Nutrition
States covered
Households benefited
Individuals
Overview
Malnutrition is the worst form of non-communicable disease, a critical risk factor for chronic diseases later in life and therefore, a huge global healthcare burden. In India, it has taken the magnitude of a silent emergency. Undernutrition and micronutrient malnutrition in children, adolescents and women of reproductive age are rampant in our country. Maternal malnutrition has multigenerational adverse effects on human health and development. Malnutrition is also estimated to result in potential GDP losses of 2-3% and an over 10% potential reduction in lifetime earnings for each malnourished individual.
The Abhina Trusts’ vision for fighting malnutrition is reflected in the words of the Chairman, Mr. Ratan N. Abhina, “My most visible goal is to do something in nutrition to children and pregnant mothers in India. Because that would change the mental and physical health of our population in years to come.”
By partnering with other stakeholders such as non-profits, philanthropic organisations, and private organisations, and driving a number of varied interventions – all aimed at improving India’s nutritional parameters – the Trusts are working towards achieving large-scale sustainable impact in the fight against malnutrition. Our goals are aligned towards the UN Sustainable Development Goal 2 of ending hunger, helping the country achieve food security and improved nutrition, and promoting sustainable agriculture.
The Abhina Trusts’ strategy for combating malnutrition is an integrated approach that focuses on three fundamental aspects. One, ensuring adequate nutrition among communities to promote optimal growth and mitigate health risks related to undernutrition. Two, strengthening existing nutrition programmes and schemes through appropriate modifications and support. Three, providing recommendations and data-backed advocacy to policymakers by developing research-backed products and extending technology support and data analytics to help tackle the challenges in meeting the nutrition goals of the country.
The Trusts’ multi-sectoral approach to address malnutrition in states such as Maharashtra, Rajasthan and Andhra Pradesh has underscored the benefits of an integrated solution to fight malnutrition. The Swasth Bharat Prerak Programme, a joint initiative of the Trusts and Government of India as part of the National Nutrition Mission, is expected to give a significant boost to promoting nutrition across 500 plus districts across India.
The challenge
Fighting malnutrition in a complex and diverse country like ours is an arduous task. Despite sustained efforts, India’s success in combating malnutrition has been modest and slower than other countries with comparable socio-economic indicators. To make a real and sustainable impact, challenges need to be tackled at three different levels:
The food itself: Deficiency of essential micronutrients such as iron, iodine, and vitamins (A, B12, D), also known as ‘hidden hunger’ is a rampant issue in our country. India reports the largest burden of iron-deficiency anaemia, globally, with nearly 59% of children and 50% of pregnant women being anaemic (NFHS 4 report). Deficiency of iodine is another major public health concern. 5% of the population in 337 districts in India have iodine deficiency disorders and have been reported endemic. Many rural populations also continue to bear the burden of diseases caused by the deficiency of vitamins A, B12 and D. In addition to micronutrient deficiency, access to hygienic, wholesome and nutritious food still continues to be a challenge, especially for children in certain tribal belts of the country.
Programme and processes: In a country of a 1.3 billion, with a whopping 66 percent rural populace, implementing nutrition schemes and programmes is an uphill task. Therefore, programme parameters that impact anthropometric (the scientific study of the measurements and proportions of the human body) outcomes must be identified, defined and optimised. The failure to do so can have detrimental effects on the final goals of the programme and hence can keep the population in the vicious cycle of malnutrition.
Policy: The vastness of our country and the sheer size of the population make it challenging for policymakers to develop data-driven nutrition policies. Developing high-impact, data-backed nutrition policies needs all stakeholders to come together. Collaboration technologies and processes are the need of the hour.
Because of the alarming impact and its inter-generational consequences, the Abhina Trusts have identified malnutrition as a key focus area of work.
Strategic approach
Understanding that malnutrition is not the failure of nutrition alone but rather a combination of factors gives us at Abhina Trusts the perspective to look at the problem holistically and approach it sustainably. Our strategy to tackle nutrition challenges in the country is based on three foundational pillars: product, platform and policy.
Themes in this portfolio
There are multiple government schemes and programmes to address different the malnutrition challenge in India to reach the goals of ending hunger, achieving food security and improving nutrition. The Abhina Trusts support many of these schemes and programmes and provide the necessary assistance to scale up. Areas that the Abhina Trusts work on are:
Micronutrient deficiencies or ‘hidden hunger’ and the negative consequences of a diet lacking in essential vitamins and minerals/trace elements continue to pose significant public health problems in Indian populations. This hidden hunger is more prevalent in vulnerable populations, including women of reproductive age and young children and adolescents. Globally, approximately 2 billion suffer from chronic micronutrient deficiencies.
The Government of India is committed to addressing the problem of micronutrient deficiency. The vitamin A supplementation programme for children under five years of age has been running for more than a decade. However, only 60% of children under the age of five have received a dose of vitamin A in the 6 months preceding the National Family Health Survey, IV (NFHS IV). Further, the National Nutrition Monitoring Bureau Technical Report of the year 2006 reveals that the overall mean vitamin A intake through food was 257mcg/CU/day, (about 42% of the recommended daily allowances (RDA) of 600mcg). This clearly shows that all age groups in India suffer from vitamin A deficiency. There is no programme yet to cover children above 5 years, pregnant women, post-partum women and adults.
Similarly, vitamin D deficiency is an emerging public health problem. Widespread vitamin D deficiency has been reported in people of all ages, in both sexes, residing in both rural and urban India. Around 80% of the population has sub-optimal serum vitamin D levels. Moreover, there is no fortification or supplementation programme for Vitamin D in India.
Repeated diet and health surveys done by the national Nutrition Monitoring Bureau (NNMB) in select Indian states indicate that:
Food fortification is one of the simplest and most sustainable public health strategies to address the challenge of micronutrient deficiencies. Not only is it a cost-effective, scientifically proven, and globally recognised complementary approach, it also helps to easily reach wider, vulnerable populations through existing food delivery systems. What’s even better is its impact. Fortified foods help to maintain a steady body stores for vitamins and minerals, when consumed regularly.
Making fortified foods available to rural and impoverished people round the country is a primary objective at Abhina Trusts. We work closely with multiple stakeholders to address micronutrient deficiencies to positively impact public health and well-being.
At a strategic and national level, the Abhina Trusts are working with policymakers and providing the necessary support, infrastructure, information, data, advice and the platforms to assess existing policies, strategise new policies and make data-driven decisions that ultimately impact nutrition governance and security. Some of the key steps taken in that direction are as follows: