Showing posts with label malnutrition. Show all posts
Showing posts with label malnutrition. Show all posts

Friday, 20 January 2023

Anemia, Beyond the check

 

Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia, also referred to as low hemoglobin, can make you feel tiredglobin, and weak. There are many forms of anemia, each with its own cause. Recently published National Family Health Survey(NFHS 5) data shows people of all most all age group, especially women are vulnerable to anaemia in the country. The data reports that 67% of children below 59 months of age  suffer from anaemia which is 9% more than what observed in previous survey. Adolescent girls belonging to the age group 15 years to 19 years is found to have 59% prevalence and that about 57% of reproductive women population  (15 years to 49 years) also found to have low hemoglobin count than required which is 4% higher than previously reported


Some of the important contributors of this current situation includes malnutrition, lack of proper sanitation, locally endemic infectious diseases etc.  Thus it is clearly understood that the problems regarding anemia cannot be covered by nearby medical supplementation

 The central government is constantly keeping an eye on the issue of anemia since independence. The recent program "Anaemiamukt Bharat" is working on 6×6×6 strategy. It implies to give special attention for six vulnerable beneficiaries through six different interventions via six institutional mechanism.

Keeping the policy apart, individuals can initiate some lifestyle modifications such as including micronutrient food in diet, maintaining proper sanitation for preventing intestine infections which  create loss of essential nutrients etc. Without concious effort from individuals, state won't be able to create an impact on anaemia burden of the country.

-Mohammed Bin Basheer 




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Friday, 24 January 2020

NUTRITION AT SCHOOL




Nutrition is the intake of food, considered in relation to the body's dietary needs and a
balanced diet, together with physical activity, is a cornerstone of good health. The
international organisations are increasingly focusing their efforts on nutrition as they
underscore the importance of it, not only on at the individual level but as an asset for the
sustainable development of a country . As Ban Ki Moon stated: “Nutrition  is both a maker and a marker of development. Improved nutrition is the platform for progress in health,education, employment, empowerment of women and the reduction of poverty and inequality, and can lay the foundation for peaceful, secure and stable societies”. 

Nutrition is therefore a very complex and multifaceted issue as it encompasses a broad range of topics and, taken form a Sustainable Development Goals perspective, can be taken as the focal point from which one can address every one of those. Unfortunately a big share of the world population faces issues related to malnutrition, this being defined by the WHO as the condition related to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients. Whilst many western countries are facing a growing burden of Obesity and overweight individuals, the other side of the coin is represented by those developing countries affected by undernutrition and micronutrient-related malnutrition, with 90 per cent of the developing world’s chronically undernourished (stunted) children living in Asia and Africa. 

Under nutrition is defined as the outcome of insufficient food intake and repeated infectious diseases. It includes being underweight for one’s age, too short for one’s age (stunted), dangerously thin for one’s height (wasted) and deficient in vitamins and minerals (micronutrient malnutrition). According to Unicef, more than one third of the world’s children who are wasted live in India, with the rural communities having the highest rates of undernutrition and micronutrient deficiencies. Other nutrition issues faced by many underprivileged communities is Iron-deficiency-Anaemia (IDA), for which India earned by far the world sad record, and Protein Energy Malnutrition (PEM). The Indian government recognizes the importance of an adequate nutrition in order to end the vicious circle of poverty and its paramountcy for development, as noted in the national nutrition policy. The same document underlines the importance of nutrition education and the fact that schools are an ideal setting for that. Reason why the Mid-may meal scheme is been designed. Unfortunately, as noted in the previous article the shortcomings about the implementation of the programme are manifest and if we take them from a “nutritional” angle we notice that the programme failed to provide nutritious food as per programme guidelines.Therefore the question is: 

What can be done to remedy to these
shortcomings? The ministry of Human Resource Development highlights the importance of community participation for the successful implementation of the scheme, in order to
ensure an effective monitoring at the local level and underlining the importance of the
participation of NGOs which work at a grassroots level, having a hands-on approach to
such issues and dealing directly with the problems faced by the communities, thus creating a dialogue between those and the government. 

Therefore NGOs such as Heeals can be paramount for the remedying of the government shortcomings regarding the implementation of programmes such as the MDM scheme; tackling issues such as Infrastructure implementation, nutrition education and nutritional balanced meal provision. It is paramount to empower voiceless and unprivileged communities in order to buttress their rights as the issues that their facing are not an accident or a natural outcome of their actions, but they are socio-economical phenomena engendered by asymmetrical power relations and lack of access to the most basic resources and agency. 

