India had been witnessing rapid economic growth in recent years
but the growth was not seen to be reflected in the nutritional status of
mothers, children and adults. There had been a meagre decline of 1% in the
proportion of underweight children in the country between the two NFHS in
1998-99 and 2005-06 (from 47% to 46% for the age group of 0-3 years). There had
been no substantial improvement in calorie consumption among households.
According to NSSO rounds from 1983 to 2005, the mean per capita consumption of
calories had never crossed minimum calorie intake of 2400 Kcal and 2100 Kcal in
rural and urban areas respectively. Still. about 75% of households failed to
consume this minimum calorie which had even increased from 64% as observed
This situation prevailed in spite of various national and state level programmes in the country which ensured nutrition directly or indirectly. Under the overarching role of the Planning Commission, various ministries and departments were involved to improve nutritional status Programmes directly related to nutrition going on were Integrated Child Development Services Scheme, Nutritional Programme for Adolescent Girls, Mid Day Meal Programme for primary school children, Public Distribution System, Iron and Folic Acid Supplementation through Prevention and Control of Anemia Programme, Vitamin A Prophylaxis Programme and National Lodine Deficiency Disorders Control Programme. Provision of literacy through the Department of education, employment through the Ministry of Rural and Urban development and increased food production through Ministry of Agriculture also played an important role.
In this background, the National Nutrition Policy was formulated to improve nutrition, for the first time in 1993 and was accepted by the Government of India. It viewed nutrition as an outcome of a complex array of factors such as agriculture, food production, purchasing power market prices, knowledge, changing tastes and gender differences etC. The document reviewed the nutrition status and various programs and enlisted long term or indirect and short term or direct interventions to improve the nutrition status. The details of nutrition status are given in the chapter on National Nutrition Programmes.
National Plan of Action on Nutrition
As a follow up of National Nutrition Policy, a National Plan of
Action was formulated in 1995 with sectoral commitments, by 14
nutrition-related ministries/departments, viz. Agriculture, Food, Civil
Supplies, Forestry, Education, Health & FW, Food Processing, Rural Areas
and Employment, Urban Development, Labour, Welfare, Information and
Broadcasting and Women and Child Development, which was to serve as the nodal
agency responsible for the implementation of National Nutrition Policy. The
action was started by various ministries/departments to fulfil their
commitments. Ministry of Agriculture started training programme related to
kitchen gardens, rearing of goat, sheep, pig, fish culture etc. to promote
products and increased the availability of green leafy vegetables and other
nutritious foods at household levels. Ministry of Forests & Environment
involved local communities in growing nutrition rich fruits like mango, ber,
amla, guava, orange, apple etc. and distributing seedlings of plants producing
fruits rich in vitamin A. Ministry of Civil Supplies had recast Public
Distribution System as Targeted Public Distribution System (TPDS) so that
people below poverty line were programme of Grain Banks in the most
inaccessible tribal areas inhabited by primitive tribes Ministry of Education
launched a nation-wide programme of Nutritional Support to Primary Education
(Mid-Day Meal Scheme) in 1995 to give boost to universalisation of primary education.
By 1997 the programme was expanded to cover 5.57 crore primary school children
in 4426 blocks with a focus on low Female Literacy Block. Ministry of
Information has been supporting by developing and telecasting and broadcasting
messages on nutrition, family welfare related themes. Ministry of Health &
Family Welfare is involved in the prevention, early detection and management of
micronutrient deficiencies, health and nutrition education, infection control
and promotion of small family norm to achieve improved nutritional status.
The National Nutrition Policy had set various goals to be achieved by 2000. All the concerned departments reviewed the progress achieved and revised their goals for the tenth plan/2010. The goals in policy had been revised in the light of these revised goals.
Important developments during the Eleventh Plan period
Important developments during the Eleventh Plan period.
The WHO Child Growth Standards were introduced in mid 2008 under ICDS as well as NRHM, for the monitoring and promotion of young child growth and development The ICMR Expert Committee revised the Recommended Dietary Allowances for Indians, in 2010, taking into account the fact that body weight and physical activity are major determinants of energy requirement. Recommendations were also made for energy requirements for reference children as well as energy requirements per kilogram so that the gap between the energy requirement and energy intake can be computed on the basis of current stature. This is an important measure as the country has entered the dual nutrition burden era.
NRHM Village Health and Sanitation Committees were expanded in July 2011 to include nutrition and ICDS to become Village Health, Sanitation and Nutrition Committees, recognized as subcommittees of Gram Panchayats.
To reinforce interventions for prophylaxis and control of nutritional anemia, the use of Double Fortified Salt (DFS) was mandated in government Food Supplementation programmes such as ICDS and MDM.
RMNCH A revised the strategy for iron and folic acid supplementation in February 2013. It includes the National Iron Plus Initiative, Weekly Iron and Folic Acid Scheme and Preventive Use of Folic Acid in planned pregnancies during the peri-conception phase.6 (Details of these have been discussed in the chapter on Reproductive and Child Health Programme.)
The National Food Security Ordinance was passed in 2013, which is an initiative for ensuring food and nutritional security to the people. It gives the right to the people to receive an adequate quantity of foodgrains at affordable prices.
Strategy during the Twelfth Plan
The paradigm shift from food security to nutrition security to meet the needs of macro, micro, and phytonutrients through dietary diversification adopted during the tenth plan continued in the eleventh plan. Public health measures were undertaken for procurement and supply, building institutional capacity in organizations for monitoring and mapping micronutrient deficiencies deworming children at regular intervals and providing safe drinking water and sanitation. Sustained efforts were made for food fortification to reduce/eliminate micronutrient deficiencies including universal salt iodization to eliminate Iodine Deficiency Disorders (IDD) and a multi-pronged strategy to reduce the prevalence of anaemia, micronutrient deficiency like vitamin A deficiency and associated health hazards. Horticulture interventions were undertaken to increase availability and self-sufficiency. All these measures will continue in the Twelfth Plan.
To promote food security in the Twelfth Plan, strategies planned are as follows:
1.Strengthening and restructuring of the ICDS.
2. Preparing a multisectoral programme to address maternal and child malnutrition.
3.Launching nation-wide information, education, communication campaign against malnutrition.
4. Bringing strong nutritional focus to the programs of the ministries that deal with health; drinking water supply and sanitation; school education; agriculture; food and public distribution.