Undernutrition Garners Little Attention in Indian Media

Undernutrition is an emergency in India, where almost half of all children under the age of three are underweight. However, even in the face of such a crisis, this issue garners little attention in Indian media.

POSHAN Media Fellows
POSHAN Media Fellows

To address the lack of nutrition reporting in India, POSHAN and OneWorld Foundation implemented the six-month OneWorld-POSHAN Fellowship on Maternal and Child Undernutrition from May–December 2013. Six journalists from various media outlets such as The New York Times, Dainik Jagran, The Hindu, Chapte Chapte, The Hindustan Times, and www.newsclick.in participated in the program.

On March 19th, POSHAN and OneWorld organized a workshop with the six media fellows to share their learnings from their reporting from the field. The workshop focused on their experiences and observations during the course of their travels to various parts of the country collectively preparing over 30 pieces on mother and child undernutrition.

Many fellows spoke about the huge problems they saw in the field with nutrition services for the poor. For example, Mukesh Kejriwal of Dainik Jagran presented photos exposing flaws with the Integrated Child Development Services (ICDS) scheme. One photo showed a broken-down Anganwadi centre without a roof. He spoke about the lack of commitment of officials at the centres that he visited, and how in one centre, the officials had locked up the materials that were meant to be used for the welfare of children.

Malavika Vyawahare from The New York Times spoke about how there is no proper compilation of nutrition data on which the government can actually base its work. She also spoke of an instance in which she saw a modern, electric weighing machine in an Anganwadi centre in a tribal district in Maharashtra, which was useless because that part of the country is not connected to the electricity grid.

Neha Dikshit, who wrote her articles for www.newsclick.in, focused on the fact that some of the government schemes meant to improve the plight of rural women and children have in fact been detrimental for them. She mentioned how a Haryana government scheme providing cash assistance to marriageable women led to teen marriages, deaths of pregnant girls, and parents started forced schools to give under-age certificates.

Pankaj Jaiswal, from The Hindustan Times, spoke about the existence of undernutrition in the so-called 'well fed' urban population. Thanking the fellowship program for raising his awareness on the issues, he said that he is likely to keep writing on the issue.

Freelance journalist Saadia Azim spoke about how migrants are facing the brunt of nutrition problems. During her travels to villages in Bengal, she found that poor diet haunted all migrants, regardless of caste, religion, or even region. For her, a huge issue was that nobody was even talking about malnutrition as an election issue.

The fellows concluded the meeting with a consensus on how much more the media needs to do in terms of reporting on nutrition. They stressed that the issue of undernutrition has an impact on national security and wellbeing of the country and thus needs to be taken up much more in the media and addressed by the government.

Learn more by visiting the OneWorld-POSHAN Fellowship on Maternal and Child Undernutrition site to read all the news articles.

IFPRI Hosts Policy Seminar on “Social Protection, Food Security and Nutrition” in New Delhi

Written by Suman Chakrabarti, Poverty, Health and Nutrition Division, International Food Policy Research Institute, New Delhi

The International Food Policy Research Institute (IFPRI), organized a policy seminar on “Social Protection & Safety Net

Source: Pallavi Rajkhowa/IFPRI
Source: Pallavi Rajkhowa/IFPRI

Interventions” in the month of February in New Delhi. The seminar touched on the role of food and cash transfers in improving poverty, food security and nutrition, in global and regional contexts. All speakers were well received by the audience and the seminar was lively with an array of wide ranging questions and discussions.

The first speaker, John Hoddinott, Deputy Director at the Poverty, Health and Nutrition Division – IFPRI , Washington,  DC, pooled insights from recent studies in Ecuador, Niger, Uganda and Yemen, on social protection programs and their nutrition outcomes. He highlighted the relative advantages and drawbacks of cash, voucher and food transfers in terms of cost effectiveness, achievement of caloric intake increase and impact sufficiency to reduce chronic under-nutrition in young children. In addition, he shared very recent findings on the impact of combining behavioural change interventions with cash transfers in Bangladesh.

