Lack of dietary diversity among pregnant women, children worrying: Health experts

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July 10, 2021 3:08 PM

In terms of existing programmes at the national and state level, she said there is a need for increased monitoring and tracking of critical growth parameters, weight and height of children under the age of two.

Noting that poor growth under the age of two is largely irreversible, Vir said timely, frequent and effective counselling is essential.

There is a lack of dietary diversity among pregnant and lactating women as well as children across the country with the consumption of fats and oils on the rise and that of green leafy vegetables seeing a decline leading to micronutrient deficiencies, top healthcare experts have said.

Mini Varghese, Country Director, Nutrition International India said the reasons for compromised dietary intake are two-fold.

“Firstly, the production of green leafy vegetables is generally seasonal which impacts consumption patterns and overall nutrition outcomes. Secondly, at the family level intra-household dynamics are complex and define access to nutritious foods, with men generally getting preference for both quality and quantity of food,” she said.

In terms of existing programmes at the national and state level, she said there is a need for increased monitoring and tracking of critical growth parameters, weight and height of children under the age of two.

“It is at the time of complementary feeding after the age of about 8 to 9 months where the malnutrition slope starts. This is due to unsatisfactory complementary feeding. Further, when monitoring does happen, there is no system where alerts are generated. The system isn’t dynamic enough to target children who are slipping on the growth parameters” Varghese said.

Another contributing factor to the nutritional deficit is the pitfalls of the supplementation programmes such as the Take Home Ration (THR) system, she said.

While it is claimed that the system is successful in meeting the calorific needs of children, it was found that children aren’t always consuming the rations being provided and many times these rations have high sugar content to meet energy needs, Varghese added.

“Therefore, a stronger monitoring of the system is required along with a focus on meeting nutritional needs rather than energy needs. The THR needs to be given to meet the deficits in children after reflecting on the regional and traditional state practices,” she said.

Dr Archana Chowdhury, Lead-Maternal New-Born Child Health, Nutrition International India said while the onus is on the government to address malnutrition and policies and programmes are in place, community participation can play an important role in the implementation of these.

“Encouraging community monitoring, tracking and assessing of services through capacity building of the local governance authorities and frontline workers can help generate data on the outcomes of the programme,” she said.

“Moreover, while health and nutrition facilities and systems exist, the uptake is slow. This can be addressed through awareness building within communities and holding local authorities accountable for outcomes at the district level,” Chowdhury said.

Understanding the special needs of communities at a district level is needed for planning and ensuring equitable access to nutrition services, she added.

“Further, the quality and coverage of programmes is a challenge that needs addressing. The current system is very data and outcome oriented in measuring the success of the programme. There needs to be shift of focus from outcome indicators to input and processing indicators,” Chowdhury said.

Dr. Sheila Vir, Director, Public Health Nutrition and Development Centre, said the rise in undernutrition in children to a great extent seems to be due to poor young child feeding practices comprising breastfeeding and complementary feeding.

Appropriate feeding of semisolid food of right quality (referred as complementary feeding) in right quantity and frequency to a child along with continuation of breastfeeding seems to be the primary gap.

Noting that poor growth under the age of two is largely irreversible, Vir said timely, frequent and effective counselling is essential.

“For influencing feeding practices, a well-planned and effective social behavioural and communication (SBCC) strategy is imperative since the behaviours are ingrained in society and in family traditions and we need to reach mothers, caregivers, family members, and others in the extended circle of influence,” Vir added.

She said eating right through the life cycle should be a public movement and private medical practioners should also address the issue of appropriate breastfeeding soon after delivery and introduction of child feeding practices at around six months. “The new education policy should include the practical details on feeding in the school curriculum,” she added.

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