08 December 2010

Action or Protraction? The Nutrition Council of India meets!

Nearly 1000 days after it was established the Nutrition Council in India finally met. The conclusion was that Indian nutrition efforts should be much more focused on the nutrition of mother and baby for the 1000 days after conception.

There were plenty of positive statements of intent coming out of the meeting:

1. The Integrated Child Development Service (ICDS) will be restructured in a way that allows for flexibility, with a special focus on pregnant and lactating mothers and children under three (although under 2 would be better).

2. There will be a a multi-sectoral programme to address undernutrition in 200 high-burden districts. This programme will bring together various national programmes through strong institutional and programmatic convergence at the State, District, Block and Village levels (how?).

3. A nationwide information, education and communication campaign would be launched to address issues of status of women, the care of pregnant mothers and children under two, breastfeeding, and the importance of balanced nutrition, health, hygiene and sanitation. The campaign would involve people’s representatives, civil society activists, the media and leaders of the entertainment industry (what would be different about this campaign?)

4. The Ministries that deal with Health, Drinking Water Supply and Sanitation, School Education, Agriculture and Food & Public Distribution will bring strong nutrition focus to their programmes (and what will incentivise them to do this?)

The Prime Minister, who chaired the meeting, requested the Ministry of Women and Child Development and the Planning Commission to review the progress in implementation of the decisions of the Council after three months.

These action points are very good, but I have real worries about delivery, enforcement and accountability (as you can see from my comments in parentheses).

Several of the participants in the meeting called for things that would help: a National Nutrition Mission Authority, the assignment of the ICDS to a mission mode programme, the creation of new institutional arrangements with executive authority under the Nutrition Council, the establishment of a Policy Coordination Unit and new nutrition surveillance systems.

These would all have helped convince us that delivery, enforcement and accountability were not being left to chance and yet they were not mentioned in the action points.

So does this meeting set in train action or protraction on tackling undernutrition in India? I very much hope it is the former.

In 3 months time the picture should become clearer.


Derrill Watson said...

I am aware of the nutrition and child development literature that discusses the importance of the first two years of life. Why do you claim that the first point would be more effective if it stopped considering the nutrition and welfare of children between 2 and 3 years of age? Saying that the first two years are the most important does not say the third year has a marginal benefit of 0.

Lawrence said...

Derrill, thanks for this point. I certainly did not mean that the 25-36 month age group should be ignored, I was just reflecting the consensus among nutritionists that the -9 to 24 month group is the priority.

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