Build on nutrition security

Adopting successful local strategies will help break the vicious inter-generational cycle of malnutrition

A child’s crucial phases of development are dependent on the quality of care towards health and nutritional status. These are non-negotiable and must be supported by the child’s family and community health systems.

Malnutrition has major consequences for a child’s health, immunity, cognitive and physical development and the economic productivity of individuals and societies. Children with low birth weight are 2.6 times less likely to progress to higher educational levels. Stunted (low height for age) children will earn at least 10% less in their lifetime earnings.

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Investments made in children’s health with appropriate care and nutrition will yield benefits for the country’s future and will boost growth and economic prospects.

Telangana’s Initiatives

Telangana is one of the few States that aims to promote the welfare of women, children, disabled and senior citizens. The Supplementary Nutrition Programme (SNP) enacted by the State is a crucial element of the Integrated Child Development Services (ICDS) to eradicate malnutrition. Its services are offered to pregnant and lactating women, and children between the ages of seven months to six years.

As per a Comprehensive National Nutrition Survey (CNNS) report, in Telangana, 29.3% among children under five years are stunted, which is below the national average. The prevalence of wasting and severe wasting among children is 17.9% and 5.6% respectively. None of the districts in Telangana have a very high prevalence of stunting (that is, higher than 40%).

Zero hunger and good nutrition have the power to transform and empower the present and future generations. The Government of India is committed to improving the nutritional status of children and women through Poshan Abhiyaan. The mission mode approach provides impetus to strengthen implementation and its monitoring. There are core programmatic inputs including funding, human resources, supplies and infrastructure that are critical to the functioning of these Poshan Abhiyaan pillars.

Balamrutham Model

The Balamrutham food model of Telangana has set a wonderful example to tackle child malnutrition in a promising manner with the support of a strong political will. Balamrutham serves not only as a weaning food but also as a caloric-dense food to reduce malnutrition and is, therefore, used as part of supervised feeding for malnourished children.

The Telangana Women & Child Welfare Department formally launched Balamrutham under the ICDS to provide improved supplementary nutrition to children between seven months and three years of age and it is turning out to be a boon for over 15 lakh children across the State. The weaning food is a preparation of wheat, chana dal, milk powder, oil, and sugar. It is fortified and thus provides 50% of iron, calcium, vitamins, and other Recommended Dietary Allowance (RDA) that children require per day.

The recommended quantity is 100 gm, which is to be given to children 3-5 times every day. For children below one year, Balamrutham can be served as porridge mixed with hot water and for older children, it can be given in the form of ‘Laddu’. It is distributed in packets of 2.5 kg per child per month on the first day of every month, on Nutrition Health Day-1. to mothers of 7 months-3 years children as Take-Home Ration (THR). Along with the Balamrutham packet, these children also receive 2 eggs a week at the Anganwadi centres under the ICDS Food Model for 7 months to 3 years. Around 2,500 tonnes of Balamrutham, which costs nearly Rs 12 crore, is supplied to Anganwadi centres every month. The aim is to offer “chemical-free, hygiene and nutritious food to all children in the State”.

It is expected that Balamrutham will serve as an effective supplementary nutrition diet during the child’s crucial period of 7 months to 3 years and, along with counselling to mother on Infant and Young Child Feeding (IYCF) practices, will prevent the incidence of chronic malnutrition.

High Coverage

The coverage of Balamrutham is high, nearly 70% of children from the target population consume Balamrutham and about 58% of children are the sole consumer of Balamrutham in their households. Coverage did not vary significantly between poor and non-poor households, suggesting that a household’s socio-economic status is not a barrier in accessing Balamrutham. The main drivers of coverage is the high coverage of the ICDS programme itself and, more specifically, the taste of Balamrutham, the caregivers find the product being good for the children, and the fact that the product is easily available and free.

Improving the quality of foods, feeding practices, and the nutrition of children in the first two years of life, represent a critical window of opportunity to break the inter-generational cycle of malnutrition. If this critical opportunity is missed, child malnutrition will continue to grow, malnourished girls will become malnourished women, who give birth to low birth weight infants and these children will eventually suffer from poor nutrition-related morbidities in the first two years of life.

The best opportunity to break this vicious inter-generational cycle is to focus on targeted interventions in improving the nutrition of infants, children, and women from conception through the first two years of life by adopting successful local strategies to achieve desired health outcomes.

(The author is Executive Director, The Coalition for Food and Nutrition Security)

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