From UPSC perspective, the following things are important :
Prelims level : Nothing much
Mains level : Case study from Orissa
Odisha is one of the Empowered Action Group States or eight socio-economically backward states of India. It has done remarkably well in health and nutrition outcomes over the past two decades.
- Its infant mortality rate has significantly declined.
- Its under-five mortality rate almost halved in the National Family Health Survey (NFHS)-4 from NFHS-3.
- It has seen a steep decline in stunting in children under five.
- Anaemia in children and pregnant women has also decreased since NFHS-3.
- Antenatal care and institutional deliveries have shown good improvement.
- Nutrition has a strong correlation to health and is integral to growth and development.
- Timely nutritional interventions of breastfeeding, age-appropriate complementary feeding, Vitamin A supplementation, and full immunisation are effective in improving nutrition outcomes in children.
- A nutrition action plan based on convergence – with health, nutrition, and WASH programmes.
- Decentralising the procurement of supplementary nutrition under the Integrated Child Development Services programme. This has led to fair access to services under the ICDS by all beneficiaries.
- A rise in utilisation of services under the ICDS as compared to a decade ago.
- Supplementary nutrition – There has been a marked improvement in supplementary nutrition received by pregnant and lactating women in NFHS-4 compared to NFHS-3.
- Despite progress in child and maternal indicators, Odisha continues to be plagued by a high level of malnutrition.
- Stunting – There is stark variability across districts in stunting ranging from as high as 47.5% in Subarnapur to a low of 15.3% in Cuttack.
- Wasting is high in 25 out of the 30 districts. Almost half of the under-five children from tribal communities in Odisha are underweight, and 46% are stunted.
- The infant mortality rate among tribals is the fourth highest in Odisha, Madhya Pradesh, Rajasthan and Chhattisgarh.
- Reduced supplementary food – food given under the ICDS programme has shown a significant increase. Less of such food is given as children grow older.
- Feeding – There is also a decline is children receiving timely complementary feeding. Less than 10% of children receive a minimum acceptable diet. This can be attributed to a lack of understanding and awareness about nutrition due to illiteracy.
- Another challenge for Odisha is in reaching out to remote and particularly vulnerable tribal groups.
- This could be the reason why tribal women and children are lagging behind the national average on nutrition and health indicators.
- It is essential to improve the implementation of schemes and ensure last-mile delivery of nutrition services.
- A part of the solution lies in setting up mini Anganwadi centres catering to far-flung tribal hamlets.
- Raising awareness through community campaigns on the need for good nutrition would help improve the utilisation of services by beneficiaries.
- The International Food Policy Research Institute called for inter-department engagements to accelerate the nutrition outcome in Odisha.
- There is a need to improve sanitation, women’s education and underlying poverty to tackle undernutrition.
- Underweight children should also be identified precisely so that the monitoring mechanism for improving service delivery can be strengthened.
- The National Nutrition Mission sets an example with its inter-ministerial convergence and real-time monitoring mechanism for tracking each beneficiary and tackling malnutrition.