Malnutrition refers to a condition that arises due to the lack of proper nutrients or an imbalance of nutrients in the body. It can occur due to inadequate intake or absorption of essential nutrients such as vitamins, minerals, protein, and carbohydrates. Malnutrition can result in stunted growth, weakened immune system, anemia, and other health problems, and can be particularly harmful to young children and pregnant women.
According to the Global Nutrition Report 2020, nearly one in three people worldwide is either malnourished or overweight. The report also highlights that while progress has been made in some areas, such as reducing stunting in children under five, the world is not on track to achieve most of the 2025 global nutrition targets.
In India, malnutrition remains a significant public health challenge. The National Family Health Survey (NFHS) 5 data from 2019-20 highlights that 34.7% of children under five are stunted, 17.3% are wasted, and 33.4% are underweight. The data also shows that malnutrition is higher in rural areas and among disadvantaged communities, such as Scheduled Castes and Scheduled Tribes.
The NFHS-5 data also highlights the need to address micronutrient deficiencies, such as anemia, which affects a significant proportion of the population. The data shows that 59.7% of children aged 6-59 months and 53.1% of women aged 15-49 years are anemic.
Efforts are being made to address malnutrition in India through various interventions, including social protection schemes, such as the Integrated Child Development Scheme (ICDS), Mid-Day Meal Scheme, and the Public Distribution System (PDS). The government has also launched initiatives to promote the production and consumption of nutrient-rich foods, such as the National Nutrition Mission (Poshan Abhiyaan) and the National Food Fortification Program. However, sustained efforts are needed to address the complex and multi-faceted challenge of malnutrition in India.
Multi-dimensional determinants of Malnutrition
Malnutrition is a complex issue that has multidimensional determinants. Some of the key determinants of malnutrition are:
- Mother’s Health: Maternal health plays a crucial role in ensuring the nutritional status of children. Poor maternal health, such as anemia or undernutrition, can lead to adverse birth outcomes and affect the growth and development of children.
- Social Inequality: Malnutrition is often associated with social inequality and poverty. Marginalized groups such as Scheduled Castes, Scheduled Tribes, and other vulnerable communities are more likely to suffer from malnutrition due to limited access to food, healthcare, and other resources.
- Sanitation: Access to clean water and sanitation is critical for maintaining good health and preventing diseases. Poor sanitation can increase the risk of diarrheal diseases, which can lead to malnutrition due to nutrient loss.
- Lack of Diversified Food: Limited access to diverse and nutritious food can lead to nutrient deficiencies and malnutrition. This is particularly true for households with limited income, as they may not be able to afford a diverse diet.
- Food Insecurity: Food insecurity, which refers to the lack of access to sufficient, safe, and nutritious food, is a significant determinant of malnutrition. Food insecurity can lead to undernutrition, overnutrition, or both, depending on the availability and affordability of food.
- Failure of Government Approaches: The government has launched various schemes, such as the Integrated Child Development Scheme (ICDS), to address malnutrition. However, the success of these schemes has been limited due to factors such as inadequate funding, poor implementation, and lack of community participation.
- COVID-19 and Children: The COVID-19 pandemic has exacerbated the problem of malnutrition among children, particularly in low- and middle-income countries. School closures and disruptions in food supply chains have led to a decrease in access to food and nutrition services, which can have long-term effects on children’s health and development.
Addressing the multi-dimensional determinants of malnutrition requires a comprehensive and integrated approach that involves various sectors such as health, education, agriculture, and social welfare. It also requires a focus on community participation and empowerment to ensure that interventions are tailored to the specific needs of different communities.
National Family Health Survey-5 and Malnutrition
The National Family Health Survey (NFHS) is a large-scale survey conducted in India to collect data on population, health, and nutrition indicators. The latest survey, NFHS-5, was conducted in 2019-2020 and provides important insights into the state of malnutrition in India.
According to the NFHS-5 data, malnutrition remains a significant public health challenge in India. The survey found that 34.7% of children under the age of five are stunted, which means they are too short for their age due to chronic malnutrition. Stunting is a long-term consequence of malnutrition and can lead to poor cognitive development, lower educational attainment, and reduced economic productivity in adulthood.
The survey also found that 17.3% of children under five are wasted, which means they are too thin for their height due to acute malnutrition. Wasting is a severe form of malnutrition that can lead to increased morbidity and mortality.
