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50% Of All Childhood Deaths Are Due To Malnutrition: This Is What Our Government Has To Offer

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By Prachi Salve:

The recent death of infants in Malda district of West Bengal has once again brought to light the pressing problem of malnutrition in India.

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Most efforts to fix this problem have focused on providing nutrients and mineral rich food while what may matter more, as is increasingly evident, are factors like the mother’s health, hygiene and sanitation. While the Government has stepped up spending to tackle malnutrition, it does not, however, do much to address the other causes.

India is likely to have 33% malnourished children by the end of 2015 while the target under the United Nations’ Millennium Development Goals (MDGs) is to bring it down to 26%. According to UNICEF and the Global Health Database maintained by World Health Organization, India has more malnourished children than sub-Saharan Africa and nearly one-in-every-5 malnourished children in the world is from India.

Malnutrition is one of the leading causes (about 50%) of all childhood deaths. And malnourishment at an early age can lead to long-term consequences as it affects motor, sensory, cognitive, social and emotional development.

A study conducted by the medical journal Lancet in India, found that 78% of the infant mortality in here was due to low birth-weight and diarrheal diseases. This shows that there is not just a need to focus on providing essential nutrients but also better hygiene and sanitation.

The last available National Health Survey (NHFS 3, 2005-06) of Ministry of Health shows that 42.5% of Indian children below 5 years are underweight. The prevalence in urban, rural areas and scheduled tribes is 32.7%, 45.6% and 54.5%, respectively. This figure is of course very old and must have changed.

Now for some positive news: there has been a decline in the number of malnourished children from 52.7% in 1991-92 (NHFS 1) to 47% in 1998-99 (NHFS 2) and to the current level of 42.5% in 2005-06 (NHFS 3). It stands to reason that the decline in the subsequent decade to the present period must also be in the 5-7% range, possibly higher if you look at other economic indicators that have improved.

The Congress-led United Progressive Alliance (UPA) Government had launched various programmes like Integrated Child Development Scheme (ICDS), Mid-Day Meal Scheme, Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG) and Indira Gandhi Matritva Sahyog Yojana (IGMSY) to address the issue. Let us look at the budget allocations for the programmes:

We can see that most of the interventions have actually seen an increase in allocations. While ICDS has seen an increase of 26% for the current year over the previous year, the mid-day meal scheme has seen an increase of 5%. The RGSEAG has seen its allocation double this year to over Rs 1,700 crore.

Let us now look at health-oriented schemes: The ‘Sabla’ scheme was launched in 2011-12 to provide an integrated package to adolescent girls, which includes nutrition, micro-nutrient supplementation and health check-ups. A total of Rs 787 crore has been released for 2010-12. And the IGMSY scheme was launched to address malnutrition among pregnant women.

The ministry of women and child development runs comprehensive programmes for nutrition. Three out of the four schemes referred to above are run by the child development ministry. So, it becomes important to look at the ministry’s budget for nutrition-related programmes:

So, the allocation has more than tripled from Rs144 crore in 2012-13 to Rs 553 crore in 2014-15. The highest allocation this year (Union Budget 2014-15) is for the national nutrition mission. The programme was launched in September 2003 for policy direction and effective co-ordination of nutrition programmes being implemented by the Government.

The Mission has a two tier- supervisory structure. It is headed by the Prime Minister and includes concerned Union Ministers, Chief Ministers by rotation, academicians, technical experts and NGOs. Moreover, Finance Minister Arun Jaitley, while presenting the Union Budget on 11th July 2014, said: “A national programme in mission mode to halt the deteriorating malnutrition situation in India would be put in place within six months.”

Conclusion: Firstly, despite targeted efforts, malnutrition rates remain high and subsequently the infant mortality rates in the country have also not come down. One solution is to clearly work more exhaustively on the outlying areas, like hygiene and sanitation. This calls for tighter co-ordination between departments and spends, which in general is a campaign promise by the current Government- to make ministries and departments work better together.

This article was originally published by IndiaSpend.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

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Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

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MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

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A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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