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NATIONAL NUTRITION POLICY I ~II<t<1"IIiI 1993 GOVERNMENT OF INDIA DEPARTMENT OF WOMEN & CHILD DEVELOPMENT MINISTRY OF HUMAN RESOURCE DEVELOPMENT NEW DELm CONTENTS I.

Introduction II.

Need for a Nutrition Policy within the Development context Ill.

The Nutrition Status of India.

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IV.

The Existing Policy Instruments for combating Malnutrition.

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V. Nutrition Policy Instruments.

VI.

Administration and Monitoring.


INTERVENTION PROGRAMMES TO COMBAT MALUNTRITION PAGE No.

1 1-2 2-5 5 6-10 10-12 13-25 I.

Introduction NATIONAL NUTRITION POLICY Widespread poverty resulting in chronic and persistent hunger is the single biggest scourge of the developing world today.

The physical expression of this continuously re-enacted tragedy is the condition of under-nutrition which manifests itself among large sections of the poor, particularly amongst the women and children.
Under nutrition is a con4ition resulting from inadequate intake of food or more essential nutrient(s) resulting in deterioration of physical gT9wth and health.

The inadequacy is relative to the food & nutrients needed to maintain good health, provide for growth and allow a choice of physical activity levels, including work levels, that are socially necessary.
This 'condition of under-nutrition, therefore, reduces work capacity and productivity amongst adults and enhances mortality and morbidity amongst children.

Such reduced productivity translates into reduced earning capacity, leading to further poverty, and the vicious cycle goes on (figure 1 below).

, The vicious cycle of Poverty Poverty r Impelred Prod8dIftty \ SiDaII.
Body size f1I Adults Low intake of food " Nutrients 1 Undemutrltion Repeated Insults from Nutrition , related diseases " lDfedions :/ Stunted Dev.

of CbUdrea " Growth faltering Figure 1 The nutritional status of a ropulation i$ therefore critical to the development-and well being of , a nation.

D. Need for .

Nutrilloa Polky within &beDevelopmtDtContext:, The need for a National Nutrition Policy is implicit in both the paramountcy of nutrition in development as well as in tbe complexity of the problem.
This general problem of under-nutrition should be ICen as a part of a larger set of processes that produces and consumes agricultural commodities on farms, trans(orms them into food in the marketing sector and sells the food, to customen to satisfy nutritional, aes:hetic and social needs.

Within this set, there are three sub-sets 1 .....---- of issues, within the broad sectors of agriculture, food and nutrition, with various linkages among them.

In fact, the third subset, viz.


Nutrition, is the net- result of the other two su\:)sets(figure 2 below).

2 Politics 'Urban Rural Intermediate L Mark~t Prices Subsistence Fanning Direct Consumption Feedina Changing tastes Environment Groups Figure 2 a-n. Land Labour Water T edIIIoIau Biological Chemical MedwIical i Crop Choice It is both possible as well as necessary to devise policy interventions for influencing the working of these sets and thereby improving the nutritional status of the society.
The nature of linkages determine the fate of such interventions.

The diagram above gives the various linkages of these three sub-systems,determining the nutrition status of a society, and it underscores the complex and multi- dimensional nature of the problem of nutrition.

For instance, post independence India has a proud record of achievement in food production.
From being a deficit nation, depending on food imports in the sixties, to having become surplus in foodgrains in the eighties, is a saga of concerted agricultural research, extension work and development, resulting in a dramatic productivity increase.

And yet, from all accounts, endemic malnutrition and ill health resulting from malnutrition continue to stalk the country.

It IS this stark reality that underscot;esthe need for a nutrition policy.
Increased food production does not by itself necessarilyensure nutrition for all.

According to, the 1978-88 round of NSS, nearly 29.2% of India's population..isestimated to be below the defined poY~rtyline.

While, at the matro-Ievel, this group constitutes the nutritionally at risk population, eyen within this,group the women arid the children represent nutritionally the most fragile and vulnerable sections.
This is the result of intra-household gender discrimination, which perpetuates the age old inequities.

