Question

Give Reasons
1 Unavailability of the doctors in rural areas.
2 India has many undernourished children.​

Answer 1

Answer:

Keywords: Malnutrition, strategies, under-five children, India

INTRODUCTION

1. Malnutrition among under-five children is a major public health problem in India. This is reflected by the fact that the prevalence of under-weight children in India is among the highest in the world, and is nearly double that of Sub-Saharan Africa.[1] It is also observed that the malnutrition problem in India is a concentrated phenomenon that is, a relatively small number of states, districts, and villages account for a large share of the malnutrition burden — only 5 states and 50% of villages account for about 80% of the malnutrition burden.[1] Each year approximately 2.3 million deaths among 6-60 months aged children in developing countries are associated with malnutrition, which is about 41% of the total deaths in this age group.[2] A recent study, among children aged between 3 months and 3 years of age conducted in 130 districts through Demographic and Health Surveys in 53 countries over a period from 1986 to 2006 found that — variance in mild under-weight has a larger and more robust correlation with child mortality than the variance in severe under-weight.[3] The study concluded that the prevalence of mild under-weight deserves greater attention as a useful signal of changing public health conditions among preschool children in developing countries.[3] Therefore, it is important for the health system to detect malnutrition at an early stage for planning and implementing timely interventions at the community level.

• Millennium Development Goal 1 (Target 2) aims to halve, between 1990 and 2015, the proportion of people who suffer from hunger as measured by the prevalence of under-weight among under-5 years children.[4] The burden of under-nutrition among under-five children has not changed much even though various intervention programs are in operation in India. Current changing dietary patterns are also affecting the nutrition status of under-five children resulting in increased prevalence of adult noncommunicable diseases such as obesity, diabetes, hypertension and coronary heart disease. The need of the hour is to examine the burden of under-nutrition and obesity, study it's determining factors and assess the effectiveness of the various approaches to combat malnutrition among under-five children. The present review article discusses the issues and strategies for strengthening service delivery to under-five malnourished children in India.

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