Safeguarding nutrition is priority amidst a public health crisis

Hemalatha R | Updated on November 20, 2020

Covid has shown us that we are only one public health crisis away for all progress on malnutrition to be at the risk of reversal   -  iStockphoto

Covid-19 has exposed the fragility of health systems and aggravated under-nourishment

Over a month ago, the Nobel Committee decided to award the highly prestigious Nobel Peace Prize to the UN’s World Food Programme, which has been addressing the dual problems of hunger and food security worldwide.

This is significant because it draws national and global attention to the issues of food security, hunger and malnutrition and reemphasises why we need to shine the spotlight on nutrition for all, especially in view of Covid-19 pandemic.

Malnutrition has been an issue of concern, even before the pandemic. And yet, the under-5 mortality rate (U5MR) and the neonatal mortality rate in the first month of life (NMR) have dropped substantially in India since 2000.

The major contributor for this scenario is improved maternal and child nutrition status. Similarly, mortality rate among the children who have severe acute malnutrition (SAM) has been low in India.

Globally, studies show that children with SAM are at a higher risk of mortality (10-20 per cent). However, in India, a much lower mortality rate (1.2 per cent) is observed among children with wasting (SAM), thus suggesting that the condition is not necessarily acute in India. This is significant because it highlights the need to focus on country-specific solutions for dealing with malnutrition — since nutrition is a multifaceted issue that is often deeply localised and varies widely because of demographic and socio-cultural factors. Perhaps, it is time to review the definition of SAM through a detailed analysis of the available data on wasting, associated complications, and mortality.

Lessons from Covid

The Covid-19 pandemic has not only brought forth the fragility of health systems but also aggravated the problems of under-nourishment, stunting and wasting across the globe. Experts warn of disastrous increases in malnutrition in both the immediate and long-term future as the key programmes to deliver food and supplements to the vulnerable populations are disrupted due to the pandemic in many countries. In fact, a recent study suggests that the pandemic could lead to a rise of 1.2 million under-5 deaths across the globe due to malnutrition, with over a quarter occurring in India.

UNICEF estimates that an additional 6.7 million i.e. 14.7 per cent children under 5 years of age could suffer from wasting, thus becoming severely undernourished due to Covid-19.

In India, the pandemic has led to temporary disruption of some essential nutrition services such as the Integrated Child Development Scheme (ICDS), which provides supplementary nutrition for children and pregnant women. Similarly, the mid-day meal programmes in schools have been interrupted.

While the government has been taking steps to ensure all essential services are resumed, the pandemic has thrown up a larger and a more complex question: how can we ensure that we address malnutrition holistically so as to safeguard our populations against future public health crises?

Power of collaboration

There is a lot more that needs to be done — especially when it comes to developing multi-sectoral partnerships. The pandemic has taught us one thing — the power of collaboration — without which we cannot hope to tackle a public health issue as complex and pervasive as malnutrition. There is also an opportunity to leverage collaborative platforms across sectors. Through such dynamic partnerships, the country can work towards achieving the ambitious nutrition targets that it has set for itself.

The ICMR-National Institute of Nutrition (NIN) has been working to develop sustainable policy recommendations to tackle the issue of malnutrition, through initiatives like the Nutrition Atlas, which maps data on the nutritional status of populations both at micro and macro levels, and implementation of technology-based real-time data collection to track nutrition and health status.

The pandemic has shown us that we are only one public health crisis away for all progress on malnutrition to be at the risk of reversal. We cannot wait for the next crisis — the time to act is now to ensure that the holistic nutrition needs of every citizen of the country are met.

The writer is Director, ICMR- National Institute of Nutrition, Hyderabad. Views are personal

Published on November 20, 2020

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