All this emphasise the complexity of the problem and the need for tackling the Nutrition Policy consciously and at several levels siml1ltaneously.Mere economic development, or even the adequacy of food at household levels, are no gurantees for a stable and satisfactory nutritional status.
At the same time, however, the overall development strategy of a country is likely to have a pronounced beal"ingon what nutritional planning can accomplish.Therefore, the task is not merely in terms of formulating a nutrition policy but also in terms of locating and grounding it in the overall development strategy of the country.

Nutrition has to be tackled independently, alongwith other development issues.

This is not all.

The time dimension is also important.


A Policy having a mere long term effect, even if bepeficiatfor the nutritionally at risk population, would not suffice.

After all, this group has too little 3 to live on in the long run and has too much to die of in the short run.

Therefore.

both short as w.cll as long term strategies, arc called for.

comprising bOth direct as well as indirect interventions, III.
The Nutrition Status of IRdia: (A) The Aggregate Position Regardillg'lntake: (1) Calorie & Protein Intake:-There has been a steady increase in aggregate consumption of caloriesat household level (Table 2).

During 1957-79, in urbanareas,the aggregate intake levels of protein were above the ICMR recommended level for all income groups except slum dwellers, Eve-n in rural area's.
between 1975and 1989,aggregate consumptionlevels of all groups taken together were 1tigher than the recommendedlevels.In fact, time trendsshowthat the average intake of calories a1 the lowest income group had a definite increasing trend during the seventies (Graph 1).

However, there has not been a commensurate increase in consumption of proteins and protected .foods like fats and oils (Table 1).

Dietary patterns have also remained largely unchanged despite' increase in calorie consumption.
rhe bulk of calorie intake increase is ascribed to the intake of cereals.

Some disaggregate data" regarding rural areas show the" vulnerability the landless agricultural labour "famili.esevenaslate as in 1979when the Green Revolu:tion was well under way.

qrought years have.witnessed marginal decreases in the aggregate consumption of proteins and high energy foods (Table n. of (2) Mlcr~nutrient Intake:-During 1975-79,in urban areas.
aggregate.intake levels of Iron were above the ICMR rccommendeo levels for all groups.

For Vitamin "Au.

however.

deficiencies existed among all .groups except the High IncomeGroups.

(B) The Dis-aggregated Picture Although, the NNMB reports regarding average household food consumption levels do not point to any significant intake'shortfall except for Vito "An, these average figures actually mask the real picture.
According to a NNMB-NSSO Survey, even at an aggregate level in terms of monthly household income.

food expenditure of the sampled families .

(Figure 3: NNMB 1983-84 below:) 34% of household earn considerably less than the >verage around Figure 3.

NNMB-NSSO Survey Data NNMB"NSSO Survey Report.

'Average' per caput food expenditurelmensem NNMB Survey (1988).. HQusenold pet caputlmc.nsem Rs.

73-80 '60%-70% of total Expenditure) <Rs.60 (in 34% of households) Source:-.NNMB (1983-84)-p.6 .
**NNMB Interim Report of Repeat Survey (1988-89) --- Thus, even though_\here has been a drop in the population below poverty linc;since 1960(from 56.8% to 29.2% in 1987-88)in terms of numbers, a staggering250 million people suffer from varying degrees of malnutrition in India.

There is, however, no doub~that the impressive gains of the Green Revolution in terms o!

national food security a~d effective early warning systems have eradicated famines and situations of extreme hunger and starvation.
What still remain are different degrees of chronic and endemic hunger which, in the coli~extof prevailing patterns .of intra-household food distribution particularly in rural families, translate into a grave danger for the nutrition status of women and children.

ThtCiis.

the crux of the nutrition situation in India.


The major nutrition problems of Indi.. can be classified as follows:- (1) Under-nutrition resulting in: (a) Protein Energy Malnutrition (PEM); 4 (b) Iron deficie ncy; (c) Iodine defic,iency fd) Vito "~" deficiency.

