While the percentage of stunted children has seen marked improvements in recent times, progress has been really slow. States must follow Maharashtra’s mission approach example to tackle the problem of child malnutrition
Almost one in three children in India under five years of age will still be stunted by 2022 if present trends continue. This worrying revelation was made earlier this week by the UN World Food Programme in collaboration with the Indian Government’s Ministry of Statistics and Programme Implementation after an analysis of the country’s food and nutrition security.
Although child stunting, a measure of chronic malnutrition, has come down, the progress has been quite slow at an annual rate of about one per cent. This means that 31.4 per cent of the children will still be stunted by 2022 and India may not be able to meet its poshan abhiyan goal to bring down stunting of children from 38.4 per cent in 2015-16 to 25 per cent by 2022.
This report states that the poorest 30 per cent of the Indian population consumes an average of 1,811 kilo calories. This is much lower than the 2,155 kilo calories required everyday. Children have borne the brunt of this economic inequality. High rates of stunting have been recorded among children in the poorest wealth quintile (51.4 per cent).
In other words, children from the marginalised communities do not have equitable access to food. While the rate is 43.6 per cent among children from the Scheduled Tribes and 42.5 per cent among those from the Scheduled Castes, it is much higher (51 per cent) in children born to mothers with no education. It comes as no surprise that almost one in two children is stunted in States like Bihar and Uttar Pradesh. Here, the percentage of stunted children stands at 48 per cent and 46 per cent respectively.
If India is to meet its 2022 target, it needs to double its rate of progress. One way to do so is to invest in high-quality interventions, especially in Early Childhood Development (ECD) for the 158 million children in the 0-6 age group. This group comprises approximately 13 per cent of the Indian population.
Globally, well-designed interventions targetting this group have already proven to be a cost-effective way of improving outcomes for all children, especially the vulnerable and disadvantaged. Since ECD involves interventions in health, nutrition, along with early education, it has the potential to prevent stunting.
Maharashtra is one of the States which showed a remarkable decline in stunting. There was a significant reduction of child stunting by around 15 percentage points during the period 2006-2012. This was possible due to focussed nutrition interventions. However, recent district health data seems to suggest that this progress has since then reached a plateau. The State has decided to address this concern through more focussed ECD interventions.
Maharashtra has joined hands with the United Nations International Children’s Emergency Fund (UNICEF) to launch a responsive care-giving programme in 18 blocks in four districts and covers 2,559 anganawadi centres in the tribal, rural and urban areas in Palghar, Yavatmal, Aurangabad and Pune. Under this responsive care-giving programme, children in the 0-3 age group are monitored through home visits as well as at the anganwadi by workers and their helpers.
Additionally, a meeting of mothers is held every month to teach better care-giving and build their knowledge on nutrition, health and cognitive skills.
For the 3-6 year age group, the focus is on improving skills and education at the anganwadi centre through the specially developed Aakar Early Childhood Education (ECE) programme. Here, too, a monthly mothers’ meeting is held to ensure engagement with the child’s mental and physical development.
Importantly, the State-wide Aakar ECE curriculum is specific to Maharashtra. Designed by the State and UNICEF to suit children in the age group of 3-6 years, this is more contextual to the State. While it is based on the National Early Childhood Care and Education (ECCE) Policy, the Aakar curriculum has been developed keeping the local culture and needs in mind.
The Anganwadi Worker (AWW) being the key to the success of this intervention, their capacity-building as well as that of the Child Development Project Officer (CDPOs) and anganwadi supervisors was first carried out. Training on early childhood education methodologies and developmental milestones as well as stimulation therapy for brain development of children were underlined because the brain makes 700 synaptic connections per second after birth and grows to 80 per cent of its weight before three years.
Equally important has been improving their communication skills to counsel mothers on the importance of ECD in preventing stunting, especially in blocks where female literacy is poor.
In Palghar, a primarily tribal block, the programme is being implemented by Save the Children in collaboration with its local partner Grammangal. Getting the mothers here to see anganwadis as a place for learning and growth, (both mental and physical), and not merely for take-home rations and mid-day meals is still a work-in-progress in a district plagued by malnutrition of children.
Helping take this forward has been the low-cost teaching-learning aids developed by Grammangal which AWWs and mothers can make from locally available material to promote learning and develop diverse cognitive competencies. The process is slow but where there is will, there is always a way.
(The writer is a senior journalist)
