Poshan Abhiyan Scheme

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Context: The State governments and the Union Territories utilised a mere 30% of the funds released under the Poshan Abhiyaan, or the National Nutrition Mission since it was launched in 2017, according to an analysis of the data shared in Parliament. 

Relevance:
Mains: GS II- Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

Concerned ministry: Ministry of Women and Child Development (MWCD)

Background:

  • A United Nations Children’s Fund report has found that more than a quarter of children under age 5 worldwide are permanently “stunted” from malnutrition, leaving them physically and intellectually weak and prone to an early death.
  • The report says the better provision of vitamins, clean water and breastfeeding could have helped these 165 million children achieve normal brain and body development.
  • The country with the largest number of stunted children in India with 61.7 million, or 48% of all Indians under age 5.
  • The Comprehensive National Nutrition Survey, released by the Ministry of Health and Welfare in October, showed that 35% of children under the age of 5 are stunted and in this age group, 17% are wasted (low weight for height) and 33% underweight (low weight for age)
  • Government is implementing several schemes and programs under the Umbrella Integrated Child Development Services Scheme as direct targeted interventions to address the problem of malnutrition in the country.
  • All these schemes address one or other aspects related to nutrition and have the potential to improve nutritional outcomes in the country.
  • Malnutrition is not a direct cause of death but contributes to mortality and morbidity by reducing resistance to infections.
  • There are a number of causes of death of children such as prematurity, low birth weight, pneumonia, diarrhoeal diseases, non-communicable diseases, birth asphyxia & birth trauma, injuries, congenital anomalies, acute bacterial sepsis and severe infections, etc.


National Nutrition Mission (Poshan Abhiyan): 

National Nutrition Mission: 

  • The POSHAN Abhiyaan is a multi- ministerial convergence mission with a vision to address malnutrition with a targeted approach by 2022.
  • Objectives: The goals of NNM are to achieve improvement in the nutritional status of children from 0-6 years, Adolescent Girls, Pregnant Women and Lactating Mothers in a time-bound manner by 2022.
  • The NNM is a comprehensive approach towards raising nutrition level in the country on a war footing.
  • Pillars of the MIssion:
    1. ICDS-CAS(Common Application Software)
    2. Convergence
    3. Behavioural change, IEC Advocacy
    4. Training and Capacity building
    5. Innovations
    6. Incentives
    7. Grievance Redressal
  • The programme ensures convergence with various programmes and ministries i.e.,
    1. Anganwadi Services,
    2. Pradhan Mantri Matru Vandana Yojana (PMMVY),
    3. Scheme for Adolescent Girls (SAG) of MWCD
    4. Janani Suraksha Yojana (JSY),
    5. National Health Mission (NHM),
    6. Swachh-Bharat Mission,
    7. Public Distribution System (PDS),
    8. Department of Food & Public Distribution,
    9. Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) and
    10. Ministry of Drinking Water & Sanitation.
  • It will comprise a mapping of various schemes contributing towards addressing malnutrition, including a very robust convergence mechanism which includes:
    1. ICT based Real-Time Monitoring system,
    2. incentivizing States/UTs for meeting the targets,
    3. incentivizing Anganwadi Workers (AWWs) for using IT-based tools,
    4. eliminating registers used by AWWs,
    5. introducing measurement of the height of children at the Anganwadi Centres (AWCs),
    6. Social Audits,
    7. setting-up Nutrition Resource Centres,
    8. involving masses through Jan Andolan for their participation in nutrition through various activities, among others.
  • The Ministry of Women and Child Development (WCD) in association with the Bill & Melinda Gates Foundation and Deendayal Research Institute is developing a POSHAN atlas under POSHAN Abhiyan. 
    • The POSHAN atlas will map the crops and food grains grown in different regions of the country in order to tackle malnutrition by promoting regional cropping patterns and embracing local food that are rich in protein.
  • Major impact: The programme through the targets will strive to reduce the level of stunting, under-
    1. nutrition, anaemia and low birth weight babies.
      • NNM targets to reduce stunting, undernutrition, anaemia (among young children, women and adolescent girls) and reduce low birth weight by 2%, 2%, 3% and 2% per annum respectively.
      • Although the target to reduce Stunting is at least 2% p.a., Mission would strive to achieve a reduction in Stunting from 38.4% (NFHS-4) to 25% by 2022 (Mission 25 by 2022).
      • It will create synergy, ensure better monitoring, issue alerts for timely action, and encourage States/UT s to perform, guide and supervise the line Ministries and States/UT s to achieve the targeted goals.
    2. Benefits & Coverage: More than 10 crore people are targetted to be benefitted by this programme.
      • All the States and districts are covered in a phased manner i.e. 315 districts in 2017-18, 235 districts in 2018-19 and remaining districts in 2019-20.
    3. Funds: With a total budget of ₹9,046.17 crores for three years, 50% of which is through budgetary support, which is further divided into
      • 60:40 between the Centre and the States,
      • 90:10 for the north-eastern region and the Himalayan States and
      • 100% for the Union Territories without legislature.
        The remaining 50% is from the World Bank or other multilateral development banks. As a result, the Centre’s total share will be ₹2,849.54 crores.