(II:) Low Birth Weight Q'Iildren; (2) Seasonal dimensions of Nutrition; (3) Natu ral calamities & the landless.

(4) Markt:t Distortion ~nd Disinformation; (5) urbanisation.
(6) Special Nutritional PlrOblems of Hill People, Industrial Workers, Migrant Work,ers, and other sI.ecial c3ltegories; (7) Problems of Overn utrition, overweight and I')besity for a small section of urban population.

India and much of thie Third World Inutrition status is characterised by varying degrees of For undernutrition for women ,and children.

(1) (a) PEM: Protein E;nergy Malnutrition is the most widespread form of malnutrition among pre-school children of our country.
A majority of them suffer from varying grades of malnutrition.

An many as 43.8* per cent children suffer from moderate degrees of PEM and 8.7* per ce,nt suffer from severe extreme forms of maloutrition.

The prevalence of malnutrition in (:hildren as reported in various survey reports is given in Table 4.

Surveys conducted be*9Viaen1975 a~d 1990 indicated that the percentage of normal children (for both the sexes pooled) has increased from 5.9% to 9.9% while the moderate form of from 47.5% to 43.8%.
The percentage of severely malnourished malnutrition dedined children declined from 15% to 8.7% (Table 4).

The child population of urban slums had the lowest proportion of children with normal body weight and recorded the highest proportion of se:verely malnourished children (Table 4).

Between 1975 and 1990, increase in the percental~e of normal children was appreciable in all the States, except Karnataka and Orissa, where the increase was marginal as spown in Table 4,.
The percentage of severely malnourished children in the States of Oujarat and Madhya PMdesh failed to show any marked upward trend.

.

NNMB, NIN (Table 4) (b) Iron Deficiency: Nutritional Anaemia: Nutritional anaemia among the pre-school children and expectant and nursing mothers is one of the major preventable health problems in It has been estimated in various studies particularly those conducted by NIN that India.
roughly 56 per cent pre-school children and almost 50 per cent of the expectant mothers in the third trimester of pregnancy suffer from iron deficiency, whi!=his basically due to inadequate or poor absorption of iron from a predominantly cereal-based diet.

Low iron intake, the problem.

According to NNMB Report of repeat surveys (1989-90), between 1975 and 1990, a marginal decline of 1.8 mglcu was observed in the mean Iron intake at an over all levels in only Karnptaka, Maharashtra, Gujarat level.
During 1989-90, the intakes were above the RDI coupled with hookworm infestation and Madhya Pradesh.

and infections, aggravates further (c) Iodine Deficiency Disorder In India, ne;nly' 40 million persons are, estimated to be suffering from goitre and 145 million are living in the known goitre endemic regions.

The prevalence of goitre in these endemic to 68.6% in regions It is also estimated that 2.2 million children are afflicted with cretinism and Mizoram.
about 6.6 million are mildly retarded and suffer from varied degrees of motor handicaps.

It is estimated that iodine deficiency also accounts for 90,000 still births and neo-natal deaths every year.

in Assam (Cachar Distt.)

from 1.5 per cent ranges 5 In its severest (d) Vitamin 'At Dencency: Nutritional blindness which affe.
its over seve.n million children in India per year results mainly "from the deficiency of "'itamin A. coupled with protein form, it often result~ nn loss of vision and it has been energy malnutrition.

estimated that around 60,000 children become blind ~\very year (Source: NIPCCD : Situational Analysis of Children: March 1989 : p42).

Vir Imin A defic:iency is as:sessed on the basis of conjuctival xerosis and Bitot's spot.
A stue y Df NNMB bas illdic8Ited that, its prevalence while there were no manifestations of Vitamin A defll ~ency in infants.

a higher prev-Sence was :.een in school age increased with age (Table 5).

Further, it was the hlighest among slum children in all the income groups.

it Ie midole income group (4.7%) children (7.8%), in none of the States and the low income group (4.1 %).

