Niti Aayog action plan calls for reshaping existing schemes and progressively covering all districts in 3 years starting from 2017-18. Remote monitoring will be done by cloud telephony and Interactive Voice Response service. Daily data from Anganwadi Centres —which provide hot cooked food—will be uploaded to a web portal. After establishing new admin structures in each district, a Nutritional Social Audit will track various metrics and publicize data on apps and websites. **Undernourishment will be mapped to identify endemic zones & vulnerable districts. Cases of severe nutrition will be reported separately. GIS will track severely undernourished children and families as they move across India, with the view to providing continuity of care, feeding and medical assistance. It can also link up to various schemes for social development, food security, employment, etc.NFHS 2015-16 survey found prevalence of underweight (35.7%), stunting (38.4%), wasting (21%) and anemia (58.4%). Report talks of inter-generational under-nourishment due to multiple deprivations— caused by or related to poverty, social exclusion and gender discrimination. It found differences between communities that are within the same soicio-economic grouping.════════════════════════
In a new approach to tracking malnutrition among Indian children, the ministries of women and child development and health and family welfare, along with other departments, plan to focus on high malnutrition areas and put in place a digital surveillance system.
The plan will be executed under the National Nutrition Strategy proposed by government think tank NITI Aayog.
The government will cover districts already identified under various programs, i.e. 184 high priority districts under National Health Mission, 200 districts under Integrated Child Development Services Scheme (ICDS), 162 districts covered under ICDS Systems Strengthening & Nutrition Improvement Project (ISSNIP), with flexibility to states in the finalization of districts.
In Phase I (2017-18), 254 districts and identified urban areas will be covered; in Phase II (2018-19) additional 254 districts will be covered, totaling to 508 districts; and Phase III (2019-20) will cover the remaining districts based on needs assessment and performance.
Once nutrition is provided under various nutrition programs, the government will conduct Nutrition Social Audits to track the children and their health progress. At national and state levels, a website and necessary apps will be created for this.
“A part of the problem could be addressed by monitoring through Cloud Telephony and Interactive Voice Response Service (IVRS)-based daily monitoring system for hot cooked food in the Anganwadi centres (AWCs). The mobile phone-based daily monitoring IVRS system, is a two-way direct communication system between the state headquarter and the Anganwadi workers (AWWs). The software receives real-time data on daily basis from the AWWs regarding number of children being served hot cooked meal and simultaneously makes it available on the web portal,” NITI Aayog chief executive Amitabh Kant said.
NITI Aayog has also proposed setting up a National Nutrition Surveillance System. “Mapping of undernourished endemic zones of the country in terms of identifying ‘high risk and vulnerable districts’ for the rest of districts, cases of severe under nutrition in children should be included in the routine disease reporting system,” NITI Aayog has recommended.
The nutrition surveillance system will be geographic information system (GIS)-based for tracking severely undernourished children, families and communities in the long run. “This will not only ensure child-wise tracking, appropriate care, feeding and medical interventions for severely undernourished children but also help link the families of severely undernourished children with social protection measures, food security measures and to access employment through Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) and other livelihood options,” NITI Aayog further recommended.
Nearly every third child in India is undernourished—underweight (35.7%) or stunted (38.4%) and 21% of children under five years are wasted as per National Family Health Survey (NFHS-4) 2015-16. Moreover, the NFHS-4 data indicates that every second child is anemic (58.4%).
This intergenerational cycle of under nutrition is accentuated by multiple deprivations related to poverty, social exclusion and gender discrimination. Nutrition vulnerabilities are compounded by differentials in socio-economic status and vary by vulnerable community groups such as scheduled castes (SC) and scheduled tribes (ST).
