Prioritising the Health of our Children
- Essential Services
- by Jitendra Rath
- 12 Sep, 2016
Every year in India, the first week of September is observed as the National Nutrition Week. This was conceived first time in 1982 by the Food and Nutrition Board. This is an annual event to intensify awareness on nutrition and its impact on productivity, economic growth and ultimately on development. In 2016, the National Nutrition Week turned 34. However, observing the week over the years has not really brought any tangible changes on the ground. Be it Assam or Madhya Pradesh, Bihar or Odisha, the stories of our infants and children are the same. Many are either underweight or stunted. Most are severely undernourished and lives are lost because of this. The recent deaths of 19 Juang children in Nagada, a village in Jajpur district of Odisha, is just a tip of the iceberg.
There is no dearth of reports on the status of undernourishment among children in the country; government data, UN agencies, reports from international agencies all of them present the same sorry state of affairs. Undernourishment first came up for discussion during the first round of the National Family Health Survey (NFHS) data. NFHS-1 was released in 1992-93. This debate intensified further with startling data during the NFHS-2 and NFHS-3 results in 1998-99 and 2005-06, respectively.
In 1993, the Ministry of Women and Child Development came up with the National Nutrition Policy to tackle the complexity of the problem. However, the subsequent rounds of survey reflected negligible improvement in the status of undernutrition. A comparison of the second and third round of NFHS show that despite the efforts, especially through the Integrated Child Development Services (ICDS) programmes, the nutritional status of children under the age of three did not improve much.
Between 1992-93 and 2005-06, the percentage of stunted children (children too short for their age) reduced from 51 to 45 and that of underweight children from 43 to 40. Though these numbers are on a decreasing trend, the rate of decrease has been very slow if put in a periodic frame. The percentage of children wasted (low weight for their height), however, rose from 20 in NFHS-2 to 23 in NFHS-3.
The first phase of NFHS-4 (2015-16) data, for 15 states, was released in January this year. Although numbers for Odisha, Jharkhand, and Chhattisgarh are yet to come, the overall trend is not very encouraging. Though there is decrease of underweight, stunted and wasted children but the rate of this reduction is very slow. NFHS-4 highlights another anaemia, another key issue. As per the released report more than half of children are anaemic in 10 out of 15 states; this is a widespread problem.
The question then is ‘do we have a long term and an explicit plan to fix the problem of undernutrition among children?’ ‘Are we looking at the causes that have led us to this situation?’
ICDS is one of the key government programmes to fight this problem. However, there are lot of questions on prioritizing and funding of this programme. During the previous UPA government, ICDS programme received regular and decent budget allocations. However, with the new government in place, it has substantially reduced in last two financial years. For 2016-17, Rs 14,862 crore was allocated for the programme which is the lowest in last five years.
Earlier, there was also a proposal for restructuring the programme and creating a position for a second ICDS worker – an assistant to share the load of work of the existing worker. But with the proposal of financial devolution under 14th finance commission, the onus now lies on the states to take a call on the new appointments. Huge budget cuts and passing the buck shows the lackadaisical commitment of the government towards children.
In Odisha, undernourished children and their state has been making headlines in every newspaper in recent times. The state had a Nutrition Operation Plan (NOP), prepared with the support of DfID, for the 2009-13; this still continues. The state government has identified 15 high burden districts to intensify support to improve nutritional status of children. The last review of NOP which was held in January this year reflects the existence of high rate of underweight children in these districts. Koraput tops the list with 41.2% underweight children followed by Malkangiri (38.3%), Nabarangpur (35.4%) and Nuapada (33.7%).
The proposed appointment of a second ICDS worker is a far cry, in Odisha, at the moment, there are unfilled position for 2906 ICDS workers. In addition, 30% of the supervisor positions are vacant. These are critical positions that need to be in place in order to deliver and monitor the nutrition programmes.