The NFHS-5 data also highlights the need to address micronutrient deficiencies, such as anemia, which affects a significant proportion of the population. The survey found that 59.7% of children aged 6-59 months and 53.1% of women aged 15-49 years are anemic. Anemia can lead to fatigue, decreased physical performance, and increased susceptibility to infections.
The data also shows that malnutrition is higher in rural areas and among disadvantaged communities, such as Scheduled Castes and Scheduled Tribes. This highlights the need to address social inequalities and improve access to healthcare, sanitation, and nutritious food for marginalized communities.
Efforts are being made to address malnutrition in India through various interventions, including social protection schemes, such as the Integrated Child Development Scheme (ICDS), Mid-Day Meal Scheme, and the Public Distribution System (PDS). The government has also launched initiatives to promote the production and consumption of nutrient-rich foods, such as the National Nutrition Mission (Poshan Abhiyaan) and the National Food Fortification Program. However, sustained efforts are needed to address the complex and multi-faceted challenge of malnutrition in India.
International Agencies and Malnutrition
| International Agencies, Surveys, Reports, and Data | Description |
| United Nations | Sets a goal to end all forms of malnutrition by 2030 through the Sustainable Development Goals (SDGs), and supports programs and initiatives such as the Scaling Up Nutrition (SUN) movement. |
| World Health Organization (WHO) | Provides technical guidance and support to countries to address malnutrition, conducts research and surveillance on malnutrition, and produces reports and guidelines related to nutrition. |
| Global Nutrition Report | Annual publication that provides a comprehensive analysis of the state of malnutrition worldwide, produced by an independent expert group, and provides an overview of progress and challenges in addressing malnutrition, as well as recommendations for action. |
| Demographic and Health Surveys (DHS) | Large-scale household surveys conducted in low- and middle-income countries to collect data on health and nutrition indicators, funded by the US Agency for International Development (USAID), and provides important data on malnutrition, including stunting, wasting, and anemia. |
| World Food Programme (WFP) | Provides food assistance to people affected by conflict, natural disasters, and other emergencies, and supports programs to improve food security and nutrition in vulnerable communities, including school feeding programs and nutrition-sensitive agriculture interventions. |
| UNICEF | Works to promote the rights and well-being of children worldwide, provides technical support and funding to countries to address malnutrition, including through programs such as the Community-based Management of Acute Malnutrition (CMAM). |
Government Initiatives
ICDS
The ICDS scheme is an important initiative of the Government of India to improve the health and nutrition status of children and pregnant and lactating women. It provides a range of services, including supplementary nutrition, immunization, health check-ups, referral services, and nutrition and health education. The scheme is implemented by trained service providers, including Anganwadi Workers, Anganwadi Helpers, Lady Supervisors, and Medical Officers.
| Scheme | Integrated Child Development Services (ICDS) |
| Objectives | To improve the nutritional and health status of children under the age of six and pregnant and lactating women. |
| Components | 1. Supplementary Nutrition 2. Immunization 3. Health Check-ups 4. Referral Services 5. Nutrition and Health Education |
| Coverage | All children under the age of six and pregnant and lactating women in rural and urban areas. |
| Service Providers | 1. Anganwadi Workers (AWWs) 2. Anganwadi Helpers (AWHs) 3. Lady Supervisors 4. Medical Officers |
| Supplementary Nutrition | – Provides hot cooked meals, take-home rations, and fortified food to children and pregnant and lactating women. – The meals are provided for 300 days in a year. – The take-home rations and fortified food are provided to pregnant and lactating women. |
| Immunization | – Provides immunization services to children under the age of six and pregnant and lactating women. – Vaccines provided include BCG, DPT, OPV, and measles. |
| Health Check-ups | – Provides regular health check-ups to children and pregnant and lactating women. – The check-ups include growth monitoring, weight measurement, and health assessment. |
| Referral Services | – Refers children and pregnant and lactating women to medical facilities if needed. |
| Nutrition and Health Education | – Provides nutrition and health education to children and their mothers. – The education covers topics such as breastfeeding, hygiene, and sanitation. |
PM Matru Vandana Yojana
The Pradhan Mantri Matru Vandana Yojana (PMMVY) is a maternity benefit scheme introduced by the Government of India to provide financial assistance to pregnant and lactating women for their first live birth. The scheme provides a total benefit amount of Rs. 5,000 in three installments, which are transferred directly to the beneficiary’s bank account. The scheme is applicable to all pregnant and lactating women who are aged 19 years or above and have completed at least six months of pregnancy. The scheme is monitored by the Ministry of Women and Child Development at the central, state, and district levels.
