Mapping, counselling families with pregnant women essential to fight malnutrition: nutrition experts

Noting that the rate of child undernutrition increases steadily between 0-24 months and then stabilizes from 2 years onwards, nutrition experts have recommended mapping and counselling such families in the first 1,000 days of a child's life starting from its conception.

The National Family Health Survey-5 which was released in December last year presented a grim scenario according to which malnutrition increased among children in 2019-20 in comparison to 2015-16 in 22 states and UTs.

Around 13 states and UTs out of the 22 surveyed recorded a rise in the percentage of children under 5 years who are stunted in comparison to 2015-16. While 12 states and UTs recorded a rise in the percentage of children under 5 years who are wasted, 16 states and UTs recorded a rise in the percentage of children under 5 years who are severely wasted and underweight in 2019-20 in comparison to NFHS-4, the NFHS-5 found.

Nutrition experts have recommended introducing a model that ensures targeted and timely counselling of all pregnant and nursing women in the first 1000 days of life, since conception, is essential. ''This strategy is incorporated in the POSHAN Abhiyaan program design. However, for effectively rolling out the strategy, efforts need to be directed at mapping households with pregnant women and/or 0-24 months and channelizing intensive efforts towards reducing child undernutrition,'' they said. They further said execution of such a plan will take us one step closer to the vision of a malnutrition-free, healthy India by adding interpersonal counselling to the ongoing people-led movement.

''The first thousand days of life are important for the promotion of optimal growth and development of the brain. In fact, 80 percent of brain development takes place in the first 1000 days of life,'' said Dr Sheila Vir, Director, Public Health Nutrition and Development Centre, New Delhi.

''For healthy physical and mental development, a child needs to be well nourished. Addressing the problem of poor knowledge and poor adoption of appropriate maternal nutrition and child feeding practices and new-born care practices is a primary challenge towards reducing chronic child undernutrition or child stunting which negatively influence overall cognitive development and under-five mortality,'' she said. Vir said recent research estimates 68 per cent of under-5 mortality in India is associated with child malnutrition. ''A focus on mapping and repeatedly counselling families with pregnant women, newborns and children below 24 months, in rural or urban areas and in low or high wealth index families, is essential for preventing child growth faltering and preventing child undernutrition,'' she said.

Dr Sebanti Ghosh, Country Program Director, Alive and Thrive, FHI360 further recommended intensified, contextualised and focused counselling that allows room for engaging negotiations on a case-to-case basis. ''For instance, during home visits, a frontline health worker can open a dialogue about consumption of food groups by the mother and child and suggest easily-sourced or kitchen garden-grown additions that would add to the nutritional value of each meal,'' Ghosh said. She further said during targeted counselling, information about eligibility for public distribution system (PDS), take-home ration (THR), and immunisation drives can also be discussed at length. ''Topics of significance, like water, sanitation and hygiene, and toilets, are other areas that could benefit from intensified counselling,” said Ghosh.

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