A new series on maternal and child malnutrition in The Lancet has revealed how malnutrition can be tracked even in unborn children by linking their weight with their gestational age. The figures for India are almost a decade old and from the 2005-06 National Family Health Survey but the four paper series highlighted the importance of political will and policy initiatives in tackling the problem.
Speaking at the launch on Friday,Rural Development Minister Jairam Ramesh linked lack of sanitation facilities with malnutrition and announced his ministrys plan to use women self-help groups to promote nutrition interventions. I dont see the same degree of political enthusiasm on sanitation. I think we neglect this at peril…. When we talk about sanitation,we can only giggle. But I think it is more than giggles…It has profound implication on malnutrition, Ramesh said. Speakers including Ramesh spoke about the economic repercussions of malnutrition,the need to introduce interventions based on scientific evidence and the importance of intensification of ground level coverage.
Dr K Srinath Reddy,president of Public Health Foundation of India,cited the example of Thailand where remarkable strides had been made in tackling malnutrition in just a decade by appointing one community health worker for every ten households.
During the panel discussion,many paediatricians expressed misgivings about some of the recommendations in the papers particularly on the matter of nutrition supplements that seemed to push for a greater engagement with the private sector.
Dr Robert Black,professor of International Health at the John Hopkins Bloomberg School of Public Health,said: Many of these apprehensions are based on misinterpretation of our recommendations. We do not recommend any product whatsoever. I can understand there are concerns about the role of the food industry and that there are historical reasons for these concerns but there may be ways to engage with the private sector and look for solutions together rather than brand the private sector as evil.
Paper 4 of The Lancet series,which looks at the international initiative Scaling Up Nutrition (SUN) as a model for multisectoral approach to tackling malnutrition,has been panned by some sections of the medical community. Dr Purnima Menon senior research fellow of the International Food Policy Research Institute,who is one of the authors of the paper,clarified that it does not in any way endorse SUN which has at various times in many of the 35 countries where it is active,been accused of stonewalling legislations that seek to regulate advertising of food supplements as nutrition solutions.