As demonstrated by Amartya Sen, hunger and food insecurity are not related to food availability but to the lack of access to it on the part of certain individuals, and if we are to support the right to an adequate standard of living, including adequate food, we have to support and empower those people whom are more in need, making their voices audible as well as endorsing a pragmatic solidarity” approach. As Paul Farmer stated, the idea that some lives matter less is the root of all that is wrong in the world.

-        By -Andrea Angeli
WASH Intern Coordinator
Source
1 Global Panel on Agriculture and Food systems fo Nutrition; http://glopan.org/sites/default/files/
SDGPolicyBrief.pdf
2http://ucx3x320eshgjxppibt1rqg0.wpengine.netdna-cdn.com/wp-content/uploads/2016/06/SUNMovement-
Strategy-and-Roadmap-Ban-Ki-moon-message.pdf
3 UNSCN; http://glopan.org/sites/default/files/Downloads/SDGPolicyBriefSummary.pdf
4 WHO; https://www.who.int/news-room/fact-sheets/detail/malnutrition
5 UNICEF; https://unicef.in/Story/1124/Nutrition
6 UNICEF; https://www.unicef.org/progressforchildren/2006n4/undernutritiondefinition.html
7 UNICEF; https://unicef.in/Story/1124/Nutrition
8 WHO; http://www.who-seajph.org/article.asp?
issn=2224-3151;year=2018;volume=7;issue=1;spage=18;epage=23;aulast=Rai ; https://
www.hospitalmanagement.net/comment/anemia-prevalence-nears-40-india/; https://
timesofindia.indiatimes.com/india/51-of-indian-women-aged-15-49-anaemic-most-in-world-study/
articleshow/61538152.cms
9https://wcd.nic.in/sites/default/files/nnp_0.pdf
10 see “Food and Hygiene” article.
11Government of India, Ministry of Human Resource Development; https://
elementaryeducation.tripura.gov.in/mid-day-meal; see “Food Hygiene” article.
12 Government of India, Ministry of Human Resource Development, Department of School
Education and Literacy; http://mdm.nic.in/mdm_website/Files/Guidelines/
3.MDM1%2021.09.2010.pdf
13 Amartya Sen, “Poverty and famines”, 1981, Oxford India Paperbacks
14ICESCR
15 For the concept of “pragmatic

Friday, 11 October 2019

MDMS: Malnutrition and Solutions


What’s On Your Plate?
In Milan, where I live, lunch consists in a first course (usually pasta or rice, sometimes the much-hated soup), a second plate of meat or fish, a side dish of vegetables and finlly fruit or dessert.
In a dish in Paris we could easily find fish, spinach, potatoes, cheese and bread.
If we were children in Bangkok we could see ourselves served with pork in sweet and sour sauce, rice and a pudding wrapped in banana leaves.

What about India? On 15 August 1995 the NP – NSPE (National Programme of Nutritional Support to Primary Education) was launched. The programthen led, in 2001, to the creation of the MDMS (Mid Day Meal Scheme).Over the years the scheme has undergone some changes and modifications, which led to the current shape of the program, renamed the National Program of Mid Day Meal Scheme: extended to all areas of the territory, with a summer extension in those severley affected by drought, provides for a quantity of food equal to 450 calories and 12 grams of protein per day for at least 200 days a year; all students up to 8th class in the primary school benefit from the program, in every Government school or subsidized school(asreported on the Department of School Education&Literacy web page).
So, what does any Indian student eat? Rice, lentils, roti, fruit and milk once a week. What about proteins? What about eggs?
What’sbad?
Although some improvements have been ascertained with the introduction of the program, as reported on the official page of the Mid Day Meal Scheme in the Findings of Research studies, cases of poor quality in the food served in the schools and malnutrition among children are constantly reported.
This August, a video in which about 100 students were recorded eating roti and salt at lunch, still inside the MDMS, became viral. The scandal lead to the immediate suspension of the teachers and the principal of the school under investigation, and to an official appeal from the National Commission for Human Rights to the Government of Uttar Pradesh: the selected commission then r equested a full report on the matter. However, as reported by the weekly journal The Week,the Government ofUttar Pradesh was already aware of serious cuts within the program. A study conducted on 40 schools in 2016 by GIDS (Giri Institute of Development Studies in Lucknow) has highlighted how“not all school had kitchen sheds due to lack of space and funds; […]. Regarding the availability of food supplies […] of the 40 schools in the study, only 26 had supplies worth a month. On the quality parameter, three in 10 schools described the food as of “average” quality”. The quantity of the meal was also reported to be insufficient […]. […] lack of plates at schools because of which children had to get utensils from home […].”
Another more recent report by the MHRD (Union Ministry of Human Resource Development), dating back to March 2017, found that around 63% of schools still use firewood to cook meals instead of the healthier and greener LPG.
If from the health point of view the risks are clear and obvious, from a social point of view the situation cannot be considered any better: the program has failed to achieve one of its main goals, to improve the number of enrollments to primary school. Indeed, the latest report drafted by CAG (Controller and General Auditor of India) shows how the schools in which the scheme is being put in place record a decline in the registrations in the last five years (from 146.9 million in 2009/2010 to 138.7 million in 2013/2014, as reported by the DownToEarth website).
What’snext?
Given what has been said so far, the need to make changes in the program, or at least to follow it as it was actually designed became increasingly obvious. In particular, deficiencies have been highlights in the amount of food available for meals in schools, as well as its poor quality (some times even worms have been found in children’s dishes).
What would then be necessary to do? First of all, it is clear and evident the importance of increasing the quantity of food served (a 7-8 year old child needs about 1500-1700 kcal per day). An improvement in the quality of food would be of fundamental importance, establishing a chain of controls that can guarantee at least the minimum requirements.
These are us two of the changes that must necessarily be implemented, in the hope that one step at a time India will achieve what the program was created for.

