressing malnutrition in Jharkhand, the issue remains a significant challenge, especially chronic malnutrition among infants.

The Prevalence of Malnutrition in Jharkhand

Malnutrition remains a pressing concern in Jharkhand, with chronic malnutrition among infants under six months rapidly increasing to 32%. This trend is a cause for concern and necessitates immediate attention to prevent its long-term implications. Healthcare Infrastructure and Challenges: Access to healthcare facilities, training for healthcare professionals, availability of essential medical supplies, and overall care standards require extensive improvement in Jharkhand. The additional chief secretary of the state health department, Arun Kumar Singh, emphasized the need for strengthening healthcare services to address the rising prevalence of severe acute malnutrition in infants younger than six months. Despite the challenges, there have been notable improvements in reducing malnutrition rates in Jharkhand. Experts report a decrease in children suffering from acute malnutrition from 29% in 2015-16 to 22% in 2019-21. Similarly, the prevalence of children with restricted growth has decreased from 45.3% to 39.6%, and severe acute malnutrition among children has fallen from 11.4% to 9.0% during the same period.

The Impact of NFHS-5: The National Family Health Survey (NFHS-5) conducted by the Ministry of Health and Family Welfare has shown improvements in women and child nutrition in Jharkhand. For example, the prevalence of anaemia among pregnant women has decreased from 62.6% in 2015-16 to 56.8% in 2019-21. Similarly, the percentage of stunted children decreased from 45.3% to 39.6% during the same period.

SAAMAR Initiative: A Beacon of Hope

Recognizing the persistent challenges in addressing malnutrition, the Jharkhand government, under the leadership of Hon’ble CM Hemant Soren, launched the SAAMAR (Strategic Action for Alleviation of Malnutrition and Anemia Reduction) initiative on December 29, 2021. SAAMAR initially identified five tribal-dominated districts, namely Chatra, Latehar, Sahebganj, Simdega, and West Singhbhum, for the project’s pilot phase. These districts reported high malnutrition rates and posed significant challenges. The SAAMAR initiative, with its multi-sectoral approach, community engagement, and focus on tribal women, offers hope for a healthier and more prosperous future. To build a truly inclusive society, it is imperative to continue strengthening healthcare infrastructure, enhancing maternal and infant care, and ensuring access to nutrition for all. Only through sustained efforts can Jharkhand overcome the scourge of malnutrition and achieve the goal of a prosperous and healthy society for all its citizens.

Multi-Sectoral Approach: To address malnutrition comprehensively, the state government engaged various departments, including Health and Family Welfare, Food and Civil Supplies, Rural Development, and Women and Child Development. This multi-sectoral approach aims to improve the nutritional status of the population.

Community Engagement: Community leaders, schools, and village organizations play a pivotal role in implementing the SAAMAR initiative and raising awareness about the importance of nutrition for healthy living. During Rashtriya Poshan Maah, activities like Swasth Balak Spardha (Healthy Child Competition), Poshan Bhi Padhai Bhi (Nutrition as well as Education), and addressing Anemia through Test, Treat, Talk will be conducted. These initiatives aim to instil a culture of nutrition awareness and promote healthy competition for overall well-being. Additionally, the Jan Andolan movement under Poshan Maah will engage Gram Panchayats and Urban Local Bodies, aligning with the vision of a Suposhit Bharat.

App-Based Data Collection and Holistic Support: The SAAMAR initiative utilizes technology with app-based data collection tools to identify malnourished children and women suffering from anaemia. It also establishes Malnutrition Treatment Centers and local health centres to provide nutritional advice and assistance. Moreover, the initiative integrates social protection measures and livelihood options to improve family income.

Focus on Tribal Women: SAAMAR’s unique feature is its focus on tribal women, addressing their specific nutritional needs and behaviours, which have not been adequately documented in the past.