According to NNM1' to the recommend.

:d was the average intake comparable In the urban areas followed by industrial.
labour (6.3%), (1990).

Icv~1.

(e) Prevalence of Low Birth Weight Children: The prevalena status during pregnancy and infan cy.

In India .30% of all of low binlH weight children is still unacceptably high for India.

The nutritional status of 'infants is closcty related to the the mat~rnal nutritional less thaI 2500 ~ms.)

andtb'is pattern is infants born are low birth weight babies (Weight the avc~ragc ibirth weight almost constant ranged between 2.5 and 2 kg.
and the prevalence of low birth weight nmgcdbetween 26 ill the rural communities.

This and 57 per cent in the urban slums and 35 to 41 per cent is a matter of concern since 90 per cent of the deaths 0 :cur among ir.lf.antswith birth weight below 2000 gms.

Low birth weight was found!

0 be connect:d w:iLb~veral factors.

such.

as age of the mother.

maternal weight.

w ~ight gain duling pr~gnancy.

interpregnancy interval.

haemoglobin less than 8 gms.

pel <;:entand matcm!IJ ,illiteracy.

since 1979.


An ICMR study reported that the National Health Policy has set a goal of bringiHg daw».

Keeping in view the fact that birth weight is the most ir 1portant determinant Qf child the maternal nutritional status is the mos!'

decisive factor the low birth weight by 10 per cent and the pf(,~sent .maternal m\'Jrtality rate It w~\s found by in the State of Karnataka.

consunnption of energy by ~D.men survival and that low birth weight.
incidence of from existing rate of 4 per 1000 to 2 per 1000 live births b)' 2000 A.D. the NNMB in 1989 that.

was the highest (2580k calories) and Orissa (2468k Calories).

of calories was .Iess than the recommende~ 2400k calorie~i.

ie.

2992k calories, as compared to that of other States viz.

Wt~st ~gal In the rest of in Pfe~nting the States.

the ColY!iWDption Women face high risks of malnutrition an'd disease at all t he three critical stag'es.
~- infancy'and childhood, adolescence and reproductive phase.

Child mortality ratefigute$ show high rates for female children than their male coumcrparts perhaps indicative of social prejudices leading to neglect" f female babies.

(Table 6).T'his is When girls attain ado.lescence, they go through a second spurt of growth and I'heir bodies grow much more rapidly to prepare them for child bt:aring.

But.
But.

unfortunat,ely, the intake of nutrients during this period is significantly low', the calories and prot tin gaps ranging from 300-400 calories and 2-22 gms.

of protein respectively.

Table 7 gi' 'es the energy and protein intakes of males and femal,cs of different age groups.

It is sc:n that including child.

adolescent and adu.lt population, is very much lower than the recommended level.

The intake of iron is 'also lower than the rer.ommended level in children of all age gjroups.
adolescent girls and\ adult women.

the daily intake of Vito "A" by all age groups, (2) Seasonal Dimensions:- In the duality of the Indian situation.

where high-yielding there are serious seasonal modern agriculture co-exists with rain-fed subsisten,ce farming.

In large pans of Jndi,a.

the rainy months are the dimensions of worst months deweeding.

ploughing and other works demand maximum en'crgy from them.

while food stoe}.s at home dwindle and market prices rise.
These are: again the months when water-borne :ctiseases are so frequent.

This condition goes 01'1aggravating till late October Of even the nutrition question.

for is winen cultivation.

landless poor.

This rural, the 6 indebtedness the months of November.

These are and compulsive market rural involvement of the landless and the small/marginal cultivators.

When the first kharif harvest arrives.

the situation is no better with widespread distress sales by the small/ marginal farmers.
AU these make nutrition a casualty during this period.

Seasonality of in subsistence agriculture affects nutrition through the double jeopardy of employment high energy demand of peak work seasons and fluctuation in household level food food intake among men.

women aod availability, which tend to exacerbate differential children.