Like Nagada, there are many villages in the state which are waiting to make the headlines with news of undernourished and dying children. The state government has identified 5864 villages in 15 high burden districts which are in far flung areas. The incidence of Nagada village shows that the trend is changing. The geography of undernourishment is not limited to the poorest districts (Jajpur is one of the developed districts) and they must be identified.
Although ICDS needs more attention, there are other steps that need to be taken to tackle the undernourishment problem. The state government, on a pilot basis, plans to promote millet in ICDS. This is a baby step in this direction. Though there is a provision for the involvement of the community in the running of the Anganwadi, there is neither any participation by the community nor are steps taken towards promoting community based monitoring of nutrition and health services. These should be encouraged.
Fighting undernutrition and ensuring better health for our children needs a multi-dimensional, convergent and life-cycle approach. Promotion of traditional food practices and bringing dietary diversity in the food intake, and strengthening the system of community governance (especially focusing on community based monitoring) could be the game changers. Furthermore, there is a need for proper and timely identification of undernourishment among children by using all the three parameters that are weight for age, height for age and weight for height. Establishment of Nutrition Mission in some of the states is a very positive step and it must be established in the remaining states too.
India is growing. But this growth will mean nothing if the condition of our children does not change. There are many priorities but children must be the foremost.
Written by: Jitendra Rath, PO, Odisha.
Photo credit: Savvy Soumya Misra/ Oxfam India
[1] Juang are Particularly Vulnerable Tribe (PVTG) a tribe in Odisha.
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Oct 7, 2019 | ursila
The changing world of humanitarian work
Sep 10, 2019 | ursila
Can India be a Leader in Disaster Risk Reduction Measures in Asia?
Oct 7, 2019 | ursila
A struggle for survival: Assam Floods
Nov 11, 2019 | Anisha
Lessons to be learnt from the Gorakhpur tragedy
Oct 24, 2019 | ursila
Is Section 498A anti women?
Nov 11, 2019 | ursila
The Irresistible & Oppressive Gaze: A Survey Report by Oxfam India
Oct 24, 2019 | oxfamadmin
North East Floods: How you can help those affected?
Oct 1, 2019 | Ravi
Oxfam is responding in Assam Floods 2017
Oct 1, 2019 | Ravi
Lipstick Under My Burkha Official Trailer - Winner of Oxfam's Best Film on Gender Equality Award
Sep 27, 2019 | Ravi
Sourcing Life
Oct 7, 2019 | Anisha
MEETING TOILET TARGETS
Oct 7, 2019 | oxfamadmin
Disaster Changed Her Life
Oct 24, 2019 | Anisha
#HaqBantaHai Campaign on Access to Free Medicine: Bihar
Sep 10, 2019 | Anisha
Be The New Norm
Oct 7, 2019 | Ravi
Oxfam India’s Recommendations for National Policy for Women
Sep 27, 2019 | Ravi
The Greatest Earning: EDUCATION
Dec 5, 2019 | Anisha
Women Farmers or Labourers?
Oct 24, 2019 | Avantika
Farewell Dirty Water
Jan 9, 2020 | Avantika
Clean Water Can Save Lives
Oct 24, 2019 | Avantika
Making men an ally on women's rights
Oct 24, 2019 | Avantika
'Initially the men opposed. They thought we women were being disruptive.'
