Food & Nutrition Security

Issues: Malnutrition, a Silent emergency

There is every reason to believe that Odisha, a state in India’s eastern coast endowed with natural and human potential and a glorious history, culture and tradition has a bright prospect to emerge as a developed state and a global nutrition pioneer. Good nutrition has the power to transform and empower the present and future generations. With investments in food and nutrition related initiatives, the state can remove the age old poverty and the backward tag that has plagued it for centuries. Odisha lags behind many other states in key nutrition outcomes. The prevalence of stunting and wasting among the children less than 5 years of age is 38.2% and 18%, respectively (RSOC-2013-14). 62% of women and 65% children are anaemic and chronically energy deficient. Moreover, a large section of the tribal suffer from sickle cell anaemia. Stunting among the tribal children and Other Backward Caste (OBC) Children is 46.1% and 41.3% respectively. Strangely, 77.7% households are practicing open defecation in Odisha. Malaria is endemic in some regions. Good sanitation, hygiene and safe drinking water have a bearing on good health and nutrition. Malnutrition has a consequence on productivity, GDP, infant mortality and economy. The infant mortality rate (IMR) is 53% and the Maternal Mortality Rate (MMR) is 237. The reported deaths of 19(nineteen) Juanga tribal(Primitive tribal group) children due to malnutrition in Nagda and Naliadab villages of Jajpur district in the month of July’16 raises serious questions on policy and program delivery effectiveness and public accountability. Interestingly, the reported death is happening on the 150thAnniversary of Naanka Durbhikya (The Great Odisha Famine) when at least 1 million people, a third of the population of the state, died in 1866. There might not be food famine but it seems the nutrition famine is engulfing the margianlised and compounds the vulnerability of the state which is still reeling under poverty and disaster.

Policy/Action:

The National Food Security Act (NFSA), 2013 has a clear mandate for the ‘Food and Nutrition Security’ in a life cycle approach. Odisha is one of the pioneering states to establish ‘State Food Commision’ for the purpose of monitoring and review of implementation of this act. The Act prescribes to cover minimum 67% of the state population and key food and nutrition entitlements like Targeted Public Distribution System (TPDS) and universal coverage of pregnant and lactating mothers and children under six years of age under Integrated Child Development Service (ICDS) and universal coverage of primary school children under Mid-Day Meal (MDM) programs in the state. Pregnant and lactating mother and children under six years of age are entitled to get adequate calorie, protein and other micronutrients under the scheme. An analysis shows that if the TPDS and ICDS programs perform properly, then pregnant and lactating mothers and Antyodaya households can meet 70% and 85% of their food and nutrition need through TPDS and ICDS respectively. Similarly, the children under six years of age can meet 100% of the nutrition needs through ICDS supplementary nutrition program. Apart from food entitlements program, there are other entitlements and programs like NREGA, Mission Indradhanush, Sabla, maternity benefit schemes which contribute towards better nutrition and health outcomes. However, there are major service and supply gaps on nutrition front. As per RSOC-13-14, only 24.6% women receive full ANC (receipt of 3 ANC, 2 doses of TT and consumption of 100 IFA tablets/3 bottles of IFA syrup) and 62% children aged 12-24 months are fully immunised (BCG, Measles, 3 doses each of DPT and Polio vaccine (excluding polio vaccine given at birth).

The Government of India is prioritising actions on nutrition. The revamped Prime Minister’s Nutrition council, National Nutrition Mission, mandatory food fortification, direct benefit cash transfer, increasing the cost of supplementary nutrition, special programs on maternity benefit, adolescent girl, deworming and sanitation provide opportunity for the nutrition in the country. The government of Odisha must take these advantages. India is a signatory to World Health Assembly (WHA) goal which mandates reduction of stunting, wasting, anaemia among children with a defined target. Similarly, Sustainable Development Goal II mandates to end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants to end hunger, achieve food security and improved nutrition and promote sustainable agriculture safe, nutritious and sufficient food all year round by 2030. Odisha’s nutrition policy and action needs a reflection and paradigm shift in view of in -country and global developments.

Recommendations / Policy Asks:

The return to investments in nutrition has a high cost benefit ratio. The countries which invested in nutrition decades back are reaping its benefits. It is all about fighting malnutrition and micronutrient deficiencies together. Odisha has all the potential to become a global nutrition pioneer. However, it needs strong political will and a people’s movement to realise the same. Focusing on first 1000days of life, the state needs to strengthen and diversify the current Integrated Child Development Service (ICDS) supplementary nutrition program, Targeted Public Distribution System (TPDS) program and Mid-Day meal program with an expanded food basket. The synergy, coordination and convergence between health, environment, agriculture and other line functions and themes can optimise the impact. It is necessary to set the data and baseline right. Decentralized bottom-up planning, intra-departmental coordination and management, monitoring and empowerment (training/orientation) are the bedrock of coordination, convergence and governance. The role and contribution of health, environment, forest, agriculture, ag-nutrition value chain, education and other sectors assume paramount importance to demonstrate impact at scale. The multi-stakeholder platforms and new structures and institutions such as the Department of Nutrition, Nutrition Mission, State Food and Nutrition Commission under NFSA-2013, State Nutrition Resource Centre, and Project Directorate on Nutrition are key drivers of success. Accessing nutritious food lies in the fact that the governance becomes functional and more accountable and responsive to people’s needs. Voluntarism works in Asian countries and it has demonstrated impact. A commitment to build 200,000 – 250,000 female change leaders (women and girls) at the hamlet level with local government and community support will be transformative in nature to this successful and long overdue nutrition movement. Nagada should set the agenda and Odisha should lay the foundation of a great Nutrition revolution in the country.