The Niti Aayog’s recent report on ‘Strategy for New India @ 75’ rightly recognises that the multidimensional determinants of undernutrition are inadequately reflected in policymaking. It argues that there must be convergent action with annual health, nutrition and sanitation plans being made in an integrated manner for all districts. In the case of Integrated Child Development Services (ICDS), which is the main programmatic platform through which nutrition outcomes are to be achieved, the report finds that its focus on the first 1000 days of the child’s life is inadequate.&nbsp;

It argues that while children under 2-3 years of age must be given highest priority in nutrition interventions, much of the ICDS interventions are focussed on the delivery of services to children in the age group of 3 to 6 years. While the diagnosis is not entirely wrong, the recommendations at the end of the chapter do not show an adequate understanding of what needs to be done to correct this situation.

Researchers and activists have been making the same point for many years now. There is a consensus that there is a need to better reach the younger child. In the current model of the ICDS, where it is largely centre-based with part-time workers, this is not possible. The FOCUS report, 2006, recommended that every anganwadi centre must have two workers, with the primary responsibility of the second worker being the care of children under three years of age and pregnant and lactating women. In a number of subsequent reports, not just the Right to Food campaign but even UN bodies and the Planning Commission have made similar recommendations.

There has been a tremendous expansion in the ICDS following Supreme Court orders in 2006 directing that anganwadi services be universalised. The number of anganwadi centres in the country grew from about 6.5 lakhs in 2006 to almost 14 lakhs currently. The coverage of children under six receiving any ICDS services increased from 28 per cent children in 2005-06 (NFHS-3) to 54 per cent in 2015-16 (NFHS-4). However, although there has been this quantitative expansion in the programme as much attention has not been paid to improving the quality as well as addressing the design gaps.

One of the design issues, as discussed above, is enhancing the outreach to children under three. The Niti Aayog report suggests that this must be done through home visits to be conducted by accredited social health activists, a second auxiliary nurse midwife or community infant and young child feeding counsellors. This means the requirement for additional human resources is being recognised and needs to be provided for in the budgets for the ICDS.

While there was an increase in ICDS budgets commensurate to the higher number of anganwadi centres, throughout the last five years the central government’s allocations for ICDS has been stagnant around Rs.16,000 crores a year in nominal terms and declining in real terms.

The NFHS-4 finds that only about 10 per cent of children in the age group of 6 to 24 months in the country currently receive an adequate diet. While this requires counselling on infant and young child feeding, for the children in this age group it is also equally important to ensure the presence of an adult caregiver as well as the availability of energy-dense diverse foods. A number of NGO experiences across the country have shown that community-run daycare/crèche services can play a significant role in reaching out to children under two years of age and this has an impact not health and nutrition outcomes as well. One of the reforms in ICDS must, therefore, be to convert anganwadis into anganwadi-cum-crèches so that they can be accessible to younger children as well. Different models of crèches will have to be thought of depending on local contexts.

The problem with the ICDS is not that it is food-centric to the neglect of everything else rather than it is under-resourced and lacking investments – financial as well as technical and political. The ICDS is meant to provide pre-school education as well as health and nutrition services and without adequate infrastructure and human resources, achieving these twin objectives is impossible.&nbsp;

Therefore, while on the one side when nutrition is on the agenda, the ICDS is blamed for its excessive focus on older children and preschool; when preschool is the issue being discussed, the problem with ICDS is that it is preoccupied with nutrition! This can be avoided if we keep the child in the centre and not the scheme.

 
(This article was originally published on The DNA. Read the <a href="https://www.dnaindia.com/world/report-tradition-turns-fatal-nepali-woman-two-sons-die-in-outlawed-menstruation-hut-2706410">original article</a>)

(Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL) 
&nbsp;

The Niti Aayog’s recent report on ‘Strategy for New India @ 75’ rightly recognises that the multidimensional determinants of undernutrition are inadequately reflected in policymaking.