Martina Pignatelli
International Cooperation &Development Student
Italy

Sources:
o   Department of School Education&Literacy, “Mid-Day MealScheme”
o   The Week, “UP govtwasaware of severe shortcomings of mid-day mealscheme”
o   The Indian Express, “Report on Mid-day MealScheme: 63 per centschoolsstill use firewood for cooking”
Down To Earth, “Mid-day mealhasfailed to attractchildren to government schools, says CAG audit

Friday, 1 March 2019

Fighting hunger and malnutrition: Is the Midday meal scheme really effective?

In the Convention on the Rights of the Child, to which India is a party, India has committed to yielding “adequate nutritious foods" for children. Proper nutritional support is fundamental for children from their birth through adolescence, as it has a profound impact on their ability to grow, learn, and thrive. It is a well-documented fact that chronic malnutrition impairs the physical as well as cognitive development in growing children. The Mid-Day Meal Scheme is a school meal program implemented in 2001 by the Government of India. It was an improvement over the existing nutrition program which guaranteed food grains to children enrolled in Government and Government-aided schools. It has been initiated to address the issue of classroom hunger in school-aged children by providing a cooked meal every day. It is designed to improve the nutritional standing of school-age children nationwide.The program supplies free lunches on working days for children in primary and upper primary classes in government, government aided, local body and alternate innovative education centers. 

One of the first surveys on the Mid-Day Meal, by Dreze and Goyal (2003), highlighted several good consequences of the scheme, such as improved attendance rate, child nutrition and social equality. Interviews revealed that the introduction of the MDMS improved not only the attendance of children, but also made them more likely to stay after the lunch break; it has also proved helpful in eradicating hunger. In areas where hunger is endemic, the Mid-Day Meal might be the only thing saving children from chronic malnutrition.The Mid-Day Meal Scheme has played an important role enhancing enrollment, attendance in schools, and in improving socialization among classes. To that effect, it has surely done its part in helping eradicate hunger. Moreover, it gave women the chance to get employed. 

The program has undergone many changes since its launch. With the enactment of the National Food Security Act in 2013, the nutritional content of food (calorie and protein content requirement has since been increased for MDMS) has become an integral part of the right to food in the country. Moreover, from the year 2009 onwards the following changes have been made to improve the implementation of the scheme: I. Food norms have been revised to ensure balanced and nutritious diet to children of upper primary group by increasing the quantity of nutritional ingredients II. Cooking cost (excluding the labour and administrative charges) has been revised III.The honorarium for cooks and helpers was paid from the labour and other administrative charges per child per day provided under the cooking cost. Moreover, specific norms for engagement of cookcum-helper have been made.This shows that the scheme is muddled in the game of numbers rather than going into the qualitative aspects of the food served. 

Even if the Mid-Day Meal Scheme is an innovative scheme to get children from poor socioeconomic status to enroll for elementary education it has been facing serious problems. This is mainly due to the poor quality of food served because of inadequate infrastructure and adverse impact on children’s health & subsequent. Secondly, the government’s focus is on reach not on quality but quantity. The government only concentrates on statistics as to how many number of schools they are able to cover and provide food. They don't give importance to quality. In fact, most of the children who study in village government schools are very poor and end up eating this as their only meal for the day. There is no one to inspect the quality of the food being served to them. 