| Scheme | Pradhan Mantri Matru Vandana Yojana (PMMVY) |
| Objectives | To provide financial assistance to pregnant and lactating women for their first live birth. |
| Eligibility | – All pregnant and lactating women who are aged 19 years or above. – Women who have completed at least six months of pregnancy. – Women who are registered under the Anganwadi Services Scheme or the Janani Suraksha Yojana. |
| Benefit Amount | – Rs. 5,000 in three installments. – The first instalment of Rs. 1,000 is provided on early registration of pregnancy. – The second installment of Rs. 2,000 is provided after six months of pregnancy. – The third installment of Rs. 2,000 is provided after the child is born and all the required immunization is completed. |
| Implementation | – The scheme is implemented by the Ministry of Women and Child Development. – The payment is made through Direct Benefit Transfer (DBT) to the beneficiary’s bank account. |
| Coverage | – The scheme covers all pregnant and lactating women across the country. – The scheme is applicable for the first live birth only. |
| Objectives | – To provide financial assistance to pregnant and lactating women for their first live birth. |
| Monitoring | – The scheme is monitored by the Ministry of Women and Child Development. – The implementation of the scheme is also monitored at the district and state levels. |
Mid-day Meals
The Mid-Day Meal scheme is a government initiative that provides free nutritious meals to school-going children. The objective of the scheme is to increase enrollment, retention, and attendance in schools. The scheme is applicable to all children studying in government and government-aided schools across the country. The meal provided under the scheme includes carbohydrates, proteins, vitamins, and minerals, and is served during lunchtime in the school premises. The scheme is implemented by the Ministry of Education in partnership with the State Governments and UT administrations. The meal is prepared by local NGOs or self-help groups. The scheme is monitored by the Ministry of Education at the central level, and the implementation of the scheme is also monitored at the district and state levels.
| Scheme | Mid-Day Meal scheme |
| Objectives | To provide nutritious meals to school-going children in order to increase enrollment, retention, and attendance. |
| Eligibility | – All children studying in government and government-aided schools. |
| Benefit | – Free lunch to children every school day. – Nutritious meals including carbohydrates, proteins, vitamins, and minerals. |
| Implementation | – The scheme is implemented by the Ministry of Education in partnership with the State Governments and UT administrations. – The meal is prepared by local NGOs or self-help groups. – The meal is served in the school premises during lunchtime. |
| Coverage | – The scheme covers all government and government-aided schools across the country. |
| Monitoring | – The scheme is monitored by the Ministry of Education at the central level. – The implementation of the scheme is also monitored at the district and state levels. |
POSHAN Abhiyan
The National Nutrition Mission (Poshan Abhiyaan) is a government initiative aimed at improving the nutritional status of children, pregnant women, and lactating mothers. The objective of the scheme is to achieve specific nutrition-related goals through the provision of nutrition-specific and nutrition-sensitive interventions such as the provision of iron and folic acid tablets, Vitamin A, deworming tablets, and nutritional counselling. Behavioural change and awareness generation activities are also carried out for mothers and caregivers. The scheme is implemented by the Ministry of Women and Child Development in partnership with the State Governments and UT administrations through the Integrated Child Development Services (ICDS) platform. The scheme covers all pregnant women, lactating mothers, and children under six years of age across the country. The scheme is monitored at the national, state, and district levels through various indicators such as stunting, wasting, and underweight. An online dashboard has been set up for real-time monitoring of the scheme’s progress.