Oct 1, 2019 | Avantika
Tax havens resist reforms one year on from Panama Papers exposé
Oct 1, 2019 | Avantika
इख़्तियार
Oct 24, 2019 | Avantika
Lessons from the Grassroots
Sep 10, 2019 | Avantika
This is What Child Marriage Looks Like
Nov 18, 2019 | Avantika
Oxfam India Held Youth Festivals In Lucknow And Raipur
Sep 9, 2019 | Avantika
Oxfam at the North-East Disaster Risk Reduction Conclave 2017
Sep 9, 2019 | Avantika
Finding Solutions to Early and Forced Marriage
Sep 27, 2019 | Avantika
Silence Has No Honour
Sep 27, 2019 | Avantika
Solidarity Is Our Weapon- The International Women’s Strike
Oct 24, 2019 | Avantika
4 reasons why Oxfam supports the International Women’s Strike on the 8th March
Oct 24, 2019 | Avantika
Union Budget 2017-18: Neglected Social Sector
Sep 10, 2019 | Avantika
Putting Data at the Heart of Business Responsibility
May 13, 2019 | Avantika
Mainstreaming DRR in Local Development Plans to Reduce Aid Dependency
Oct 1, 2019 | Avantika
Union Budget 2017-18: A Look at the Health Sector
Apr 5, 2019 | Avantika
खेल - जेण्डर आधारित असमानताओं को उजागर करने को एक सषक्त माध्यम
Apr 5, 2019 | oxfamadmin
Why Brazil should not take a U-turn on its health system
Oct 7, 2019 | Avantika
Your questions answered: Oxfam’s Inequality report
Oct 1, 2019 | Avantika
Unpacking the Risks of Doing Business in India
Nov 14, 2019 | Avantika
We Never Learn
Sep 27, 2019 | Ravi
Promote men’s involvement for changing social norms
Oct 24, 2019 | Avantika
Ten years of the Forest Rights Act: Opportunity lost?
Oct 1, 2019 | oxfamadmin
Meet the Bravehearts Standing Up Against Domestic Violence
May 27, 2020 | oxfamadmin
Addressing Violence Against Women and Girls the SAARC Way: Combat Human Trafficking
Sep 10, 2019 | oxfamadmin
Oxfam India’s journey from programme to campaign
Oct 24, 2019 | oxfamadmin
सामाजिक मान्यताओं को चुनौती देता संगठन
Dec 5, 2019 | oxfamadmin
Changing The World – One Couple At A Time
Oct 24, 2019 | oxfamadmin
A Lesson on Education from Uttar Pradesh
Oct 7, 2019 | oxfamadmin
Fair Sharing of Mining Revenue for the Tribals
Oct 24, 2019 | oxfamadmin
An Open Letter to Chhotu, Munna and Bachcha
Jun 12, 2020 | oxfamadmin
Educating the Educators
Sep 27, 2019 | oxfamadmin
10 Years of Domestic Violence Act: The Way Ahead
Oct 24, 2019 | oxfamadmin
Oxfam Best Film on Gender Equality Award Gets Grand Reception
Sep 27, 2019 | oxfamadmin
Wrestling Social Norms Out
Oct 3, 2019 | oxfamadmin
The Toilet Conundrum
Oct 24, 2019 | oxfamadmin
Inequality in India: what's the real story?
Sep 27, 2019 | oxfamadmin
Making surface water safe for drinking
Oct 1, 2019 | oxfamadmin
Quality Education- The unfinished agenda of RTE Act
Sep 27, 2019 | oxfamadmin
Tale of Two Women
Sep 27, 2019 | oxfamadmin
Violence in women’s own backyard
Sep 9, 2019 | oxfamadmin
We failed yet again
Sep 10, 2019 | oxfamadmin
Providing access to iron-free drinking water
Oct 7, 2019 | oxfamadmin
Her Series - Tale of Buguru Chitamma: How a cooperative transformed fisher women into leaders
Oct 24, 2019 | oxfamadmin
Why the CAF bill conflicts with the Forest Rights Act?
Oct 7, 2019 | oxfamadmin
Renew to Live Anew
Sep 9, 2019 | oxfamadmin
What do we want: Health as a ‘Right’ or just an ‘Assurance’
Nov 18, 2019 | oxfamadmin
Oxfam International signs historic deal to move to Nairobi, Kenya
Oct 24, 2019 | oxfamadmin
Why is passing the Women’s Reservation Bill urgent?
