India is aspiring to be a $5-trillion economy in the next five years! Will she make it?

The wealth of nations depends in part on the health, nutrition, skills and knowledge of their people,observed Adam Smith. But malnutrition, in all its forms, imposes unacceptably high costs, as high as $3.5 trillion per year, or $500 per individual.

Experts says that multiple forms of malnutrition (MOM) reduce nearly 8 per cent of the nation’s economic growth owing to reduced schooling, cognitive impairments, compromised adult labour productivity, and increased healthcare costs.

Eight million Indian children suffered from severe acute malnutrition (SAM), particularly worrying because children with SAM are nine times more likely to die than well-nourished children. In fact, 17.3 per cent of India’s productive years of life (disability-adjusted life years or DALYs) were lost last year alone due to MOM caused ill-health, disability or early death. (Lancet 2019)

Impressive economic benefits of $18 return from every $1 invested are noted in reducing wasting and stunting. In India, the yields are even better — three times more than the global average ($34.1-$38.6). India has an impressive portfolio of programmes to cater to maternal-child health and nutrition.

More holistic approach

The long-standing Integrated Child Development Services (ICDS) programme targets prevention of acute malnutrition via home-based counselling for pregnant women, monthly home-based counselling for caretakers of infants below six months for promotion of appropriate feeding practices, monthly growth monitoring for all infants aged 0–3 years, and community awareness and capacity building of Anganwadi workers. Infants under six months also get their immunisations monitored.

The community-based approaches (CMAM-a methodology to treat acute malnutrition in young children) help in the timely detection of severe acute malnutrition and provide ready-to-use therapeutic foods or other nutrient-dense foods at home for kids without medical complications. Published literature indicates that a treatment and prevention programme could avert 15,016 DALYs (an estimated cost per DALY averted equals $23).

Our focus to reduce MOM by providing for calories alone is now increasingly being replaced with a more holistic approach. Recent times have witnessed ambitious but multi-sectoral programmes like POSHAN Abhiyaan coming to life that urge the convergence of several stakeholders (right from health and nutrition to water, sanitation, to the environment, to agriculture, to development, etc.) employing multi-pronged strategies, technology and media for better delivery and impact. The Government of India has been trying to alleviate malnutrition, stressing on the first 1,000 days of a baby’s life, anaemia prevention, diarrhoea management, paushtik aahar (nutritious food), and hygiene, sanitation and safe drinking water.

Amidst several challenges in the path to attain Kuposhan Mukt Bharat or malnutrition-free India, our collective efforts comprising a focused strong leadership, political will, adequate resources, evidence-based research and academic support, civil society efforts (Jan Andolan), converged multi-sectoral action and harmonised messaging will go a long way in ensuring a nourished and nurtured population across the nation.

To circumscribe the malnutrition demon, to ensure that every child has the right to a swachh, swasth and suposhit Bharat, a diverse set of stakeholders across the board will have to invest early, in a sustained fashion, act collectively and urgently, and monitor regularly. Here’s hoping to see India as a pioneer in adopting, advocating and demonstrating success in using an integrated multi-sector approach to tackling multiple forms of malnutrition.

The writer is Head, Nutrition Research, and Additional Professor with the Public Health Foundation of India