In Bihar on July 16 20013 23 children lost their lives after eating their Mid-Day Meal due to poisoning because the oil used for cooking was kept in was previously used to store pesticide. There are many such unreported cases where students who eat this meal have reported of dysentery and ill health. So parents and children fearing safety have declined to have food served in these Mid-Day Meals . The MDMS guidelines dictate that the meal should be of good quality, nutritious, tasty, digestible, and varying from day to day to ensure variety in the menu. Moreover, high standards of hygiene and cleanliness are expected to be maintained during the cooking and serving of the meal, along with transparency in accounts. Additionally, states having indulged in diversion of funds meant for the scheme, for instance providing less rice to schools. Another problem related to the Mid-Day Meal Scheme is afflicted with large-scale caste and gender-based discrimination. In some places the upper caste children refuse to eat food cooked by lower class women and backward classes students are made to sit separately from the others. 

Lastly, it emerged during the study that though 99 per cent of the schools had facilities for operation of the MDMS, and 97 per cent of them provide cooked meal during most the days, yet in about 11 per cent of the villages, the food was served only a few days a week, while in 2 per cent of the cases, it was served very rarely. In 38 per cent of the cases, the prescribed menu was not followed and the quality of food was also allegedly poor. 

HEEALS is directly involved in implementing hand washing with soap in the Mid Day scheme in children’s daily routine. It is working on WASH (water, sanitation and Hygiene) projects in seven states works in slum schools, schools in unauthorized colonies, orphanages and refugee camps. Through spreading education on sanitation and personal hygiene and delivering basic hand washing material, HEEALS is working to increase the attendance rates of pupils in schools, reduce the number of diseases and deaths and improve the health of people across Indian society. Moreover, another HEEALS commitment is to promote children cooperation between genders and castes.

-Bene 
WASH & MH Intern Coordinator 


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Tuesday, 25 September 2018

CLOSE LINKS BETWEEN A BALANCED DIET AND MENSTRUAL HYGIENE



The strength of the relationship between a correct nutrition and a healthy
menstrual condition is often undervalued and unknown. Sometimes, in fact,
the consequences of malnutrition are pervasive and massive but also hidden.
This is why the malnutrition, specially concerning under nutrition, represents
a global challenge that requires both social and economic efforts.
Malnutrition can be seen as an outcome of bad interaction between different
agents, such as: agricultural food system, environment, health system, and
the individual-household decision making process. It is fundamental that in an
enabling environment, completed with specific intervention and programmes,
woman are allowed to have access to safe food, social safety nets, physical
and mental care, health and family planning services and water sanitation.
Moreover, all those factors contributes to the empowerment of women,
increasing their acknowledge and consciousness about nutrition and hygienic
issues.
A big role in women's empowerment is played by agriculture. In fact,
agriculture not only has effects on expenditures and consumption of food, but
also has a strong link with women's employment and their own nutrition and
health conditions. A problem related with agriculture, as findings shows, is
that farmers tend to sell more expensive and nourishing products, retaining
less expensive cereals for domestic consumption. This is why is necessary to
support an environmentally sustainable food production that includes a
diversification of products, allowing the availability of nutrient-dense foods
and small-scale livestock.
Speaking more particularly about woman’s health, we should consider the
age group between 15 and 25 years old, the younger women group among
whom fertility is more concentrated, who face the largest disadvantage in
India. This is considered a problem especially in relation to the pre-pregnant
underweight condition in India, in fact scholars affirms that approximately
42.2% of pre-pregnant women have their Body Mass Index (BMI) under
18.5kg/m2, this means that a strong percentage of Indian women before
pregnancy suffers from underweight and malnutrition.
But how this reflects on women's life? First of all, it has implication in work
capacity and productivity, regardless the work they carry out. It means that in
a work environment women in this condition may be considered less
productive. Another reflection implicates the social-physical and cognitive
sphere. Good nourishment allows developing all spheres in the most
appropriate way, in order to improve individual benefit. Finally, a very
important reflection of nourishment in women's life is related to the fetal and
child nutrition and development. An improvement of consciousness and
awareness in this field not only helps to ameliorate maternal healthcare and
safety, but also may largely reduce mortality in childhood and child's
undernourishment. In this sense, an improvement may have great reflection
on new generations learning capacity, improving the whole society.
But what does balanced diet means? A balanced diet is a correct
consumption of a large variety of food, which means that is appropriate to
consume a right quantity of various nutritious daily. An inappropriate diet may
cause healthy problems such as micronutrient deficiency, like a lack of
important vitamins and minerals, generating various types of symptoms.
In conclusion, all those evidences bring us to consider how much important
are good and healthy diet habits, balancing correctly all nourishments, in
order to ameliorate woman’s health and lifestyle.

-Grandoni Laura

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