Nov 18, 2019 | oxfamadmin
BREXIT & What It Means for Humanitarian Aid
Oct 7, 2019 | oxfamadmin
Rahul Bose: Films should be gender sensitive
Oct 24, 2019 | oxfamadmin
Portrait of a Teacher: Successful introduction of multi-lingual education for Odisha’s tribal communities
Nov 6, 2019 | oxfamadmin
Tax dodging is a crime against developing countries
Sep 10, 2019 | oxfamadmin
Signs of social risks impacting Indian businesses
Oct 7, 2019 | oxfamadmin
Tikamgarh revisited, what’s happened to the amazing fishing communities I visited in 2006?
Jan 9, 2020 | oxfamadmin
Where school means freedom
Sep 10, 2019 | oxfamadmin
Yes, Prime Minister
Oct 30, 2019 | oxfamadmin
India’s National Budget 2016-17: Missed Opportunity to Address Inequality?
Oct 1, 2019 | oxfamadmin
Free The Night
Sep 9, 2019 | oxfamadmin
Woman, Open Your Eyes…
Oct 24, 2019 | oxfamadmin
From Darbhanga to Davos: Access to Affordable Medicine Still Remains a Key Question
Dec 16, 2019 | oxfamadmin
Hoping for a Second Chance: Punita Devi
Sep 27, 2019 | oxfamadmin
Activating Youth in Lucknow to Promote Girls’ Education
Sep 27, 2019 | oxfamadmin
Change is Coming: Rani Bitti’s Story
Sep 10, 2019 | oxfamadmin
Rachna’s Fight for Justice
Oct 7, 2019 | oxfamadmin
3 Key Observations from #WEF2016 that Indian Businesses Must Take Note Of
Sep 27, 2019 | oxfamadmin
Here’s Why States Need to Provide Free Basic Medicines
Nov 18, 2019 | oxfamadmin
Update: Oxfam to Provide Shelter to 300 Households Hit by The Manipur Earthquake
Apr 5, 2019 | oxfamadmin
In El Salvador, a struggle to survive El Niño
Oct 24, 2019 | oxfamadmin
Bihar designs a 15-year roadmap to reduce risk of disaster
Feb 20, 2020 | ursila
Violence as an Effective Mode of “Indian” Communication
Apr 5, 2019 | oxfamadmin
Because it’s 2015!
Sep 27, 2019 | oxfamadmin
Let’s welcome a new dawn, minus domestic violence
Oct 24, 2019 | oxfamadmin
Data and Discrimination: Women’s Ownership of Assets in India
Oct 24, 2019 | oxfamadmin
“No Woman, No Cry!”
Sep 27, 2019 | oxfamadmin
Pushing, pulling and the power of people: new horizons for corporate responsibility?
Jan 9, 2020 | oxfamadmin
Yes bank - say to inclusive and social banking and inclusive business model
Sep 27, 2019 | oxfamadmin
Creating shared value through inclusive business
Oct 7, 2019 | oxfamadmin
TATA consultancy services – empowering farmers with mobile technology
Sep 27, 2019 | oxfamadmin
What the CSR numbers don’t tell
Oct 1, 2019 | oxfamadmin
6 important things companies need to do to be inclusive
Nov 21, 2019 | oxfamadmin
Why businesses need to invest in creating a productive population for a sustainable future
Sep 10, 2019 | oxfamadmin
Jaipur rugs – weaving the lives of the poor into the global markets. an inclusive business model.
Oct 24, 2019 | oxfamadmin
The next 15 years: highlighting the role of the private sector in development
Oct 7, 2019 | oxfamadmin
Emphasizing a human rights-based approach to inclusiveness in business
Oct 30, 2019 | oxfamadmin
Privatising Forests: A Bad Idea
Oct 30, 2019 | oxfamadmin
Adoption of Agenda 2030: 17 SDGs for 15 years
Nov 15, 2019 | oxfamadmin
Five questions about the #GlobalGoals you were too embarrassed to ask
Oct 7, 2019 | oxfamadmin
Last mile smile
Oct 7, 2019 | oxfamadmin
Social responsibility of companies should not stop at 2%
Sep 27, 2019 | oxfamadmin
In ‘campaign mode’, states flout FRA rules
Sep 27, 2019 | oxfamadmin
“I will not leave my forest. I will keep my jungle”
Oct 1, 2019 | oxfamadmin
Healthcare for all in India: When, How, and Why RSBY?
