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lmost half of all Indian children between the one and 24

months of age are undernourished. According to a UNICEF report,
malnutrition is more common in India than in Sub-Saharan Africa. One
in every three malnourished children
in the world lives in India and about 46
per cent of all children below the age
of three are too small for their age; 47
per cent are underweight and at least
16 per cent are wasted. Many of these
children are suffering from Severe
Acute Malnutrition (SAM).
India is expecting a productive
workforce along with its growing
population in the next few decades.
With undernourishment accounting
for the highest mortality rate among
children, adversity in the economy is
foreseen. The prevalence of malnutrition varies across States, with Madhya
Pradesh recording the highest rate
(55 per cent) and Kerala among the
lowest (27 per cent).

In India, there are no national guidelines released for malnutrition because until now the Government has
not recognized it as a grave illness. In
most of the SAM cases, affected children are hardly tracked. There is a
dire need for a community-based programme where all the children should
be weighed and screened at the local
level. Dr Raj Bhandari, Chairperson
of the Health and Nutrition SubCommittee of the Indian Council of
Child Welfare (ICCW) and a renowned
pediatrician, says, Though the WHO
and the NHFS have guidelines as
to what therapeutic food should be
composed of, the Integrated Child
Development Schemes food alone is
not enough as it is not fortified with
micro-nutrients. He also feels that
there is a requirement for a CMAM
strategy (Community Management

alnutrition is a dreaded illness which affects

almost half of all infants in India. The World
Bank has estimated that India is one of the
highest ranking countries whose children are
suffering from malnutrition. However, surprisingly India
is yet to formulate a national guideline for malnutrition
as the consecutive Governments at the Centre have not
recognized it as a grave illness till now. Bureaucracy
Today examines the status of malnourishment in India
and the action required to prevent it.
By Meghna Chukkath

of Acute Malnutrition) consisting

mobilization of community, an outpatient therapeutic programme, a
supplementary food programme and
a patient-care programme which focuses on medical facilities.
Prevention should be a priority but treatment of SAM cannot be
neglected. Therapeutic food will be
more effective in curing the patient.
There are several States in India
which have demonstrated that locally
made therapeutic food if composed
correctly as per the standard guidelines can help, Dr Bhandari says.

Dr RAJ BHANDARI, Chairperson, Health and

Nutrition Sub-Committee of ICCW

He opines that the problem of

malnutrition should be addressed
through the Health Department
or through the convergence model
between the Health and various other
departments like that of Child and
Woman Welfare and Development.
Acute malnutrition is a medical
disorder and it should be treated
within medical parameters, he says.

launched several programmes to converge the growing rate of undernourished children, these efforts are not
enough, feels the ICCW Committee
Government schemes such as the
Midday Meal, the Integrated Child
Development Scheme, the National
Childrens Fund, and the National
Plan of Action for Children and the
United Nations Childrens Fund are
a few initiatives taken to combat this
illness. The region of UP, Bihar,
Rajasthan, especially northern India, has 60 per cent of the children
affected by SAM. The Government
with its various initiatives is doing
its bit but that is not enough. We are
looking at Acute Malnutrition, says
Dr Bhandari. 

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