At the Global level

Undernutrition:

• As stated in the WHO,2022 report, 390 million adults are underweight.
• WHO reports that 149 million children under 5 were estimated to be stunted, and 45 million were estimated to be wasted globally in 2022.
• Nearly half of deaths among children under 5 years of age were estimated to be undernutrition, which mainly occurs in low- and middle-income countries.
• According to Global Nutrition Report 2022, Global conflict conditions such as the Ukraine crisis and climate change continue to be the key drivers of this increase in malnutrition, while policy interventions are not helping to reverse this trend.
• It is alarming to know that, in developing and low and middle-income countries, nearly half of the deaths of children below the age of 5 are a consequence of undernutrition, truly showing the importance of nutritional interventions.

Overnutrition:

• According to the WHO 2022 report, 2.5 billion adults were overweight, including 890 million who were living with obesity.
• In 2022, for example, 1 in 8 people in the world were living with obesity.
• Worldwide adult obesity has doubled more than fourfold since 1990. Adolescent obesity has quadrupled as well.
• In 2022, 2.5 billion adults were overweight. Of these, 890 million were living with obesity.
• Children and adolescents aged 5-19 years had more than 390 million overweight in 2022, of whom over 160 million were obese.

At the National Level:

Undernutrition:

• According to the Global Nutrition Report 2022, India is on course to meet the stunting target, but 34.7% of its children under 5 years of age are still affected, a rate that is higher than the Asia region average of 21.8%.
• India has witnessed no progress toward achieving its target for wasting, while 17.3 percent of children under the age of five years are experiencing wasting, which is well above the average for the Asia region (8.9 percent) and among the highest in the world.
• According to the recent report of NFHS-5 (2019-21), the nutrition indicators for children under five have improved since NFHS-4 (2015-16). Stunting has decreased from 38.4% to 35.5%, the prevalence of wasting is 19.3%, which has decreased from 21.0% in NFHS-4, and the prevalence of underweight has dropped from 35.8% to 32.1%. However, severe wasting rose to 7.7% from 7.5%.
• In November 2023, the Poshan Tracker data of the Ministry of Health and Family Welfare, Government of India for around 7.44 crore children under 6 years old revealed that 37.51% of children were stunted, 17.43% were underweight, and 6% of children under 5 were wasted, with underweight and wasting rates significantly lower than NFHS-5 projections.

Overnutrition and Obesity:

• According to the WHO, 1 in 8 people in the world were living with obesity in 2022.
• Global Nutrition Report, 2022 stated that 1.6% of children under 5 years were overweight. While NFHS-5 (2019-21), reported the prevalence of obesity among adult women and men as 24.0% and 23.0%, respectively.

Urgency: Because of its complicated nature, the double burden of malnutrition requires immediate action to address both undernutrition and overnutrition. Addressing this issue necessitates specialized techniques for managing both concurrently.

Global Resources

• The WHO Global Database on Child Growth and Malnutrition:

The WHO Global Database on Child Growth and Malnutrition, established in 1986, collects, standardizes, and disseminates child anthropometric data from nutrition surveys around the world using the WHO Child Growth Standards. Since 2012, it has benefited from the UNICEF-WHO-World Bank Joint Child Malnutrition Estimates (JME) partnership. This tool allows you to look up global statistics on child malnutrition.

Available at WHO Global Database on Child Growth and Malnutrition.

• E-Library of Evidence for Nutrition Actions (eLENA):

E-Library of Evidence for Nutrition Actions (eLENA) is an online resource that provides evidence-based nutritional intervention guidelines. It is a single source of information on the most recent dietary guidelines, recommendations, and associated topics, such as scientific data, rationale statements, and expert commentary. eLENA aims to help countries effectively execute and scale nutrition programs.

Available at: WHO eLENA https://www.who.int/tools/elena

• FAO’s twin-track approach:

The Food and Agriculture Organization (FAO) of the United Nations (UN) uses a twin-track approach to combating hunger and malnutrition. This approach becomes a suitable framework for hastening success.