Oct 24, 2019 | oxfamadmin
Where is the nutrition? Ask pregnant women in a village of Bihar
Jan 9, 2020 | oxfamadmin
Learning to read at schools, but where are the textbooks?
Oct 24, 2019 | oxfamadmin
Progressive tax norms must underlie financing of the Sustainable Development Goals
Sep 27, 2019 | oxfamadmin
Teachers needed! Government schools are falling behind due to lack of funds
Oct 24, 2019 | oxfamadmin
Protect and expand India’s public healthcare system: The inequality imperative
Dec 16, 2019 | oxfamadmin
“On My Second Day At School, A Kid Asked Me What Caste I Was”
Oct 7, 2019 | oxfamadmin
India’s missing girls: A tale of healthcare neglect faced by girls
Sep 9, 2019 | oxfamadmin
Should we only give attention to women’s health on International day of action?
Nov 18, 2019 | oxfamadmin
No respite for 72-year-old Sitaram, a month after #NepalEarthquake
Oct 7, 2019 | oxfamadmin
One month on, education of children still jolted by Nepal earthquake
Oct 24, 2019 | oxfamadmin
New worry for Nepal; landslides, floods may block relief work
Oct 7, 2019 | oxfamadmin
Monsoon preview in Kathmandu blows away shelters in relief camp
Oct 1, 2019 | oxfamadmin
Last mile distribution of relief supplies is biggest challenge in Nepal: Indian ambassador
Oct 7, 2019 | oxfamadmin
When Delhi’s Streets Buzzed with ‘Haq Banta Hai’
Oct 7, 2019 | oxfamadmin
Lack of water, toilets making things worse for women in Nepal
Oct 7, 2019 | oxfamadmin
Oxfam India gets government approval to respond to #NepalEarthquake in 28 hours
Apr 5, 2019 | oxfamadmin
Desperation creeping in, people in Nepal wait for aid
Oct 7, 2019 | oxfamadmin
#OxfaminNepal: “More than 60,000 litres of water has been provided till now”
Oct 7, 2019 | Avantika
Political (and some other) priorities in Nepal as of 28 April 2015
Oct 30, 2019 | oxfamadmin
#Nepal Earthquake: “The death toll has crossed 2000 and this is just the beginning”
Jan 9, 2020 | oxfamadmin
#NepalEarthquake: It is going to be a long road to recovery
Oct 24, 2019 | oxfamadmin
Money Matters!
Oct 24, 2019 | oxfamadmin
All for Education, Education for All
Oct 7, 2019 | oxfamadmin
When schools continue to exclude, can education reduce caste discrimination in India?
Feb 20, 2020 | oxfamadmin
Ensuring the right to education, forming bonds for life
Oct 1, 2019 | oxfamadmin
How can India send a spaceship to Mars but not educate its children?
Sep 30, 2019 | oxfamadmin
India wins in cricket, but losing out on education
Sep 30, 2019 | oxfamadmin
Oxfam's 'Even it up' report a must read lesson on Inequality
Oct 24, 2019 | oxfamadmin
It’s time to understand ‘womanhood is beyond maternity’
Oct 7, 2019 | oxfamadmin
The True Measure of Land's Value
Oct 7, 2019 | oxfamadmin
The “Ten-thousand Committee”: Reviving VHSNCs in Jharkhand
Oct 1, 2019 | oxfamadmin
Singing their way out of child marriage
Sep 10, 2019 | oxfamadmin
Land Acquisition bill tests government’s pro-poor stance
Oct 1, 2019 | oxfamadmin
Breaking the silence, standing tall
Sep 27, 2019 | oxfamadmin
Making a Song and Dance about Child Marriage
Oct 7, 2019 | oxfamadmin
Let’s Talk About Sex
Sep 10, 2019 | oxfamadmin
Mobile technology solutions could be a game changer for maternal health: Scribes
Sep 27, 2019 | oxfamadmin
Missing Girls: The Puzzling Domestic Violence Agenda
Oct 3, 2019 | oxfamadmin
Her Ghar: A right to residence for every woman
Oct 7, 2019 | oxfamadmin
Considering Gender: A Mediaperson’s Guide to Covering Disasters
Dec 16, 2019 | oxfamadmin
True Grit
Apr 5, 2019 | oxfamadmin
Violence against women and star power: Does their magic wand work?