The second speaker, Avinash Kishore, Associate Research Fellow, IFPRI, New Delhi, shared insights from a working paper that investigates the impact of reforms in the Public Distribution System (PDS) of Tamil Nadu, Andhra Pradesh, Odisha and Chhattisgarh, on the offtake of rice from fair price shops as well as on the reallocation of savings towards other food groups.  These findings are central in the context of India’s National Food Security Act (NFSA) which was enacted in 2013.  The NFSA lays out very similar PDS reforms in terms of price reductions for key cereals and increase in the population covered, accompanied with supply side corrections, as were enforced in the aforementioned states.

The third and final speaker, Reetika Khera, Assistant Professor, Economics, Indian Institute of Technology, New Delhi, discussed her research on shifts in India’s PDS. She discussed various facets of interest within the PDS including coverage, leakage, implicit subsidies, exclusion errors, and nutritional impacts, among others.  The findings indicate an overall revival of the PDS in India albeit with high interstate variations. She concluded that there was a long way to go for improvements in the PDS, and emphasized that key reforms should focus on an expansion in the implicit subsidy given to households, incentives, computerization, and decentralization.

Issues and questions raised in the discussion period included:
- What is better in India’s context, cash or food? A balanced approach would be a contextualized response, where cash could be better for some regions and food for others.
- What might be the possible measures to control leakages in the PDS? Mechanisms to check leakages might be easier to enforce under a cash transfer paradigm with the use of IT.
-Targeting versus universalization of the PDS: Given the large targeting errors for AAYs, BPLs, and APLs, would a universalized PDS prove to be more effective?
- What is the role of the private sector in grain management? Can the private sector distribute grains more efficiently and cost effectively?
- What are the effects of transfers on households? How do they re-allocate savings from subsidies? What are the effects on women’s empowerment?

Presentation 1-Social safety nets, food security and nutrition

Presenation 2-Revival of the PDS Evidence and Explanations

POSHAN New Policy Note Explores Lessons Learned in Working Multisectorally to Improve Nutrition Globally and India

Photo Credit Aishwarya Pillai
Photo Credit Aishwarya Pillai

It is recognized that eliminating undernutrition requires actions across multiple sectors.  A child must receive food with adequate energy, protein, and micronutrients while at the same time having access to safe water, good sanitation, and quality health care.  However, services that need to be delivered are typically not led by the same sector, agency, or actor.  The agricultural sector, for example, focuses mostly on food production. The health sector usually focuses on clinical care, rather than on care and feeding in the home.

Though it is recognized that working multisectorally is critical to ensuring that adequate food, health, and care reach children, it isn’t always clear how to do so and it is rarely easy. With an aim of garnering lessons learned that could inform India’s policymakers and program implementers, POSHAN commissioned a review of global and Indian experience in improving nutrition through multiple sectors. The new Policy Note Working Multisectorally to Improve Nutrition: Global Lessons and Current Status (Please see below the paper)  in India examines best practices from other countries, including Bolivia, Colombia, Peru, Senegal, and Thailand, as well as the status of current multisectoral initiatives in India in nutrition, which include the Multisectoral Nutrition Programme to Address Maternal and Child Undernutrition, which was conceived in 2008 by the Prime Minister’s National Council on India’s Nutrition Challenges and launched in 2014. The paper features recommendations to ensure better implementation and sustainability of multisectoral approaches in India.

Last year in May 2013, POSHAN had organized a consultation on multisectoral approaches to improve maternal and child nutrition in India and had brought together key policymakers and policy advisers from a variety of ministries at the national level and from the Indian states of Odisha, Andhra Pradesh, Karnataka and Madhya Pradesh. This event highlighted lessons and experiences from other countries and from India.

Download the POSHAN Policy Note Working Multisectorally to Improve Nutrition Globally and India.pdf (661 Kb)

Empowering Women to Fight Malnutrition in Nepal

Source: Kenda Cunningham
Source: Kenda Cunningham

Parul Tyagi is Research Analyst with PHN in New Delhi office

Improving agricultural productivity can be an effective way for developing countries to achieve economic growth and reduce poverty. However, can agricultural development translate into reductions in undernutrition?  In Nepal—where agriculture is the major source of livelihood, and undernutrition continues to be a staggering problem for both children and women of reproductive age—this is a serious question.

