Dr. Rajesh Kumar, Former Mission Director, POSHAN Abhiyaan talks about India’s flagship nutrition programme, why we have a lot to learn from Northeatsern states on how to reduce anaemia and stunting, double burden of malnutrition, and Outlook Poshan initiative.
To know more about Outlook Poshan, see https://poshan.outlookindia.com/
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To know more about Outlook Poshan, see https://poshan.outlookindia.com/
#Poshan #OutlookPoshan #OutlookMagazine #OutlookGroup
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00:00 My experience with Poshan Abhiyan has a mixed feeling left in me.
00:16 To conceive Poshan Abhiyan, let me be very frank, I did not have time.
00:24 I still remember on 27th February 2015 when I joined and had a courtesy call with my secretary.
00:31 He told me that I am not putting pressure on you but you have to give a draft paper
00:38 on National Nutrition Mission.
00:41 National Nutrition Mission is now called as Poshan Abhiyan and I had taken about 10 days
00:50 time to put a concept and a paper with hardly any background of ICDS scheme.
01:04 In that concept paper, we had tried to introduce complete provision of growth monitoring devices
01:17 for taking weight, height and length and also digitalizing the Anganwadi centers and removing
01:26 11 registers by providing their smart phones.
01:33 That base paper conceived in a span of less than 10 days is now what is Poshan Abhiyan.
01:40 I was searching around for fund in 2-3 days time as told that it is a failed World Bank
01:45 project, they used to call it SNIP.
01:48 It was rolled out in December 12 and it was to close by December 15 with hardly any disbursal.
01:57 So in April 15 when we had a meeting with the World Bank, we could convince them to
02:05 restructure the World Bank project which happened in a very short time by 29th September 2015
02:10 it happened and we concurrently worked with the Bill and Melinda Gates Foundation to evolve
02:15 a structure to introduce ICDS common application software.
02:21 Having done that, we restructured the project and introduced this system into 8 pilot states
02:26 under SNIP and once the Poshan Abhiyan was approved by government on 30th November 2017,
02:33 it has been decided to go across the country and now it is being implemented in all the
02:41 districts and I personally feel quite satisfied that this technology which will revolutionize
02:50 the entire health and nutrition system, more particularly nutrition sector is as on date
02:57 the largest mHealth platform on this planet is going to evolve and evolve.
03:06 A small introduction about an event we organized with the World Bank, Lighthouse India where
03:13 about 12 countries came from Latin America, Africa and South Asia and to my memory 9 to
03:21 10 countries wanted to replicate what we are doing in Poshan Abhiyan.
03:25 Of course by dove tailing with their national policy schemes, we wish that India can lead
03:32 the other countries also while we are ourselves trying to tackle malnutrition in a very big
03:42 manner.
03:43 North-Eastern state have a different kind of ethnic profile, socio-cultural norm and
03:54 we have to learn a lot from them.
04:00 The people there are educated, even in very remote and hilly areas you will find children
04:06 going to school with proper uniform, even a necktie and bag and almost every child goes
04:13 to school.
04:14 The personal household level sanitation is very very high.
04:18 There is a concept of sanitation, there is a concept of taking bath every day.
04:26 They have toilets, may not have sewage but they have toilets.
04:32 Their dietary diversification is very good.
04:36 They are not born to ritualistic vegetables or fruits or other thing we eat.
04:43 There is a lot of biodiversity there, even a vegetarian gets access to good fruits and
04:50 diverse vegetables.
04:52 Their rice locally is rich.
04:55 They do not indulge into too much of spices and oil, greasy food.
05:00 They are physically active so you will not find obese people too many and also egg consumption
05:08 is very very high.
05:09 Places where milk is there they take milk but otherwise egg itself is good.
05:14 Majority of them are non-vegetarian so there is a balance of non-veg and veg.
05:20 And one should understand that iron and folic acid alone cannot tackle anemia because hemoglobin
05:26 is formed of a heme ring in medicine.
05:29 They call it a square ring where iron is the center and like four strands of thread, the
05:35 globin is a protein.
05:36 So if you don't give protein, hemoglobin will not be formed.
05:39 And for protein you need A class protein so a good mix of milk, egg and non-veg helps
05:45 them have proper hemoglobin level and that is how this anemia you can say that is not
05:51 so prevalent.
05:52 Of course there are pockets of anemia in tea garden which is very very deprived corner
05:56 area in Assam.
05:57 Meghalaya also has little problem but otherwise most of the states are doing very very well.
06:04 Sikkim is a state which is one of the best in country for sanitation besides education
06:11 and sanitation is the first culprit in causing frequent infections especially gastrointestinal
06:18 infection and bringing down the health level and in turn the nutrition level goes down.
06:25 So one should learn from Sikkim but not only Sikkim you should learn from the entire North
06:29 East that how to have a clean life, educated life, proper breast feeding and a balanced
06:39 diet.