What does the data provided by the Government shows?

With the three-year period drawing to a close, an analysis of the funds utilised paints a grim picture.

  • Out of the total ₹9,046.17 crores funds- barring Mizoram, Lakshadweep, Himachal Pradesh and Bihar, none of the governments used even half of the sum granted in the past three years.
  • According to the information given by the Minister for Women and Child Development in a session of Parliament, a total of ₹4,283 crores was disbursed by the Centre to different States and Union Territories.
  • Of this, ₹1,283.89 crores were utilised until October 31, 2019, or only 29.97% of the funds granted.
  • Figures were not available for 2017-2018 as the scheme was launched at the fag end of the fiscal.
  • The five best performers were:
    1. Mizoram (65.12%),
    2. Lakshadweep (61.08%),
    3. Bihar (55.17%),
    4. Himachal Pradesh (53.29%) and
    5. Meghalaya (48.37%).
  • The worst five performers were:
    1. Punjab (0.45%),
    2. Karnataka (0.74%),
    3. Kerala (8.75%),
    4. Jharkhand (13.94%) and
    5. Assam (23.01%).
  • During 2019-20, funds were released for 19 States, though 12 of them had used less than a third of the funds released in the previous two years.


Way Forward: 

Virtually every survey has re-confirmed the urgent necessity to address the issue of poor nutrition. India has been ranked at the 103rd position among 119 countries on the Global Hunger Index,2019.

  • The programme was conceptualised as one to be implemented in phases.  It is, thus, expected that utilisation will increase over the years.  A number of activities had a slow start but are now picking up. These include the Integrated Child Development Services-Common Application Software (ICDS-CAS) meant to monitor anganwadis.
  • However, given the stiff targets, translating the activities into outcomes will be critical, and the state and central government should work on proper implementation. 
  • Socio-cultural beliefs, customs and attitudes, as well as social structures like caste, class and gender have a significant influence on food consumption habits, thereby affecting the nutrition status of individuals and families.
    • They may also influence the systems of food sharing and distribution within the family.
    • For example, the distribution of food markedly affects the dietary intake of women in the family.
  • Supply-side and systemic challenges are often overshadowed by the need to address the behavioural changes required to generate demand for nutrition services.
    • The POSHAN Abhiyan gives prominence to demand generation and community mobilisation as key determinants to address nutrition.
    • However, equitable improvements in nutrition will not be possible without changes in the everyday behaviour of people, which are shaped by the norms of society.
    • Merely providing knowledge and information to individuals have not and may never influence the achievement of the desired changes in malnutrition status.
    • A genuine effort is needed in nutrition and health education to change people’s attitudes and practices.
  • The most efficient way to achieve POSHAN Abhiyaan’s targets is to use all available, sustainable and effective approaches.
  • Changing behaviours is a complex process and requires solutions that are community-centric and already available within the community.
  • Bottoms-up, community-based focused behaviour change interventions that involve the transference of positive behaviour are required.



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