The diets of women in India are often too poor to meet their nutritional needs.
A quarter of women of reproductive age in India are undernourished, with a body mass index (BMI) of less than 18.5 kg/m (Source: NFHS 4 2015-16 ). It is well known that an undernourished mother inevitably gives birth to an undernourished baby, perpetuating an intergenerational cycle of undernutrition.
Undernourished girls have a greater likelihood of becoming undernourished mothers who in turn have a greater chance of giving birth to low birth weight babies , perpetuating an intergenerational cycle.
This cycle can be compounded further in young mothers, especially adolescent girls who begin childbearing before they have grown and developed enough. When mothers take only short intervals between pregnancies and have many children, this can exacerbate nutrition deficits, which are then passed on to their children.
Foetal stunting is largely caused by the mother’s inadequate nutrition before conception and in the first trimester.
The major reason for stagnant levels of undernutrition among Indian children is because of a failure so far to adequately prevent undernutrition when it happens most - in the womb, which is caused by poor nutrition of women before and during pregnancy.
Given this, women’s nutrition – before, during and after pregnancy – has now been included as a special focus area in UNICEF India’s nutrition programming. The organization now aims to give added focus to universalize the coverage of the five essential nutrition interventions for women that have been arrived at based on global and national consensus.
The 5 Essential Nutrition Interventions for Mothers include:
1. Improving the quantity and nutrient level of food consumed in the household
This primarily includes improving access to generalized household food ration through public distribution system. Also providing access to supplementary foods under the integrated child development services scheme. To impart knowledge to improve the local diet, production and household behaviors through nutrition and health education.
2. Preventing micronutrient deficiencies and anemia
This through providing the Iron Folic Acid Supplementation deworming, Pre and peri-conceptual folic acid supplementation, Universal access to iodized salt, Malaria prevention and treatment in malaria-endemic areas, Access to knowledge and support to stop use of tobacco products during pregnancy, Maternal calcium supplementation, Maternal vitamin A supplementation.
3. Increasing women’s access to basic nutrition and health services
By providing early registration of pregnancy and quality of antenatal checkup, with emphasis on pregnancy weight gain monitoring, screening and special care of at-risk mothers.
4. Improving access to water and sanitation education and facilities. By providing sanitation and hygiene education, including menstrual hygiene.
5. Empowering women to prevent pregnancies too early, too often and too close together
By ensuring marriage at/after legal age of 18 through awareness and ensuring a girl completes secondary education. Also preventing maternal depletion by delaying first pregnancy and repeated pregnancies through family planning, reproductive health information, incentives and services. Also promoting community support system for women, skill development, economic empowerment as part of maternity entitlement. Providing community support system for women to support decision making, confidence building, skill development and economic empowerment.
The focus of nutrition programmes for Indian children has largely been post-birth, with child and feeding-centred interventions. It is known that 50 per cent of the growth failure that gets accrued by two years of age occurs in the womb owing to poor nutrition its mother both during pregnancy and before pregnancy.
Adolescent and women’s nutrition received renewed political and programme focus in 2018, owing to the national-wide launch of the POSHAN Abhiyaan 2018-20. UNICEF has also supported the Ministry of Health and Family Welfare in conceptualizing and convening for the development of Anaemia Mukt Bharat (Anaemia Free India) operational guidelines and related materials such as the reporting dashboard and communication materials.
The Initiative received national award and now is being scaled-up country-wide in a phased manner as National Rural Livelihood Mission Contribution to POSHAN Abhiyaan. For this, a national center of women collectives has been established in Lady Irwin College.