- Binu Anand, National Team Leader -- WeCan
POSHAN (nutrition) has become the buzzword within the development community in the last couple of years. The launch of Prime Minister’s Overarching Scheme for Nutrition (POSHAN) Abhiyaan has given nutrition the much-required focus. It has grabbed the attention of stakeholders across the spectrum including ministries, development partners and academia.
For a long time, alleviation of poverty and hunger remained the focal point of development partners and governments alike and understandably so. After all, WHO places 10 per cent of world’s population in the bracket that lives on less than $1.90 a day and food security is difficult to achieve amidst such rampant poverty.
However, nutrition is being recognised as a crucial aspect of the development landscape. This stems from the fact that undernutrition leads to intergenerational consequences for health and erodes socio-economic equity, adding to the burden of developing and underdeveloped countries A study conducted by Alderman (2010) highlights that “the economic returns to preventing malnutrition are on a par with those investments generally considered at the heart of economic development strategies.”
His views found support in several other studies. In retrospect, nutrition has not been a priority in the mainstream development discourse of India, despite being included in the Directive Principles which places onus on the state to improve the overall quality of nutrition among the citizens.
For the people
POSHAN Abhiyaan has changed it. It was engendered as a mission ‘for the people’, giving a call for a Jan Andolan (a movement by the people). The need of the hour today is to make it a people’s movement in letter and spirit, placing the beneficiaries at the heart of nutrition programmes and interventions as active participants. How can we do this?
First, there is a need to realise that food security does not equate to nutrition security. While food security lies at the fulcrum of most of our public welfare schemes and policies, nutrition security is often overlooked. And, second, the communities need to be brought into the fold of this concept of nutrition by focussing on decentralisation, awareness and accessibility.
Studies have posited the significance of emancipating and empowering communities for improvement of nutrition status. An assessment of selected food and nutrition programmes in Asia, Africa and Latin America conducted by Food and Agricultural Organization in 2003 showed positive linkages between capacity building of community and success of the programmes. If POSHAN is to succeed, an empowered community is going to be its backbone. Hence, the measures adopted to strengthen nutrition should focus on an inclusive approach, across the urban-rural and literacy fault-lines.
The existing systems in both urban and rural areas are strategically placed to decentralise the efforts under POSHAN and move towards last-mile convergence for better nutrition service delivery. PRIs, the elected bodies at grassroots, SHGs consisting of community members, youth groups and Integrated Child Development Services (ICDS), the world’s largest community development programme devoted to growth and development of children, and Anganwadi Centres, the epicentre of mother and child nutrition in villages, can be effectively leveraged for community mobilisation.
The fundamental step towards generating demand for nutrition services and developing an understanding of nutrient-rich food is using a 360 degrees communication approach along with an enabling environment. Interventions that stress on Information, Education and Communication (ICE) and Social and Behaviour Change Communication (SBCC) can prove to be invaluable. They can aid in creating awareness among beneficiaries about various social safety net programmes including the supplementary feeding programme, Public Distribution Scheme (PDS) fortification, mid-day meal scheme (MDM), and provisions for tribal groups.
SBCC interventions can also be effectively used for targeted behaviour change in the community on nutrition-related practices. In some of the States, for instance, Rajasthan, the government has taken the lead in developing a State-specific SBCC strategy to support nutrition programmes and interventions. Hopefully, more States will follow suit.
Research by John Hopkins University and other prominent public health bodies have shown the significance of SBCC as an approach to strengthen interventions and improve demand and quality for services. However, IEC and SBCC have certain limitations as well. The beneficiaries often end up getting caught in the web of ‘information overload’. The varied messages on what to eat, which services to access and how to go about achieving better nutrition can get confusing. Moreover, at times messaging does not resonate with local realities.
Effective messaging is needed that are customised to requirements of communities and are simple to comprehend. They need to convey the idea of eating right based on locally available and accessible nutrient-rich food. The focus has to be on educating the community on food groups and simple ways of obtaining them. While global, national and locale-based data is available to enable this, the challenge for stakeholders is to translate it into effective messaging, true to local realities and finding simple solutions.
Amidst the global crisis of Covid-19, nutrition has gained further currency. Fragile immune system, resulting from undernutrition are more prone to diseases. The pandemic, though in many ways unprecedented, will not be the last of its kind. We need to be more prepared than ever and work towards shaping communities and policies focussed on eating right.
Nutrition holds an immeasurable significance in our lives and cannot be left to chance. POSHAN and its efforts can be successful only if we can develop self-efficacy in individuals and make it more relatable for communities. There is a high probability that driving POSHAN Abhiyaan through Jan Andolan would bring a change at a cellular level, by placing the power in the hands of people.