Early Warning System (EWS): A dashboard and Early Warning System (EWS) have been established to track individual beneficiaries and their nutritional status. This system identifies distressed individuals or families and links them to social protection and food security measures.

Budgetary Allocation:  The Jharkhand government has prioritized social welfare and nutrition, allocating 6624 crores in 2021-2022, a 4% increase from the previous year’s budget. This investment reflects the commitment to addressing malnutrition and improving overall social development.

Poshan Abhiyaan in Jharkhand

The Government of India’s flagship initiative, the Prime Minister’s Overarching Scheme for Holistic Nutrition (POSHAN Abhiyaan), is designed to combat malnutrition across India comprehensively. However, despite its ambitious objectives and nationwide presence, a significant gap exists in understanding its impact and implementation, especially in states like Jharkhand. This article highlights the critical need for research and action to assess the effectiveness of POSHAN Abhiyaan in Jharkhand and calls attention to the absence of authentic scientific data at the grassroots level. It also discusses the importance of celebrating Rashtriya Poshan Maah to raise awareness about critical life stages and foster nutritional understanding across India. POSHAN Abhiyaan, launched by the Prime Minister, is a pivotal initiative to address malnutrition comprehensively in India. It operates in “mission mode” and targets pregnant women, lactating mothers, adolescent girls, and children under six. While it has made significant strides at the national level, the situation in Jharkhand raises questions about its effectiveness in the state. Authentic scientific data at the village, block, district, and state levels could be more present, hindering a comprehensive evaluation of the program’s impact. 

Comprehensive Nutrition Awareness

Mission Poshan 2.0 is a testament to India’s commitment to addressing malnutrition through a comprehensive life-cycle approach. Its primary objective revolves around raising awareness about critical life stages, encompassing pregnancy, infancy, childhood, and adolescence, with the overarching theme ‘Suposhit Bharat, Sakshar Bharat, Sashakt Bharat’ (Nutrition-rich India, Educated India, Empowered India). This holistic approach recognizes that nutrition, education, and empowerment are interconnected facets crucial to building a healthier and stronger nation. In the ongoing Rashtriya Poshan Maah, the Ministry of Women and Child Development (MoWCD) spearheads nationwide initiatives to amplify nutrition awareness. These initiatives encompass diverse activities, including the Swasth Balak Spardha (Healthy Child Competition), which fosters healthy competition to promote better nutrition and overall well-being.

Additionally, the Poshan Bhi Padhai Bhi program bridges the gap between nutrition and education, while Mission LiFE encourages lifestyle choices that benefit both health and the environment. The campaign also focuses on sensitizing tribal communities about nutrition and addressing anaemia through a comprehensive Test, Treat, Talk approach. The impact of Rashtriya Poshan Maah is noteworthy, as seen from the 2022 progress report. Over 170 million sensitization activities took place that year, emphasizing key nutrition-related themes. Remarkably, over 600 million actions have been conducted annually as part of the Jan Andolan movement during Poshan Pakhwadas (March) and Poshan Maahs (September). This demonstrates the growing momentum and commitment towards fostering nutrition awareness at the individual and community levels, paving the way for a healthier and empowered India.

POSHAN Abhiyaan is a commendable initiative with the potential to transform the nutritional landscape of India. However, its effectiveness in states like Jharkhand remains uncertain due to the lack of authentic data and research. Rashtriya Poshan Maah is a critical platform to draw attention to this vital issue and galvanize efforts to bridge the research gap. Comprehensive analysis, combined with community involvement, will be instrumental in realizing the objectives of POSHAN Abhiyaan and ensuring a healthier and empowered India. Jharkhandis are Hoping that Poshan Maah of September 2023 will give a good outcome in the coming days. It sheds light on the nutritional challenges faced in Jharkhand and has focused on research and intervention. The theme of this year is “Suposhit Bharat, Sakshar Bharat, Sashakt Bharat” (Nutrition-rich India, Educated India, Empowered India), which reflects the overarching goals of POSHAN Abhiyaan.