The Niti Aayog’s recent report on ‘Strategy for New India @ 75’ rightly recognises that the multidimensional determinants of undernutrition are inadequately reflected in policymaking. It argues that there must be convergent action with annual health, nutrition and sanitation plans being made in an integrated manner for all districts. In the case of Integrated Child Development Services (ICDS), which is the main programmatic platform through which nutrition outcomes are to be achieved, the report finds that its focus on the first 1000 days of the child’s life is inadequate. It argues that while children under 2-3 years of age must be given highest priority in nutrition interventions, much of the ICDS interventions are focussed on the delivery of services to children in the age group of 3 to 6 years. While the diagnosis is not entirely wrong, the recommendations at the end of the chapter do not show an adequate understanding of what needs to be done to correct this situation. Researchers and activists have been making the same point for many years now. There is a consensus that there is a need to better reach the younger child. In the current model of the ICDS, where it is largely centre-based with part-time workers, this is not possible. The FOCUS report, 2006, recommended that every anganwadi centre must have two workers, with the primary responsibility of the second worker being the care of children under three years of age and pregnant and lactating women. In a number of subsequent reports, not just the Right to Food campaign but even UN bodies and the Planning Commission have made similar recommendations. There has been a tremendous expansion in the ICDS following Supreme Court orders in 2006 directing that anganwadi services be universalised. The number of anganwadi centres in the country grew from about 6.5 lakhs in 2006 to almost 14 lakhs currently. The coverage of children under six receiving any ICDS services increased from 28 per cent children in 2005-06 (NFHS-3) to 54 per cent in 2015-16 (NFHS-4). However, although there has been this quantitative expansion in the programme as much attention has not been paid to improving the quality as well as addressing the design gaps. One of the design issues, as discussed above, is enhancing the outreach to children under three. The Niti Aayog report suggests that this must be done through home visits to be conducted by accredited social health activists, a second auxiliary nurse midwife or community infant and young child feeding counsellors. This means the requirement for additional human resources is being recognised and needs to be provided for in the budgets for the ICDS. While there was an increase in ICDS budgets commensurate to the higher number of anganwadi centres, throughout the last five years the central government’s allocations for ICDS has been stagnant around Rs.16,000 crores a year in nominal terms and declining in real terms. The NFHS-4 finds that only about 10 per cent of children in the age group of 6 to 24 months in the country currently receive an adequate diet. While this requires counselling on infant and young child feeding, for the children in this age group it is also equally important to ensure the presence of an adult caregiver as well as the availability of energy-dense diverse foods. A number of NGO experiences across the country have shown that community-run daycare/crèche services can play a significant role in reaching out to children under two years of age and this has an impact not health and nutrition outcomes as well. One of the reforms in ICDS must, therefore, be to convert anganwadis into anganwadi-cum-crèches so that they can be accessible to younger children as well. Different models of crèches will have to be thought of depending on local contexts. The problem with the ICDS is not that it is food-centric to the neglect of everything else rather than it is under-resourced and lacking investments – financial as well as technical and political. The ICDS is meant to provide pre-school education as well as health and nutrition services and without adequate infrastructure and human resources, achieving these twin objectives is impossible. Therefore, while on the one side when nutrition is on the agenda, the ICDS is blamed for its excessive focus on older children and preschool; when preschool is the issue being discussed, the problem with ICDS is that it is preoccupied with nutrition! This can be avoided if we keep the child in the centre and not the scheme. (This article was originally published on The DNA. Read the original article) (Disclaimer: The opinions expressed above are the personal views of the author and do not reflect the views of ZMCL)

Children under age of 3 must be given highest priority in nutrition interventions

Making the country malnutrition-free would be the bedrock of any achievement towards a New India by the year 2022, NITI Aayog Vice-Chairman Rajiv Kumar said here today.

&quot;As many as 38.4 per cent of our children are born stunted or suffering from malnutrition. It&#39;s a blemish, a stain on our national record that we cannot afford to live with,&quot; he said while delivering a presentation on New India @2022, at the inauguration of the two-day conference of district Collectors.

He said that removing malnutrition is a pre-requisite for building a knowledge economy.

&quot;How can we talk about a knowledge economy with that sort of a statistics? If we want to build a knowledge economy, the first thing we have to do is to remove malnutrition and achieve kuposhan-mukt Bharat by 2022.

&quot;If we do nothing else by 2022 and achieve only this...We would have done our country proud and a great service,&quot; Kumar said.

He said NITI Aayog has already launched a nutrition strategy and would closely monitor the implementation of the nutrition mission in the country.

&quot;The Prime Minister made me Chairman of National Nutrition Mission. We will be watching like a hawk, every state and every district, on how the mission is coming about,&quot; Kumar said, adding that they are using the latest technology to achieve this.

He said a real-time data dashboard will be installed for the purpose.

&quot;Hope Andhra Pradesh will lead the effort because this effort will be the bedrock of any achievement...Every achievement we actually want to make,&quot; the NITI Aayog vice-chief said.

Speaking on the economy, Kumar said the note ban move had resulted in a 19 per cent jump indirect tax collection.

&quot;People very often criticise demonetisation saying &#39;Oh the black income had actually not been caught red-handed&#39;. Believe me...Black wealth has at least become grey because now it is all sitting in the bank accounts, which is being monitored closely by the banking division and the CBDT,&quot; the noted economist said.

Without demonetisation, the country&#39;s security itself would have been jeopardised, he said, recalling the first warning note he sounded way back in 2007.

Hailing GST as a &quot;historic step unifying our economy&quot;, Kumar said it was forcing &quot;formalisation&quot; of all businesses in the country.

&quot;It is a very, very big step. About 40-50 per cent of our economy was un-formalised. GST will see at least 20 per cent hike in revenues as we go forward in the years to come,&quot; he said.

Kumar further said India would become &quot;unstoppable&quot; if efficient delivery of public goods and services was achieved by rooting out corruption and ushering in e-governance.

&quot;Once we achieve efficient delivery of public goods and services, basic education, basic health, law and order, street lighting, infrastructure and all that...If we do that, private sector in our country is as capable as us...This country will become unstoppable,&quot; he said.

He said the old story of India being a &quot;soft state, soft government, a corrupt government, and the endemically nonperforming government is now history&quot;.

&quot;This is the beginning of a new India in terms of e-governance where accountability and transparency will be right at the forefront,&quot; he observed.

