Curse of poverty

Friday 14 September 2007

Curse of poverty

Under-nutrition levels in India are among the highest in the world. While the overall state of nutrition and health in India is bad enough, the situation is even worse in the poorer states, not to speak of the more deprived regions within these states.

Around 40% of the children are of low birth weight and around 47% malnourished. It is understood that 60% of infant and child deaths could be prevented only if we were able to check malnutrition among children. This was reported on the last day of the National Nutrition Week (1-7 September) by representatives of the Food and Nutrition Board of the Union government and CARE. CARE has been fighting malnutrition and hunger in UP. The theme for this year’s National Nutrition Week was “Nutrition Promotion for stronger Nation”.

Malnutrition in the form of under-nutrition or deficiencies of essential nutrients continues to cause severe illness and morbidity. It is estimated that more than half of the women suffer from anaemia and almost the same proportion are at risk of iodine deficiency (source: National Family Health Survey). Millions of children are affected by insufficient vitamin A. Keeping in view the severity of the issue, CARE launched the Integrated Nutrition Health Project (INHP) in UP, in close partnership with the Integrated Child Development Services (ICDS), to improve the health and nutrition status of women and children, especially girl children.

Since infants’ feeding practices are one of the important determinants of child malnutrition, awareness generation on the nutrition care of the children is very important. Mothers and other family members need to be made aware of important issues in care of newborn and children. Therefore, the INHP focuses on the following:

a) Breast-feeding: Early initiation of breast-feeding within one hour of birth is important as this ensures better lactation as well as colostrum availability to the infants, which is considered to be the first immunisation of the child. Colostrum is rich in anti-bodies which safeguard the child from infections. Colostrum also contains high quality proteins and is very rich in Vitamin A which is required for the child’s growth during the first few days of life.

b) Exclusive breast-feeding: Only breast milk and not even water for the first six months fulfils all the nutritional requirements of the child for growth and development

c) Complementary feeding: All children need complementary foods after six months as breast milk alone cannot meet the nutritional requirements of the fast growing child. These complementary foods can be prepared at home with cereals like wheat, ragi, bajra, dal and rice after roasting and powdering, mashed seasonal fruits, green vegetables, etc.

Better utilisation of health services and better acceptance of family planning, and even better education cannot obviously compensate for and overcome the effects of poverty, economic deprivation and poor diet on nutrition, body build and stature. Substantial improvements in the nutritional status of the poorest population groups in the country cannot be achieved merely through programmes for fertility control and child survival through better health services, in the absence of substantial economic improvement. On the other hand, it is also true that the effects of economic improvement would be greatly reinforced through parallel improvement of health services and literacy.

The key to child health lies in much greater emphasis on the physical state, economic state, health and nutrition, and education of the mother. Such attention to the mother must start not after she has become a mother, not even when she is just about to become a mother, but even when she is herself an infant and a child, because it is what happens to her during her own childhood that will eventually determine the adequacy of her maternal state.