As a result.

in very poor household~.

women & children may actually faU below the survival line during lean periods.
(3) Natural calamities It Nutrition:- vulnerable to droughts.

worst affected groups arc the landless agr1cultural non-agricultural in that order.
labourers This san/e group of is most floods and famines; A.s has been established in famine periods, artisans, craftsmen and landless poor labourers, rural (4) Market Distortion & Disinformation:- famines arc caused not A striking feature which has now been established is that in food availability as by a sudden erosIOn of purchasing power of these marginal groups who compulsively depend on the market lessons from all (ood shortage, but the psychosis over the world have proved that it is ~ot any substantial of food shortage and the widespread belief regarding crop failure, that triggers off price rise spirals resulting in majo~ malnutrition situations.
so much by any real decline (landless labourers etc.).

'.

In fact (5) Urbanisation:--.

Under-nutrition in urban areas is a major;area of concern.

St1.

:diesby the nutritional status of urban slum dwellers in India is NNMB have actually shown that almost as bad as that of rural poor.

This is borne out both by figures relating to intake of food (Table 1) as well as intake of nutrients (Table 2 & 3).

The deleterious effects of rural urban movements on nutrition.

,is quite well known.


The children oJ.,urban slum dwellers and of the urban informal sector arc nutritionally fragi~ of all groups.

Uncertainty the most of income' and the absence of informal support systems within .,ociety.

so common to rural areas of India, place nutritional {nany of these families on the very edge of survival.

The fallout6f a spreading urban culture.

which encourages diversion of a high proportion of family expenditure to luxury goods & entertainm.cnt.
acute respiratory infectiens and communicable diseases characterize these urban' settlements.

in much of the third world.

sanitary condi~ions.

aggravates situation.

Poor the (6) There arc some regional and occupational specificities of the problems of nutrition.

The nutritional the special nutritional problems of some categories of Industrial Workers and migra~t workmen are other examples wb1ch need a detailed and specific response.

imbalance of hill people engaged in very strenuous labour.
(7) With the burgeoning size of Indian middle class.

ovcrnutrition with attendants of cardio arc affecting large number of people vascular problems and other health hazards particularly in the cities.

IV.

The Existing Policy Instruments for combating Malu'utrition:- Till the end of the IV PIan.

India's main emphasis was on the aggregate growth of the In the face of economy and reliance was placed on the percolation effects of growth.

cQmprising continuing poverty and malnutrition.


an alternative strategy of development.

and malnutrition.

became a national priority a frontal attacK on poverty, unemployment from the begit1ning of'the V ~Ian.

This shift in strategy has given rise to a number of interventions to improve the provision of basic services to the poor and to' devise a security system threugh which the most vulnerable sections of the poor (viz.

women and children) can be protected.

The various intervention programmes.


that we already have, arc given in the Annexure-I.

to increase the purchasing power of the poor, 7 V. Nutrition Pi,Uey Instruments: issue and needs to be tackled at various is.

to tackle the problem of nutrition both through direct nutrition for specially vulnerable groups as well as through various development .The Strategy: Nutrition is a multi-sectoral levels.

Nutrition affects development as much as development affects nutrition.

therefore.
therefore.

intervention policy instruments which will create conditions for improved nutrition.

Term .Direct Int.

:rventon-Short important A.

It (i) Nutrition Intervention for specially vulnerable JI'CMIPS: is that Ihe silent IlTImunization Programme.

(a)/ ExpandlnR the Safety Net:- oral The Universal Rehydration Therapy and the Integrated Child Development Services (ICDS) have had a considerable impact on.

child survival (lMR for 1989 stood al 91 per 1000) 8nQ extreme forms of malnutrition.
Thc position.

however.

form of hunger and malnutrition continues with over 43.8% (1988-90)* children suffering .

from moderate.

malnutrition and about 37.6% (1988-90)*' from mild malnutrition.

an overwhelmingly large number Therefore.. while more children are surviving'today.

them arc destined to remain much below their genetic potential.