A new discussion paper, Women’s Empowerment in Agriculture, Production Diversity and Nutrition: Evidence from Nepal suggests that gender equity can bridge this gap. In this paper, the authors examined the extent to which women’s empowerment in agriculture and production diversity influence maternal and child nutrition in rural Nepalese households. To determine this, they use data from a baseline survey conducted as part of the evaluation of Suaahara, a 5 year multisectoral intervention in Nepal aiming to improve health and nutrition among rural families.

They found that in households producing a wide variety of foods, maternal dietary diversity and maternal body mass index (BMI) were higher. The results for children are less clear, but production diversity was also positively associated with dietary diversity for children under two years of age. For children between two to five years of age, production diversity was associated with higher weight-for-age, weight-for-height, and height-for-age.

The authors also examined the relationship between key indicators of women’s empowerment in agriculture (based on the Women’s Empowerment in Agriculture Index ) and maternal and child nutrition. Certain indicators of women’s empowerment, in particular autonomy in agricultural production (e.g. what crops to grow) was associated with better maternal and child dietary diversity. Autonomy in agricultural production was also positively associated with children’s height-for-age Z scores. This could be because women who have autonomy in agricultural production may also have autonomy in determining decisions related to food consumption and children’s care.

Surprisingly, higher maternal workload also seems to be beneficial: more hours spent by the mother in paid and unpaid work was positively associated with both maternal and child dietary diversity and children’s height-for-age Z scores. This points to an interesting ambiguity about women’s workload: the income effect may be strong enough to mute the negative trade-offs in care she is able to provide.  However, higher workload also means higher energy expenditures. Unsurprisingly, women’s workload was not significantly associated with BMI of the mothers.

Although the authors’ conclusions are based on a one-time survey and many factors are in play, the analysis suggests that interventions to increase women’s agency and capability to make agricultural decisions may provide opportunities for more directly engaging women in agriculture,  and in turn, have a powerful influence on nutrition.

POSHAN’s Abstract Digest on Maternal and Child Nutrition Research – Issue 6

Aaganwadi centre (Photographer Aishwarya Pillai)
Aaganwadi centre (Photographer Aishwarya Pillai)

As we wrap up 2013, we are pleased to release the sixth issue of our bi-monthly Abstract Digest on maternal and child nutrition, the last issue for this year. This issue features interesting publications examining nutrition from both a biological and political lens, in India and beyond.

An India-based study in The Lancet highlights regional differences in neonatal and under-five mortality; the study highlights how several districts are on track to achieve Millennium Development Goal 4 as early as 2015, while several others may not achieve it until 2023.

A BioMed Central Public Health study examines whether high parity is associated with lower coverage of key health interventions that might lead to increased mortality. The study identifies a significant relationship between coverage of maternal and child health services and birth order, offering a potential explanation for the association between higher parity and child mortality.

Using birth cohorts from 5 countries, a study from the Journal of Pediatrics examines the relationship between maternal height and child growth, concluding the strongest associations with conditional heights for adulthood and 2 years of age. The study confirms that maternal height influences linear growth of children over the growing period.

Of two studies focusing on the political context of maternal health in India, one, featured in Science Direct, uses evidence from two South Indian states to identify three key factors that shape health policy and its implementation: consistent political priorities, policy entrepreneurship, and strong public health system administration.

Thank you for your interest in the POSHAN Abstract Digest. Please feel free to share this digest with others, and engage in discussions with us on our Facebook page! We wish you and your families a very happy new year and we look forward to sharing highlights of maternal and child nutrition publications in 2014.

Click here to download the latest issue:

POSHAN Abstract Digest Issue#6DEC2013

For earlier issues, please visit our blog.

 

Subscribe to our newsletter