| Scheme | National Nutrition Mission (Poshan Abhiyaan) |
| Objectives | To improve the nutritional status of children, pregnant women, and lactating mothers by achieving specific nutrition-related goals. |
| Eligibility | – Pregnant women and lactating mothers. – Children under six years of age. |
| Benefit | – Provision of nutrition-specific and nutrition-sensitive interventions such as the provision of iron and folic acid tablets, Vitamin A, deworming tablets, and nutritional counselling. – Behavioural change and awareness generation activities for mothers and caregivers. |
| Implementation | – The scheme is implemented by the Ministry of Women and Child Development in partnership with the State Governments and UT administrations. – The scheme is implemented through the Integrated Child Development Services (ICDS) platform. |
| Coverage | – The scheme covers all pregnant women, lactating mothers, and children under six years of age across the country. |
| Monitoring | – The scheme is monitored at the national, state, and district levels through various indicators such as stunting, wasting, and underweight. – An online dashboard has been set up for real-time monitoring of the scheme’s progress. |
Janani Suraksha Yojana
The Janani Suraksha Yojana (JSY) is a government initiative aimed at promoting institutional deliveries among pregnant women and reducing maternal and neonatal mortality. The objective of the scheme is to provide cash assistance to pregnant women who deliver in government health facilities or accredited private health facilities, as well as incentives to Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) for promoting institutional deliveries. The scheme is implemented by the Ministry of Health and Family Welfare in partnership with the State Governments and UT administrations through the National Health Mission (NHM) platform. The scheme covers all pregnant women from BPL families across the country. The scheme is monitored at the national, state, and district levels through various indicators such as institutional deliveries, maternal mortality, and neonatal mortality.
| Scheme | Janani Suraksha Yojana (JSY) |
| Objectives | To promote institutional deliveries among pregnant women and reduce maternal and neonatal mortality. |
| Eligibility | – Pregnant women from BPL families. – Pregnant women aged 19 years and above. |
| Benefit | – Cash assistance to pregnant women who deliver in government health facilities or accredited private health facilities. – Incentives to Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) for promoting institutional deliveries. |
| Implementation | – The scheme is implemented by the Ministry of Health and Family Welfare in partnership with the State Governments and UT administrations. – The scheme is implemented through the National Health Mission (NHM) platform. |
| Coverage | – The scheme covers all pregnant women from BPL families across the country. |
| Monitoring | – The scheme is monitored at the national, state, and district levels through various indicators such as institutional deliveries, maternal mortality, and neonatal mortality. |
FAQs
1. What is the meaning of malnutrition in English?
Malnutrition refers to a condition where an individual’s diet lacks the necessary nutrients, vitamins, and minerals required for proper growth, development, and overall health. It can manifest as undernutrition (insufficient intake of essential nutrients) or overnutrition (excessive intake of certain nutrients like calories) and can lead to various health issues.
2. What is a malnutrition project?
A malnutrition project is an initiative or program designed to address and combat malnutrition in a specific region, community, or population. Such projects typically involve a combination of strategies, including improving access to nutritious food, promoting education on proper nutrition, enhancing healthcare services, and monitoring and evaluating progress to reduce malnutrition rates.
3. What are the main problems of malnutrition in India?
Malnutrition in India is a complex issue with several contributing factors. Some of the main problems include:
- High Prevalence: India has a high prevalence of malnutrition, affecting both children and adults.
- Poverty: Poverty is a major driver of malnutrition in India, as it limits access to nutritious food.
- Inadequate Diet: Many people in India do not have access to a balanced and diverse diet, leading to nutrient deficiencies.
- Lack of Awareness: Limited awareness about proper nutrition and hygiene practices contributes to malnutrition.
- Poor Healthcare: Inadequate healthcare infrastructure can lead to untreated health issues that worsen malnutrition.
- Food Distribution: Unequal distribution of food resources can lead to disparities in malnutrition rates.
- Cultural Practices: Certain cultural practices and beliefs can affect dietary choices and nutrition.
- Infrastructure: Challenges in transportation and storage can impact the availability of nutritious food in remote areas.
4. How can malnutrition be prevented and treated?
Malnutrition prevention and treatment strategies include:
- Promoting Education: Educating communities about balanced diets and proper nutrition.
- Improving Food Security: Ensuring consistent access to nutritious food through various means.
- Healthcare Access: Providing healthcare services to address and treat health issues related to malnutrition.
- Public Policy: Implementing policies and programs aimed at reducing malnutrition rates.
- Food Fortification: Fortifying common food items with essential nutrients.
- Community Engagement: Involving communities in addressing local malnutrition issues.
- Monitoring and Evaluation: Continuously assessing and adapting interventions for effectiveness.
5. What are the long-term consequences of malnutrition?
Long-term consequences of malnutrition can include stunted growth, cognitive impairment, weakened immune system, increased susceptibility to diseases, and developmental issues in children. In adults, it can lead to chronic health problems such as heart disease, diabetes, and reduced productivity. Addressing malnutrition is crucial to preventing these long-term health and socioeconomic effects.
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