Stressing that India should embrace the fourth industrial revolution, Kumar said it was vital to ensure it did not cause a &quot;trade-off&quot; with employment generation.

&quot;The fourth industrial revolution is our tomorrow. Our eyes on 2022 should be with this focus in mind. We are seeing most disruptive technologies coming up in the world. We need to see that there is no trade-off between all of this and our biggest need today--- employment generation. That&#39;s our biggest priority,&quot; he said.

Andhra Pradesh Chief Minister N Chandrababu Naidu, Deputy Chief Ministers K E Krishna Murthy, N China Rajappa, Chief Secretary Dinesh Kumar, Chief Commissioner of Land Administration Anil Chandra Punetha, ministers and bureaucrats attended the programme.

Later, Real-Time Governance CEO Babu Ahamed showed the NITI Aayog Vice-Chairman the functioning of RTG Centre at the state Secretariat.Kumar praised the facility saying it is unparalleled in the country.

&quot;Visit to RTG is just startling. It&#39;s an eye-opener. Will do my best to showcase this to all the other states and to the Central government, if I can. I don&#39;t think such a facility exists anywhere in the country.

This is the best idea of an accountable, transparent and digitally-driven governance. I think this is the future. This is the future for the rest of the country,&quot; he said.

Rajiv Kumar said a real-time data dashboard will be installed for the purpose

Making the country malnutrition-free would be the bedrock of any achievement towards a New India by the year 2022, NITI Aayog Vice-Chairman Rajiv Kumar said here today. "As many as 38.4 per cent of our children are born stunted or suffering from malnutrition. It's a blemish, a stain on our national record that we cannot afford to live with," he said while delivering a presentation on New India @2022, at the inauguration of the two-day conference of district Collectors. He said that removing malnutrition is a pre-requisite for building a knowledge economy. "How can we talk about a knowledge economy with that sort of a statistics? If we want to build a knowledge economy, the first thing we have to do is to remove malnutrition and achieve kuposhan-mukt Bharat by 2022. "If we do nothing else by 2022 and achieve only this...We would have done our country proud and a great service," Kumar said. He said NITI Aayog has already launched a nutrition strategy and would closely monitor the implementation of the nutrition mission in the country. "The Prime Minister made me Chairman of National Nutrition Mission. We will be watching like a hawk, every state and every district, on how the mission is coming about," Kumar said, adding that they are using the latest technology to achieve this. He said a real-time data dashboard will be installed for the purpose. "Hope Andhra Pradesh will lead the effort because this effort will be the bedrock of any achievement...Every achievement we actually want to make," the NITI Aayog vice-chief said. Speaking on the economy, Kumar said the note ban move had resulted in a 19 per cent jump indirect tax collection. "People very often criticise demonetisation saying 'Oh the black income had actually not been caught red-handed'. Believe me...Black wealth has at least become grey because now it is all sitting in the bank accounts, which is being monitored closely by the banking division and the CBDT," the noted economist said. Without demonetisation, the country's security itself would have been jeopardised, he said, recalling the first warning note he sounded way back in 2007. Hailing GST as a "historic step unifying our economy", Kumar said it was forcing "formalisation" of all businesses in the country. "It is a very, very big step. About 40-50 per cent of our economy was un-formalised. GST will see at least 20 per cent hike in revenues as we go forward in the years to come," he said. Kumar further said India would become "unstoppable" if efficient delivery of public goods and services was achieved by rooting out corruption and ushering in e-governance. "Once we achieve efficient delivery of public goods and services, basic education, basic health, law and order, street lighting, infrastructure and all that...If we do that, private sector in our country is as capable as us...This country will become unstoppable," he said. He said the old story of India being a "soft state, soft government, a corrupt government, and the endemically nonperforming government is now history". "This is the beginning of a new India in terms of e-governance where accountability and transparency will be right at the forefront," he observed. Stressing that India should embrace the fourth industrial revolution, Kumar said it was vital to ensure it did not cause a "trade-off" with employment generation. "The fourth industrial revolution is our tomorrow. Our eyes on 2022 should be with this focus in mind. We are seeing most disruptive technologies coming up in the world. We need to see that there is no trade-off between all of this and our biggest need today--- employment generation. That's our biggest priority," he said. Andhra Pradesh Chief Minister N Chandrababu Naidu, Deputy Chief Ministers K E Krishna Murthy, N China Rajappa, Chief Secretary Dinesh Kumar, Chief Commissioner of Land Administration Anil Chandra Punetha, ministers and bureaucrats attended the programme. Later, Real-Time Governance CEO Babu Ahamed showed the NITI Aayog Vice-Chairman the functioning of RTG Centre at the state Secretariat.Kumar praised the facility saying it is unparalleled in the country. "Visit to RTG is just startling. It's an eye-opener. Will do my best to showcase this to all the other states and to the Central government, if I can. I don't think such a facility exists anywhere in the country. This is the best idea of an accountable, transparent and digitally-driven governance. I think this is the future. This is the future for the rest of the country," he said.

Getting rid of malnutrition crucial to build New India by 2022: NITI Aayog Vice-Chairman

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