Undernutrition, consisting of fetal growth restriction, stunting, wasting, and deficiency of essential vitamins and minerals along with sub optimum breastfeeding adversely impacts child survival. Globally, 45 per cent of under-five deaths can be attributed to undernutrition.
Nutrition: The first few years are forever.
Undernutrition if not tackled in time can cause irreversible damage to a child’s physical growth and brain development. The 1,000 days from the start of a woman’s pregnancy until her child’s second birthday offer a unique window of opportunity to shape healthier and more prosperous futures. The right nutrition during this 1,000 day window can have an enormous impact on a child’s ability to grow, learn, and rise out of poverty. It is critical to break the inter-generational cycle of malnutrition otherwise under nourished girls will become under nourished women who give birth to low birth weight infants.
The United Nations in India supports the efforts of the Government of India to address child undernutrition particularly to scale up equitable access to evidence based high impact nutrition interventions during the critical 1,000 days from pregnancy to a child’s second birthday to break the inter-generational cycle of undernutrition and deprivation. Convened by the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), the First 1,000 Days Task Team brings together four UN agencies including the FAO and WFP.
According to the 2013 UNICEF Report on Improving Child Nutrition – The Achievable Imperative for Global Progress, one-third of the world’s under nourished children are in India and an estimated 61 million, half of the total child population in the country, are stunted due to chronic undernutrition. While progress towards reducing child underweight in India has been made, it has been uneven. The 2010 UNICEF Report on Progress for Children: Achieving MDGs with Equity highlights that in India, the prevalence of underweight in children below five years in the richest 20 per cent of the households decreased from 37 per cent in 1992 to 25 per cent in 2006, whereas the corresponding reduction in the poorest 20 per cent households was negligible, from 64 per cent to 61 per cent.
Figure 1 shows that in India, the prevalence of stunting reaches a peak around 18-24 months, after which age corrective interventions do not have an effect.
Global evidence shows that timely nutritional interventions have proven to be effective in improving nutrition outcomes in children. These are:
Timely initiation of breastfeeding within one hour of birth.
Exclusive breastfeeding during the first six months of life. The infant is fed only breast milk and is not given any fluids, milk, or foods, not even water.
Timely introduction of complementary foods at six months: By the 7th month, breast milk alone cannot meet an infant’s energy and nutrient requirements. At this time complementary feeding should begin. Introducing complementary foods before is both unnecessary and dangerous.
Age-appropriate complementary feeding adequate in terms of quality, quantity and frequency for children 6-24 months.
Safe handling of complementary foods and hygienic complementary feeding practices.
Full immunization and bi-annual vitamin A supplementation with de-worming.
Frequent, appropriate, and active feeding for children during and after illness, including oral rehydration with zinc supplementation during diarrhea.
Timely and therapeutic feeding and care for children with severe malnutrition.
Improved food and nutrient intake for adolescent girls particularly to prevent anaemia.
However, in India, the coverage of these essential nutrition interventions is low. Figure 2 from the National Health Family Survey 2006, IIPS, Mumbaishows that only 24 per cent children are put to the breast within one-hour of birth; 46 per cent are exclusively breastfed for six months; 53 per cent are offered timely complementary foods and only 21 per cent children below two years are fed appropriately.
Sanitation Roundtable on Achieving Nirmal Bharat
As part of the Take Poo to the Loo campaign, UNICEF organised a Sanitation Roundtable at IIT Delhi which focused on possible innovative solutions to address access to sanitation. UNICEF has launched a mobile application- whenever you see open defecation being practiced, just plant a sign on the app and help crowdsource an open defecation map of India. Android Users, click here todownload: http://unicf.in/FAOD-PlayStoreBlackBerry Users, click here: http://unicf.in/FAOD-BB
Nutrition: The First Two Years are Forever
Published by UNICEF, this collection of factsheets gathers essential evidence-based interventions to improve nutrition in children under two. For each intervention, it reviews in simple language why the intervention is important, where India is in making this intervention universal, and how to make the intervention a reality for all children under two.
