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Winning The Nutrition Battle One Prerak At A Time
Winning The Nutrition Battle One Prerak At A Time
Contents
4 Malnutrition Feeding 1.3 Billion People The Right Way 22 National Nutrition Mission
Ending The Curse Of Hunger & Poverty
Trusts & Nutrition 28 Tata Sustenance Is Everything A Difference 36 Making The Catalysts For Change It Work Is Hard Work 42 Making Prerak’s Lead The Way Building 68 Nation One Prerak At A Time
Malnutriton Feeding 1.3 Billion People The Right Way
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Malnutrition ‘’Lack of proper nutrition, caused by not having enough to eat, not eating enough of the right things, or being unable to use the food eaten.‘’
Cost of malnutrition on a nation’s GDP 4% reduction in GDP **
Malnutrition disproportionately affects children and women, two of the most vulnerable groups.
That’s about $108 billion that is lost to the economy India’s economy is estimated at $2.7 trillion
Acute malnutrition in children can result in death. Undernourishment can lead to loss of cognitive ability, lower immunity, morbidity and resistance to diseases among children below the age of six. *
10% reduction in the income of a malnourished person **
Why we should care Malnutrition can result in stunting, wastage, and low-weight in children.
Mothers typically suffer from anemia because they are not getting iron-rich foods. During pregnancy, this can result in premature births, underweight babies and both infant and maternal mortality. 8
*Children upto six is the limit set by the government of India, under its flagship nutrition program **Assocham estimate 9
A Hidden Threat Malnutrition in India
31%
children in the world who are stunted live in India
Ticking time-bomb by the numbers
46.6 million
children in India who are not tall enough for their age, or are stunted
127, 671
children each day who fall behind in height
India has the highest number of malnourished children in the world.
51%
of the children in the world who are wasted live in India
25.5 million
children who do not weigh enough for their height or are wasted
70,000
children born each day are wasted
Data from the Global Nutrition Report 10
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Rs 163 billion The 163 billion rupee effort
($2.3 billion)
India’s budget for its Integrated Child Services Development Scheme (ICDS), a nutrition program to reduce malnutrition, making it the largest nutrition program in the world.
$2.3 billion is about the same as the Gross Domestic Product of Djibouti.* * Source IMF The ICDS Numbers are for 2018-19 12
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Picture courtesy - WaterAid/Ronny Sen
Can you spot what’s wrong with these children?
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Picture courtesy - WaterAid/Ronny Sen
These children are stunted. “Tackling malnourishment is not easy, because oftentimes it’s hard to identify a child who is stunted or wasted because the child is not severely malnourished. And yet, that stunting is enough to impair the child’s cognitive abilities for life.” Dr Sankar Rajan Director, Nutrition Tata Trusts 16
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The undernourishment trap
In India, millions of children are thrust into malnourishment, because they are born to poor families and to mothers who are anemic and malnourished themselves. Poor hygiene exacerbates infectious diseases, attacking the already weak immune system of those li ving in poverty. There are also several reasons why some children are disadvantaged even before birth. Girls, who grow up to be mothers, face gender discrimination as soon as they are born. It is not uncommon for pregnant women to abort female fetuses, which has made sex determination scans illegal in India.
The gender divide
Soon-to-be parents often live in the hope that the child born to them is a boy. Girl children are still perceived as a burden in many households, both rural and urban. A girl child cannot be economically useful in a poor family because of the pressure to marry her off at a young age. Her income, if she gets into paid work, accrues to the family she marries into. Boys, on the 18
other hand, can be put to work and be an earning member of the house through their lifetime. With this skewed perception underpinning their upbringing, the majority of young girls find fewer opportunities whether it comes to schooling, healthcare or nourishment. In multiple children households, if a parent can afford to send only one child to school, a boy will have a better shot at it. The more nourishing meals are served to the boys and men in households and the result is that girls often grow into women with a deficiency in several nutrients, including iron and essential vitamins. As adults, they are anemic women, who also have low awareness about their condition, manifested as weakness, giddiness, easy fatiguing and insomnia. In villages, poor access to healthcare means anemia among women often goes undetected. Even if they can see a primary healthcare worker and get tested, several of them are unable to add the iron-rich food needed in their diet to
overcome decades of anemia. They are too poor to buy proteins. Several pregnant mothers also have little or no access to guided healthcare, and end up birthing underweight babies or even dying during childbirth. When they become mothers, frequent health checkups can detect anemia early, but that doesn’t happen often enough.
Double whammy: Disease and Poverty
As a result, children born into impoverished homes have a much higher chance of being malnourished. Mostly, the families cannot afford to feed them enough times during the day, let alone feed them nutrition packed meals. Typically, meals tend to be carbohydratedriven, which are cheaper than proteinrich foods. Even when children do get nutritious meals, hygiene may be a low priority in these households. India still grapples with open defecation. While the government is pushing to build
household or community toilets in the underserved parts of the country, it is still a work in progress. Children in many of these deprived pockets are routinely exposed to fecal germs and bacteria. That, coupled with poor hygiene habits ranging from unwashed hands to contaminated drinking water, leads to diseases from diarrhea to worms, causing even those children who do get enough food to fall into a cycle of disease, low capacity and weakness. The result is they grow up to be underproductive adults, who are trapped in a cycle of poor learning, lagging growth thus often unable to climb out of poverty and hunger.
50%
pregnant mothers have anemia
59%
children below 5 with anemia
9.2%
children below 5 with diarrhea 19
Picture courtesy - WaterAid/Ronny Sen
Fixing the Diet for a Better Future
1000-day challenge
Children who overcome malnourishment in the first 1000 days have a real chance of growing up to be healthy adults, making the first 1000 days of a child’s life the most critical for delivering nutrition programs
“My most visible goal is to do something in nutrition for children and pregnant mothers in India. Because that would change the mental and physical health of our population in years to come.” Ratan Tata,
Chairman, Tata Trusts
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The Needle is Moving Perpetuate the cycle of poverty as these children grow and have their own children This results in fewer opportunities which keeps them underserved
The malnourished become rapidly marginalised
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The Malnourishment Cycle
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6
Lack of awareness and poor healthcare combines with inability to access government support
Children born into poverty
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4
Start with poor diets, lower cognitive and physical ability
Higher exposure to poor hygiene, lower ability to learn and benefit from education
Greater tendency to pick up food and water-borne diseases
Stuck In a Rut While India has been trying hard to eradicate malnourishment with several flagship programs and significant public spending, malnutrition persists. Half of the pregnant women in India suffer from anemia, producing babies who are more susceptible to malnourishment.
7.4 million
the number of low-weight babies born per year
20,273
babies born each day are of lowweight in India 22
The Indian government’s child development program (ICDS) is the largest such program in the world. In the last 10 years, the centre and the state governments have worked with local administration, not-for-profits and volunteers across the country to make headway to end malnutrition. While it’s a long road ahead, here is a progress report of the last decade. People moved out of poverty
50% **
Children with stunting down to
38% from 48%*
Mothers with anemia down to
50% from 58%*
**Data from the multidimensional poverty index, UNDP. *Data from National Family Health Survey, India. 23