06:45 The double burden on malnutrition is a real challenge before all of us.
06:51 We are talking of undernutrition and stunting which is 38.4% as per 15-16 survey.
06:57 20% people have obesity, hypertension.
07:04 India has become a diabetic capital in the world.
07:06 About 10% people have impaired sugar level or deficiency insulin.
07:12 It is a huge challenge.
07:15 I think we have to come out with radical solution in tackling the overnutrition part, the high
07:21 BMI, the obese people.
07:24 Indian diet is not as good as I was describing about our North East.
07:29 We must learn how to minimize on grease and fat.
07:33 We must also minimize on deep fried food which we are very fond of.
07:41 The pickles in rest of India and North East are made differently.
07:45 Our pickles are source of also oil and fat.
07:48 The sugar and sweet consumption which we have so much, we can't live without the
07:52 sweets.
07:53 It is not so good.
07:57 And also we need to ensure that the junk food by multinationals are not promoted.
08:02 The Ministry of Women's Child had advocated strongly that junk food should not be sold
08:07 nearby school, in the school.
08:10 The HRD Ministry gave instruction but how much is followed up.
08:13 We should learn from Kerala.
08:14 There is higher tax on junk food but there is a time to educate, bring about behavioral
08:21 change, educate people not to go for junk food.
08:26 McDonald is the biggest artery clogger of heart.
08:30 Educated Americans don't eat but we can't live without McDonald.
08:33 When we go abroad also we will be searching somewhere, especially vegetarians, some burger,
08:36 some chips.
08:37 So that's the problem.
08:40 And lifestyle is the last.
08:42 You have to be physically active.
08:44 You should learn to walk, you should learn to cycle, reduce using cars and once you start
08:50 walking short distances, once you start using cycles, I think your health status will improve
08:57 both ways.
09:03 The phrase development partner is overhyped.
09:10 I am saying with whatever experience I have got, we are all here with a common cause but
09:18 it is the citizens, the state and the nation which decides.
09:26 In Europe or America, we don't have a scheme like ICDS or midday meal scheme.
09:31 They don't need it.
09:33 We are very proud that we are running the largest child nutrition, school nutrition
09:38 program because we need it.
09:41 The day you evolve, your economy develops.
09:44 You have purchasing power, you have access to the safe nutritious food, you have access
09:49 to the right kind of vegetables and fruits.
09:51 If you have a balance of veg and non-veg, if you have milk which is produced but not
09:56 consumed is consumed, resources to buy milk, I don't think you need much of the things
10:02 but development partners are important because we are not living in an isolated world.
10:06 It is a global village.
10:08 We do need support of partners into vaccination programs.
10:13 We need their support as of now at least into good capacity building programs.
10:19 The support in associating with the grass root level people like self-help group in
10:24 Bihar, large number, lot of partners are there.
10:28 They are doing good work.
10:30 We need technological intervention like BMGF has provided support into ICDS-CAS.
10:36 But ultimately a nation has to rise.
10:38 It has to be self-sufficient.
10:39 It has to have its own resources and I don't think we are short of professionals or educated
10:44 people or competent doctors or IT experts.
10:48 I am aware of medical doctors from India giving tough fight to the native American doctors
10:54 because they are hard working.
10:55 They can work on weekends and they are quite qualified.
10:58 The best goes to America.
11:01 Best of the professional IT are also working in global multinationals.
11:05 So yes partners are important.
11:07 UNICEF is important.
11:08 WHO is important.
11:09 But they also got a job.
11:10 We are also having a job as a nation.
11:11 We should stand up and do our own job.
11:17 A great initiative.
11:21 Outlook is the first weekly which has started this program.
11:29 It's a novel program to my mind.
11:31 Nobody has done it globally, not about India only.
11:35 I compliment your editor-in-chief Mr. Ruben Banerjee.
11:41 And also I want to place on record the efforts made by Mr. Basanta Karo of PCI who stimulated
11:48 and initiated and convinced Mr. Banerjee to take up.
11:51 This is a great, great program.
11:53 I wish other media houses also come forward not to compete with you but to collaborate
11:58 with you in the great initiative portion of YARN because it has to be a mass movement
12:02 and everybody has to join hands.
12:04 And all mediums of communication, not only a magazine or a TV or a website has to do
12:09 but you are doing great and you will do greater.
12:11 Anybody whose thinking is doing great for promoting sanitation, health and nutrition
12:17 or any other social cause which has direct or indirect bearing on improving nutrition
12:22 status should apply.
12:23 But jury will take a fair call.
12:26 And I don't want to bias the people.
12:28 I think everybody should apply.
12:29 Even if you are not eligible you can apply.
12:31 The jury will see whether you are eligible or not.
12:34 So I think it's free for everybody.
12:35 [MUSIC PLAYING]