Source: Graph has been taken from a WhatsApp Group of Poshan Maah

As of September 30, 2023, all districts of Jharkhand are demonstrating remarkable progress. The state has ascended to the 10th in the national rankings, boasting an impressive tally of 3,630,782 activities. This achievement can be attributed to the diligent implementation of a robust monitoring system, which operates seamlessly from the state to the grassroots in every district. The success story of Jharkhand’s development can be attributed mainly to the effectiveness of its monitoring mechanisms. These mechanisms have ensured that initiatives and policies are executed efficiently and transparently. The state’s dedication to meticulous oversight has paid off, with each district showcasing tangible improvements in various sectors.

Furthermore, the collaborative efforts of different stakeholders, including development professionals and various governmental bodies, have played a pivotal role in securing this favourable position. Their collective dedication to the cause, coupled with their technical expertise, has not only bolstered the state’s ranking but has also facilitated the smooth execution of campaigns and projects aimed at fostering development and improving the lives of its citizens. Jharkhand’s journey towards progress is an inspiring example of how effective governance, monitoring, and collaboration among stakeholders can pave the way for positive transformation. Today, the state stands tall as a testament to the power of dedication and collective effort in driving socio-economic development.

Conclusion & Remark

Malnutrition is a critical public health challenge in India, and despite progress being made, the state of Jharkhand still faces significant obstacles in addressing this issue. While reducing child stunting is a positive achievement, adopting a comprehensive and multi-pronged approach to combat child wasting and overweight children is essential. Jharkhand is experiencing an alarming increase in chronic malnutrition among infants, demanding immediate attention to prevent its long-term consequences. To combat malnutrition effectively, it is crucial to strengthen healthcare infrastructure, provide essential medical supplies, and enhance care standards in Jharkhand. Positive trends, such as the reduction in acute malnutrition and growth restrictions, indicate that concerted efforts make progress possible.

The National Family Health Survey (NFHS-5) shows promising improvements in women and child nutrition in Jharkhand, including reductions in anaemia and stunting. These achievements are commendable but require sustained commitment and expansion. The SAAMAR initiative, launched under the leadership of Hon’ble CM Hemant Soren, offers hope for a healthier future by adopting a multi-sectoral approach, community engagement, and a focus on tribal women. The use of technology for data collection, establishment of Malnutrition Treatment Centers, and social protection measures demonstrate a comprehensive strategy to combat malnutrition. Despite the national success of POSHAN Abhiyaan, its effectiveness in states like Jharkhand still needs to be determined due to a lack of authentic scientific data and research. Therefore, it is imperative to bridge this research gap and harness the potential of Rashtriya Poshan Maah to draw attention to this critical issue and foster community involvement.

Jharkhand’s complex nutritional landscape demands unwavering commitment, research, and intervention. Despite significant strides being made in addressing malnutrition, particularly child stunting, there is a need to adopt a more comprehensive approach to combat child wasting and overweight children. The overarching theme of “Suposhit Bharat, Sakshar Bharat, Sashakt Bharat” (Nutrition-rich India, Educated India, Empowered India) reflects the goals of POSHAN Abhiyaan. It underscores the importance of collective efforts to build a healthier and empowered India for all its citizens.

Jharkhand’s commitment to addressing malnutrition through initiatives like SAAMAR and the nationwide efforts of POSHAN Abhiyaan are steps in the right direction. The focus on research and community involvement, as highlighted by Rashtriya Poshan Maah, provides hope for positive outcomes in the future. To assess the true impact of these programs, it is essential to continue these efforts and conduct comprehensive data collection and research. Jharkhand’s citizens look forward to the potential benefits that Poshan Maah of September 2023 may bring, as it shines a light on nutritional challenges, fosters research, and encourages interventions to build a healthier and more empowered Jharkhand confidently.

References

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