1. Nutrition Security in India
Moderator: Dr. Ranjan Solanki
- Dr. Prashant Ghodam

2. Framework Introduction Magnitude of problem
Dimensions of food & Nutritional Security
Nutrition-related public health problems
Nutritional status in India
Assessing Food and Nutrition Security
Initiatives to improve nutritional status
Success stories
Challenges
References

3. Introduction
In India there has been substantial reduction in moderate and severe undernutrition in children and some improvement in nutritional status of all segments of population.
These improvements resulted due to improvement of dietary intake, improved health care and ongoing developmental process, there is still milder form of chronic energy deficiency and micronutrient deficiencies widely prevalent in adults and children.
“Every man, woman and child has the inalienable right to be free from hunger and malnutrition in order to develop fully and maintain their physical and mental faculties.”

4. Introduction
Nutrition security- "Every individual has the physical, economic & environmental access to balanced diet that includes the necessary macro and micro nutrients and safe drinking water, sanitation, environmental hygiene, primary health care & education so as to lead a healthy and productive life". (Science Academies Summit 1996/2009).
Food security- “Food security exists when all people, at all times, have physical and economic access to sufficient, safe & nutritious food for a healthy and active life.” (World Food Summit, 1996)
Education and awareness are needed to utilise these services.

5. Magnitude of problem
The latest FAO estimates indicate that global hunger reduction continues: about 805 million people are estimated to be chronically undernourished in 2012–14, down more than 100 million over the last decade, and 209 million lower than in 1990–92. In the same period, the prevalence of undernourishment has fallen from 18.7 to 11.3 percent globally and from to 13.5 percent for developing countries.

6. Magnitude of problem

7. Magnitude of problem
 India has made some progress in reducing poverty level, but still ranks behind neighbouring Nepal and Sri Lanka on the Global Hunger Index and its hunger status remains classified as "serious".  India was at 63rd position in the global hunger index (GHI) last year. The 55th (out of 76 countries) position in 2014 is better than Pakistan (ranked 57) and Bangladesh (57), but trails behind Nepal (44) and Sri Lanka (39).  

8. Dimensions of food & Nutritional Security
Availability (food supplies): physical existence of food, be it from own production (household level) or from markets (regional or national level).
Access- sufficient resources to obtain appropriate foods for a nutritious diet. It is dependent on the level of household resources—capital, labor, and knowledge and on prices.
Utilization- Utilization has a socio-economic and biological aspect. If sufficient and nutritious food is both available and accessible:
socio-economic-
households make decisions/choices on what food to consume (demand) and how the food is allocated within the household
Unequal distribution leads to suffering from food deficiency; the same is true if the composition of the consumed food is unbalanced;

9. Dimensions conti…
biological utilization of food – Focused at the individual level food security, which refers to the ability of the human body to take food and translate it into either energy that is used to undertake daily activities or is stored.
Stability (sustainability): temporal dimension of nutrition security.
Chronic food insecurity- the inability to meet food needs on an ongoing basis
transitory food insecurity- the inability to meet food needs on a temporary basis. e.g. droughts or floods, civil conflict.

10. Nutrition-related public health problems
Chronic energy deficiency and undernutrition
Micro-nutrient deficiencies
Anaemia
Vitamin A deficiency
Iodine Deficiency Disorders
Chronic energy excess and obesity

11. Nutritional status in India

12. Nutritional status in India

13. Nutritional status in India

14. Nutritional status in India

15. Nutritional status in Maharashtra

16. Assessing Food and Nutrition Security
Clinical examinations
Laboratory methods
Anthropometry:
The weight-for-height:- Wasting.
The height-for-age :- Stunting. Therefore it is used as a good indicator for poverty in general.
The weight-for-age :- Underweight.
Mid-upper-arm-circumference (MUAC):-acute malnutrition. Should be >13.5 cm
Body-Mass-Index (BMI).

17. Initiatives to improve nutritional status
Increasing food production
Improving food distribution
Food supplementation
Nutrition education
Prevention and treatment of undernutrition & micronutrient deficiencies and their health consequences

18. Initiatives to improve nutritional status
Increasing food production :- NFSM (October 2007). During 12th FYP with new targets of additional production of food grains of 25 million tons of food grains comprising of 10 million tons rice, 8 million tons of wheat, 4 million tons of pulses and 3 million tons of coarse cereals.

19. Initiatives conti.. Improving food distribution-
Public Distribution System (PDS):- It is a government- sponsored chain of shops entrusted with the work of distributing basic food and non-food commodities to the needy sections of the society at very cheap prices.
The Targeted Public Distribution System (TPDS) In 1997, Provides 35 kgs per month of subsidised food grains at half the cost of the economic price to all families identified as living below the poverty line (BPL families).
Antodaya Anna Yojana: ( 2000) food-based assistance to destitute households. special grain quotas at highly subsidised prices provides 35 kgs of rice per month at Rs. 3/- per kilo or 35 kgs of wheat per month at Rs. 2/- per kg. This is to around 40% of the poorest of poor families.

20. Initiatives conti..
Food supplementation :- to address special needs of the vulnerable groups-Integrated Child Development Services (ICDS) was initiated in Children up to 6 years should be provided 300 calories and grams of protein; adolescent girls 500 calories and grams of protein per day and pregnant and nursing mothers 500 calories and grams of protein per day. Undernourished children are entitled to double the daily supplement provided to the other children (600 calories and/or special nutrients on medical recommendation).

21. Initiatives conti..
Nutritional Support To Primary Education (popularly known as the Mid-day Meal Scheme): Nutritional Support to Primary Education was launched in 1995 as a 100 per cent centrally funded, Centrally Sponsored Scheme. Under this scheme, all school children in the primary schools in government and government aided schools are to be covered Cooked meals with a minimum content of 450 calories and 12 grams of protein are to be provided on each working day of the school.
The Mid-day Meal Scheme has recently been expanded to cover children in upper primary schools too.
Nutrition education especially through Food and Nutrition Board (FNB) and ICDS

22. Initiatives conti..
The National Anaemia Prophylaxis Programme : - was initiated in 1972
The National Iodine Deficiency Disorders Control Programme : making it mandatory for all manufacturers of edible salt to iodise their product.
National Prophylaxis Programme Against Nutritional Blindness :- In 1970

23. Success stories

24. Chhattisgarh vs India

25. Chhattisgarh vs India

26. Chhattisgarh vs India

27. Chhattisgarh vs India

28. Chhattisgarh vs India

29. Challenges Starvation deaths & farmers’ suicides
Stagnant agricultural production, and falling food availability
Unemployment
Regional disparities
Low levels of household income
High and rising retail price of food
Problem mainly for poor households
Anemia in Women and malnutrition in children's

30. References
National food security mission, Ministry of Agriculture, Government of India.
FAO, IFAD and WFP. 2014,The State of Food Insecurity in the World. Available from:
Planning commission. Chapter 3.3. Food and nutrition security. Tenth five year plan Available from:
Department of Food and Public Distribution. .pdf
National nutrition monitoring bureau. National institute of nutrition. Indian Council of Medical Research. Hyderabad Available from: Nutritional_St.pdf
UNICEF, State of World Children Available from: 
Department of Women and Child Development. Integrated Child Development Services (ICDS). Available from: 
Ramachandran P, Gopala HS. Assessment of nutritional status in Indian preschool children using WHO 2006 Growth Standards. Indian J Med Res. 2011;134:5–11.