The twin approaches can be described as:

• • It Prioritizes sustainable agriculture and rural development to build resilient food systems. This involves enhancing the structure of the food economy, agricultural production, technology, and food processing.
  • It focuses on targeted support for vulnerable groups. This involves using vulnerability analysis to understand food security dynamics and manage risk.

Available at: https://www.fao.org/4/a0050e/a0050e07.htm

National Resources

• POSHAN Abhiyaan: It was launched in March 2018, POSHAN Abhiyaan, currently part of Mission Saksham Anganwadi and Poshan 2.0, aims to improve the nutritional status of children, teenage girls, pregnant women, and breastfeeding moms throughout India. The effort aims to reduce stunting, wasting, and anemia by leveraging technology, encouraging convergence, and promoting behavior change through Jan Andolan. The creation of PoshanVatikas (Nutri-gardens) is a key component, as is the emphasis on diet diversity, food fortification, and millet consumption. Poshan 2.0 improves nutritional content, delivery, and outcomes by utilizing traditional knowledge and applying regional meal plans to address dietary gaps.

Available at https://poshanabhiyaan.gov.in/

• Rajmata Jijau Mother-Child Health & Nutrition Mission: Maharashtra pioneered the mission-mode approach to combating malnutrition by establishing the Rajmata Jijau Mother-Child Health & Nutrition Mission. This Mission, launched in three phases (2005, 2011, and 2017), aims to reduce child malnutrition by focusing on the first 1,000 days after conception. It is fully supported by UNICEF and operates as an independent technical and advisory body, promoting better convergence and coordination between the Public Health Department and the ICDS Commissionerate. Importantly, it avoids state funding dependency and direct plan implementation, retaining its independence and autonomy while clearly distinguishing itself from the Department of Women and Child Development.

Available at https://mahnm.in/en/what-we-do

• Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY): The rice fortification initiative started from April 2022 by the Cabinet Committee on Economic Affairs (CCEA) as part of the Prime Minister’s Garib Kalyan Anna Yojana (PMGKAY), Government of India. It provides a comprehensive institutional framework for implementation. The initiative involves supplying fortified rice throughout the Targeted Public Distribution System (TPDS), other welfare schemes, the Integrated Child Development Services (ICDS), and PM POSHAN (formerly known as Mid-Day Meal) in all States and Union Territories (UTs). The goal is to address anaemia and micronutrient deficiencies in the country.

Availaible at https://pib.gov.in/PressReleasePage.aspx?PRID=2063447

• The “Poshan Aahaar” scheme was implemented by the Women and Child Development Department, Government of Madhya Pradesh as a part of Integrated Child Development Services (1975). Under this scheme, children from 6 months to 6 years, pregnant women, and malnourished children are given nutritious food through Anganwadis. About 80 lakh beneficiaries are benefitted from supplementary nutrition in the sanctioned Anganwadis. 50% of the amount spent on the provision of supplementary nutrition in Anganwadi centers is provided by the Government of India.

Available at https://mpwcdmis.gov.in/Poshan_aahar.aspx

• BAL SHAKTI YOJNA: The scheme was a part of Bal Sanjeevani Abhiyan (2001) aimed at arresting the rate of severe malnutrition and seeks to bring about a reduction in Grade 4 and Grade 3 levels of malnutrition among all children by one percent in Madhya Pradesh. All children identified as Grade 4 and Grade 3 levels of malnutrition under each round of the Bal Sanjeevni Campaign are provided with requisite medical treatment. Parents/guardians of the identified malnourished children are provided counseling regarding the significance of a nutritional diet. Also, they are trained in preparing a nutritional diet from low-cost and locally available foods.

Availaible at https://nhmmp.gov.in/nhmold/nrhm/Innovative-nrhm.pdf