India has been relentlessly trying to address hunger. The government of India has been working on getting consent on significant measures, enacting platforms and financing for food and nutrition. As movements started to accelerate, the coronavirus pandemic arrived. By affecting health systems, food systems, nutrition programmes, social safety nets and the economy, the pandemic has aggravated hunger in multiple ways.
India needs to come out with possible solutions to tackle hunger, including for those affected by Covid-19. Strong leadership with continuous commitment, dedicated implementation of the national nutrition mission and strengthening of social safety net need to be accorded priority. In this context, evidence-based data will come in handy to take informed decisions, implement them and ensure feedback for taking necessary corrective action.
While this pandemic has already caused havoc in the short-term, its long-term effects on health and nutrition are yet to be grasped fully. In low and middle-income countries like India, the pandemic has the potential to further damage the already poor nutritional status of vulnerable groups owing to multiple reasons – loss of income, strain on the fragile healthcare systems and disruptions to cash and food transfer schemes. However, this is also the time to kill hunger and provide the right kind of food and nutrition through a community-led approach.
As per the recent Unicef report on ‘Community based programme for children below 5 years of age with severe acute malnutrition in India – progress so far and lessons learned 2020’, care for severe acute malnutrition (SAM) children at the community level has been initiated in two districts of Telangana — Asifabad and Gadwal — by the Department of Women Development and Child Welfare with the support of National Institute of Nutrition (NIN), Hyderabad, and Unicef. NIN has taken the initiative to modify the nutrient density of the existing Integrated Child Development Scheme (ICDS) Take-Home Ration (THR) – ‘Balamrutham’.
Funded by the State government, the modified ICDS THR ‘Balamrutham Plus’ is produced by the Telangana Foods for community-based programme, and is targeted at children with SAM. Training for the frontline functionaries in the two districts has been completed. A technical advisory group has been set up to provide guidance to the State government on the implementation of the Community-Based Management of Acute Malnutrition (CMAM) programme and suggest possible scale-up strategies. State governments are putting in efforts to maintain a continuous supply chain of staple food products and ensure supply of THR amidst the crisis. Most of them are planning to provide THR at the doorstep of the recipients through frontline soldiers —ASHAs and anganwadi workers.
Nutrition and Food Security
A multi-level policy framework is required to support nutrition and food security during the pandemic. At this critical point, while the topmost priority is to save lives through Covid-19 prevention and management, we must also understand the short- and long-term impacts on food and nutrition security. It remains important for governments grappling with the public health crisis to continue to prioritise food and nutritional security.
It is vital to ensure due attention to minimise the adverse impact and disruption of livelihood and access to life-saving health and nutrition services for the poor and marginalised. The data available shows that there has been an increase in coverage of several essential nutrition services during the last few years. There is a critical need for intensified efforts to ensure the continued delivery of high nutrition impact services to the most vulnerable populations while limiting the risk of Covid-19 transmission. It is also essential to have high-frequency surveillance of vulnerable populations and close coordination across sectors, including health, agriculture, education, water and sanitation, social protection, commerce and trade. This is a unique opportunity to engage many key stakeholders around much-needed reforms to support better nutrition.
Food Supply Chains
Food systems are disrupted across the value chain — from farms to markets and consumers. Although efforts to ensure the availability of essential commodities and iodised salt under the public distribution system are under way, the reach of these programmes is also going to be impacted by State-level systems and capacity to deliver, and public trust in these government-led food security programmes. In addition, most food purchases in India are from private markets. Thus, keeping a close eye on what happens in food supply chains across the country is very important.
Other programmes that were flourishing across the country pre-Covid are the women’s self-help group programmes. It appears that many of these programmes are re-orienting efforts to reach communities, support physical distancing, produce masks and more, but at their core, such community-based programmes that rely on close physical interactions will be affected as the pandemic moves through the country.
Specific and urgent attention will be needed to ensure basic food and income security given tremendous job losses, food insecurity and reverse migration from cities to villages, which is particularly of importance for the poorest. To address the hostile impact of the pandemic, mostly on marginalised populations, the Indian government has already declared an economic relief package and social security measures. The Central government has recommended States to deliver packets of dry ration to all the beneficiaries of ICDS.
To gain a better understanding of the epidemiological and biological relationships between Covid-19 and malnutrition, demographic and nutritional assessments of such patients are critical. Hence clinical data gathering and research by the clinical community on how malnutrition affects Covid-19 progression and how it affects malnutrition among those infected is essential.
(The author is food technologist at LPU and a public policy consultant)
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