By Akhil Pradeep Kumar Menon

The NFHS 5 (2019-2012) points out significant reductions in stunting, wasting and underweight, but anaemia among children aged 6-59 months has risen from 59% to 67%. (Ministry of Women and Child Development,2021) “Malnutrition is defined as a deficiency or excess of nutrition consumption. It can be due to undernutrition or overnutrition.”(Ersado,2022)When it comes to anaemia, this is generally caused due to the lack of micronutrients like iron and zinc in one’s body. This article will thus focus more on the problem of rising anaemia (due to micronutrient deficiency). Lack of micronutrients can be caused by multiple reasons, such as loss in diet diversity, lack of food security, due to socio-economic conditions and insufficient health services during childbirth and pregnancy. To target some of these problems, the Government has launched various schemes, like the POSHAN Abhigyan and ICDS schemes.
What are these major policy interventions?
POSHAN Abhiyan (erstwhile National Nutritional Mission) is a centrally sponsored scheme which was launched in March 2018 to achieve improvement in the nutritional status of children (0-6 years), adolescent girls, pregnant women and lactating mothers in a time-bound manner and to achieve a reduction in stunting and wasting in children as well as a reduction in anaemia in women, children and adolescent girls. Under this scheme, a robust ICT platform has been created to improve governance about the provision of real-time data to make data-driven policies. It also focuses on the promotion of millets and local knowledge. Thus, this is more of an overarching policy intervention that tries to focus on various malnutrition problems.
The Integrated Child Development Scheme (‘ICDS’) was launched on 2nd October 1975 and is one of the world’s largest and most unique programs for early childhood development. (Ministry of Women and Child Development, n.d). ICDS was introduced as a response to the challenge of providing preschool education on the one hand and breaking the vicious cycle of malnutrition, morbidity, reduced learning capacity and mortality on the other. Under ICDS, one receives supplementary nutrition, immunisation, health check-ups, nutrition, and health education. The main intervention used by ICDS is supplementary nutrition, where once all the children below the age of six are, pregnant and nursing mothers are identified, the government provides them with 300 days of supplementary feeding support. This service is provided through various means like Take-Home Ration, Mid-Day Meal scheme etc. (Ministry of Women and Child Development, n.d)
While these are monumental efforts as schemes, the data, especially regarding anaemia has been disheartening, which points out that there are leakages in the current schemes. A report published by NITI Ayog in February 2022 titled “Evaluation of ICDS Scheme of India” states that there are major gaps in ICDS scheme monitoring and implementation of various ICDS activities with adequate logistics support. The report also acknowledges various gaps including lack of uniformity, insensitivity to socio-cultural issues, lack of convergence with other programs, lack of community monitoring, and non-involvement of the local leadership and community voices in addressing the multiple determinants of undernutrition. There are various other points mentioned in the report like lack of supervision, limited stakeholder involvement and lack of community ownership of the project.
All of this points out the inherent problems with the system of providing supplementary nutrition to the masses thus many scientists and developing countries are looking towards biofortification as a cheap and easy fix to their problem of micronutrient deficiency.
What is Biofortification?
Biofortification is the process of breeding nutrients into food crops, providing a comparatively cost-effective, sustainable, and long-term means of delivering more micronutrients. (Singh, Praharaj, Chaturvedi and Bohra,2016). Research also points out that conventional interventions have a limited impact, so biofortification has been proposed as an alternative long-term approach for improving mineral nutrition (Singh, Praharaj, Chaturvedi and Bohra, 2016). Biofortification is different from the presently-used food fortification is the addition of selected nutrients to foods, whether they are naturally present in the foods or not to increase the nutritional value of the foods to help consumers reach the Recommended Dietary Allowance (‘RDA’) for those nutrients (Ofori, Antoniello, English & Aryee,2022). this is part of the food processing industry. While in Biofortification the modifications are made in the plant itself, thus this process need not be repeated and all the future offspring on the plant shall have this added micronutrient content. There are research papers that point out the importance of biofortification, a paper points out Biofortification can increase the nutrient value of locally-grown crops, which can help to address deficiencies in essential vitamins and minerals and improve the nutritional status of populations that rely on these crops as a major source of energy and nutrients and contribute to food security by increasing the availability of nutritious foods.” ( Avnee, Sood, Chaudhry, Jhorar &Rana, 2016). A study conducted on 246 children between the ages of 12-16 years in Maharashtra by feeding them Bhakri (a type of roti) made from iron-rich and conventional pearl millet grains, demonstrated that the group that was provided with the iron-rich pearl millet had better iron status. (Yadava, Hossain and Mohapatra, 2018). Another randomized controlled trial study concluded that “Biofortified wheat flour had a good compliance among children and WCBAs. Significant improvement on some of the self-reported morbidity indicators (like reduction in days with pneumonia and vomiting) were reported” (Sarawak, Dhingra, Dhingra, Dutta, Deb, Kumar, Devi & Prakash, 2018)
Biofortification in India
This strategy has also been accepted in the country, where the Indian Institute of Agricultural Research (‘ICAR’) has created a report titled “Biofortified Varieties: Sustainable Way to Alleviate Malnutrition”, which is a compilation of all the cereals (Rice, Wheat, Maize, Pearl Millets etc) that have a biofortified variety that can go into production. This process is also sustainable because unlike hybrid crops produced by multinationals, the biofortified crops can be replanted every year from the pant cuttings or the seeds the farmers have saved. This also reduces the economic burden on farmers to procure seeds every year. Thus, if the government can scale up the production of biofortified seeds of rice and wheat this can be channelized through the Public Distribution System (‘PDS’) and Pradhan Mantri Garib Kalyan Anna Yojana to reach the targeted stakeholders and improve their micronutrient outcomes.