Oct 24, 2019 | oxfamadmin
Having Those Difficult Conversations
Oct 24, 2019 | oxfamadmin
Day of the Man: guarding the china shop
Oct 7, 2019 | oxfamadmin
Gender parity needs to begin at home with mother’s guardianship rights!
Sep 9, 2019 | oxfamadmin
It’s a Girl!
Oct 1, 2019 | oxfamadmin
Let’s Help End Domestic Violence!
Oct 24, 2019 | oxfamadmin
A Few Good Men
Oct 7, 2019 | oxfamadmin
Promises to keep—Implementation of PWDV Act in Odisha
Sep 27, 2019 | oxfamadmin
Make 16 Days of Activism an Everyday Practice
Oct 30, 2019 | oxfamadmin
Witch-Hunting: A less talked about form of Violence Against Women
Oct 24, 2019 | oxfamadmin
Markets Also Discriminate
Oct 7, 2019 | oxfamadmin
Let’s Talk About Domestic Violence!
Oct 7, 2019 | oxfamadmin
Getting Serious about Ending Violence against Women and Girls
Oct 3, 2019 | oxfamadmin
Right to a Violence Free Life
Sep 10, 2019 | oxfamadmin
It’s all about the money
Sep 10, 2019 | oxfamadmin
‘It’s No Longer Funny': The Funding Wars That’ll Dictate Our Future
Oct 7, 2019 | oxfamadmin
Girl, Interrupted
Oct 1, 2019 | oxfamadmin
16 Pictures From Imagining Inequality That WiIl Tell You The Truth #evenitup
Oct 24, 2019 | oxfamadmin
These 8 Goals Were Set To Develop The World, But 14 Years Since, This Is Where We Stand
Dec 5, 2019 |
A Look At The Year 2029: What Kind Of Legacy Will We Leave Behind For Our Future Generations?
Nov 18, 2019 |
These 8 Goals Were Set To Develop The World, But 14 Years Since, This Is Where We Stand
Oct 24, 2019 | oxfamadmin
BRICS bank a necessary step, but needs more transparency
Sep 9, 2019 |
Short term memory and Long term needs!
Oct 7, 2019 |
A people’s budget has to go beyond...
Oct 24, 2019 |
National Shame, National Failure
Sep 27, 2019 | oxfamadmin
Oxfam India pledges its support to #BringBackOurGirls
Oct 1, 2019 | oxfamadmin
Closing the Gap on Gender: Is India up for the challenge?
Nov 15, 2019 | oxfamadmin
She tills, she sows, but she does not own
Oct 7, 2019 | oxfamadmin
Take a pause: what do the Uttrakhand floods tell us about India’s development model?
Sep 10, 2019 | oxfamadmin
Saving lives on sharp turning roads
Oct 1, 2019 | oxfamadmin
They do mind the gap
Oct 7, 2019 | oxfamadmin
Right to Education, still a long way to go.
Oct 1, 2019 | oxfamadmin
Can We Close the Gap on Women's Inequality in India?
Oct 30, 2019 | oxfamadmin
Breaking Old Barriers and Building New Alliances for Food Justice in India and Globally
Oct 24, 2019 | oxfamadmin
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