UNICEF India Water interventions
UNICEF’s survey in 12 States in India showed over half the water samples did not meet the quality standards. The document highlights the key challenges and strategic approaches for safe drinking water.
Improving Child Nutrition – The Achievable Imperative for Global Progress
Stunting affects 165 million children under five years of age around the world, and it can trap those children in a vicious cycle of poverty and undernutrition. Yet, key interventions when delivered during a critical 1,000 day window – during the mother’s pregnancy and before a child turns two ? can lead to reduced prevalence of stunting. This 2013 UNICEF report showcases new developments in nutrition programmes and analyses progress towards reducing undernutrition. It also includes case studies from countries including from India’s Maharashtra state where nutrition has been improved at scale.
Promoting healthy growth and preventing childhood stunting
As part of the work on implementing the project Promoting healthy growth and preventing childhood stunting, the World Health Organization has worked with various experts to prepare nine papers for a supplement of the Maternal and Child Nutrition Journal. The papers will contribute to ongoing reflections on multiple aspects of the challenges presented by a World Health Assembly 2012 target for stunting reduction and ways to address them.
Nutrition Resource Platform
The Nutrition Resource Platform (NRP) is an initiative of the Child Development and Nutrition Bureau of the Ministry of Women and Child Development (MWCD), Government of India, developed with the aim to collect, collate and make available resources and materials on nutrition and child development.
Water, Sanitation and Hygiene
Naranga Pujari, Community Worker from Odisha says that clean water, hygiene and access to toilets in villages are very important for both pregnant women and children.
Mission Impossible Water, sanitation and hygiene (WASH) education in schools provides safe drinking water, improves sanitation facilities and promotes lifelong health. The Government of India (GOI) and UNICEF have been working closely to ensure that all children are reached with WASH in Schools programme.
The United Nations in India in partnership with World Comics India uses the power of comics to tell stories from across India, across communities, and across languages. Through workshops held in the country, young people, women, men and children who are poor and from marginalized communities find expression through comics. The collection of stories highlight what pregnant women should do to ensure the well-being of their children, and the importance of first 1,000 days in the life of young children.
Stories of Community Action to End Open Defecation
Community Takes Lead in Making Gadri Open Defecation Free
The tribal community of Gadri in Jharkhand, like more than 620 million Indians, only a few months back, defecated in the open and were often plagued by diseases linked to unsafe hygiene and sanitation. However, as a result of the efforts of Sanika Oraon, the mukhiya (head) of Gadri village in Jharkhand and volunteers like Sunita Oraon with support from Jharkhand Government and UNICEF, Gadri has become the first Open Defecation Free village in Jharkhand.
EcoSan Toilets Change Venu’s Village
Till 2008, every family in Pongvnantnagar village didn’t use toilets and defecated in the open, putting at risk the health of inhabitants as well as the dignity of women. Thanks to innovative EcoSan toilet models supported by UNICEF, close to 200 families in Venu’s village have now toilets.
India’s bid to Becoming Poo-Free and to Reduce Stunting
Madhya Pradesh has some 50 million people defecating in the open every day, and the State will not meet global Millennium Goal Targets for sanitation until 2105. The state is also home to some of the most undernourished children in India with 58 percent of under three’s suffering from malnutrition (compared with 45 percent nationally). 50 per cent of children under-five also suffer from stunting, an indicator of long-term persistent malnutrition, associated with a child’s low height relative to its age. Tackling India’s pervasive open defecation problem could be a significant part of the answer to saving millions of children from stunting.
Children Lead the Way to A Healthier Tomorrow in Assam
Dominated by the Bodo tribe, Rani block of the Kamrup district of Assam, where the school is located, has a high incidence of diseases such diarrhoea. Due to low awareness levels, sanitation and hygiene have taken a back seat in people’s homes. But thanks to the Child Friendly Schools and Systems (CFSS) initiative by UNICEF in collaboration with the Sarba Shiksha Abhiyan (SSA) in Assam, a national flagship programme for Education, a wave of change has been initiated in Sajjanpara primary school that has sent ripples in the community.