Despite all these positives, we have to understand this is not a permanent fix to the solution. The literature available on this material is new and scientists have not been able to properly study the side effects of the same. Also, biofortification can only successfully solve the problem of micronutrient deficiency, thus it may not have any direct effect on stunting etc. While this remains a very effective way of solving the problem the government should have a holistic vision by promoting traditional crops and recipes to look for a more long-lasting solution.
Sources
Sazawal, S., Dhingra, U., Dhingra, P. et al. Efficacy of high zinc biofortified wheat in improvement of micronutrient status, and prevention of morbidity among preschool children and women - a double masked, randomized, controlled trial. Nutr J 17, 86 (2018). https://doi.org/10.1186/s12937-018-0391-5
Harvest Plus FAQ page https://www.harvestplus.org/biofortification-hub/faqs/#:~:text=Do%20farming%20households%20need%20to,that%20the%20farmer%20has%20saved.
Yadava, D. K., Hossain, F., & Mohapatra, T. (2018). Nutritional security through crop biofortification in India: Status & future prospects. Indian Journal of Medical Research, 148(5), 621-631. doi:10.4103/ijmr.IJMR_1893_18. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366255/
Ministry of Women and Child Development (n.d.). Integrated Child Development Services (ICDS) Scheme. Retrieved from https://wcd.nic.in/integrated-child-development-services-icds-scheme
Avnee, Sood, S., Chaudhary, D. R., Jhorar, P., & Rana, R. S. (2023). Biofortification: An approach to eradicate micronutrient deficiency. Frontiers in Nutrition, 10(2023), Article 1233070. https://doi.org/10.3389/fnut.2023.1233070
Singh, Ummed & Praharaj, Chandra & Chaturvedi, Sushil & Bohra, Abhishek. (2016). Biofortification: Introduction, Approaches, Limitations, and Challenges. 10.1007/978-81-322-2716-8_1. Retrieved from https://www.researchgate.net/publication/314633825_Biofortification_Introduction_Approaches_Limitations_and_Challenges
Ofori, K. F., Antoniello, S., English, M. M., & Aryee, A. N. A. (2022). Improving nutrition through biofortification–A systematic review. Frontiers in Nutrition, 9. https://doi.org/10.3389/fnut.2022.1043655
Howarth, E. Bouis, & Saltzman, A. (2017). Improving nutrition through biofortification: A review of evidence from HarvestPlus, 2003 through 2016. Global Food Security, 12, 49-58. https://doi.org/10.1016/j.gfs.2017.01.009
Ersado, Tariku. (2022). Causes of Malnutrition. 10.5772/intechopen.104458. Retrieved from:- https://www.researchgate.net/publication/360627646_Causes_of_Malnutrition
About the Author
Akhil Pradeep Kumar Menon is a final year student of MA in Public Policy. His areas of interest are Sanitation and WASH, Solid Waste Management, Environment and Sustainability, Agriculture and Nutrition.
Thank you for this discussion! Much needed for an understanding of inclusive growth!
Akhil
Very well researched.
Informative and very useful
All the best
Great article and research on the need to tackle malnutrition through micronutrients!
A practically possible solution, Akhil. 👌✌
Well researched and written article!