This is the of the next enormity of the demographic century.

There is.

an immediate imperative to substantially expand the.

therefore.
therefore.

Nutrition intervention net through ICDS so as to cover all vulnerable chitdrcn in the age group 0 to 6 years.

Presently.

India's child population for 0-6 years is around 18% of the total population and.

out of this.

30.76 million comprise the children from the households living below the poverty line in rural areas.

Presently ICDS covers It should be our around 15.3 million children (most of them in the rural areas).

conscious policy to.

cover the remaining 15.46 million children.


who arc nuJritionally at risk.


by extending ICDS to all the remaining 2388 blocks (5153 minus 2765 blocks existing) of the country by, the year 2000. trap which faces us as we move towards .Source: Nutrition News Vol 12 No.3 May 1991 (NIN) (b) With the objective of reducing the incidence of severe and moderate malnutrition by half by the year 2000 A.D. a concerted effort needs to be made to trigger appropriate Improving growth monitoring between the agc behavioural changes among the mothers.
is a key group 0 to 3 years in particular.

with closer intervention.

'Presently.

growth monitoring has become a one-way process and the mothers.

arc mere passive observers of the entire process.

This needs to bc changed because.

after all.

nutrition management of the children will have to bc done by the mothers at home.

Getting involved in the growth monitoring of her child will give her a feeling of control <,vcr the child's nutrition process and.
combincd with adequate nutrition and health education.

to manage the nutrition needs of her children effectively.

involvement of thc mothers.

empower her initiative: of including the (c) Reachinc the Adolescent Girls:- The Government's they are made adolescent girl within 'the ambit of' ICDS should be intensified so that ready for a safe motherhood.
their n~tritional status (including iron supplementation in the body) is improved and they are given some skill upgradation training in home-based skills and eovered by non-formal education.

particularly nutrition and.

health education.

All adolescent girls from poor families should be covered through the ICDS by 2000 A.D. in all CD blocks of the country and 50% of urban slums.
recent (d) Ensurinl better coverage of expectant women:- In order to achieve a target of 10% sueh coverage should include supplemen- incidence of low birth weight by 2000 A.D.. tary nutrition right from '1st trimester and should continue during the major period of lactation.

at least for the first one year after pregnancy.

\ (ii) Fortification of Essential FoocIs:- Essential food items shall be fortified with appropriate for example, salt with iodine and/or iron.

However.
However.

given the highly extensive nutrients.

8 and decentralised proccs~ of salt marketing in the country, there is the need to identify a vehicle which can be better controlled.

Rescarch in iron fortification of rice and other the cereals population in endemic areas of the country to reduce the iodine defictcncy to below endemic levds.

should be intensified.


The distribution of iodised salt should cover all (iii) Popularlsation of Low Cost Nutritious Food:- Efforts to produeea'nd cost nutritious It intensified.

foods from indigenous and locally available raw material is necessary to involve women particularly in this activity.

popularise !&w- shall be (iv) Control of Micro-Nutrient Defidendes amongst vulnerable Groups:- Deficiencies of ViI.

"An, iron and folic acid and iodine among children.
pregnant women and nursing to mothers shrill be controlled through intensified programmes.

adolescent girls shall be introduced.

The programme shall be expanded to cover all eligible members of the community.

The prophylaxis programme, at present, do not cover all children.

For example, the ViI.

..Au programme co~ers only 30 out of about 80 million.

It is necessary to intensify all these efforts and work on a specific time frame.

should be completely eradicated by the year 2000 A.D.
The Nutritional blindness National Nutritional Anaemia and strengthened to reduce anaemia in expectant women to 25% by 2000 A.D. Iron supplementation Prophylaxis Programme extended should be B.

Indirect Polley Instruments: Long Term Inslitutional & Structural Changes:- (i) Food Security: In order to ensure aggregate food sccurity.

a per capita availability of 215 kg/person/year of foodgrains needs to be attained.
This requires production of 250 million tonnes of food grains per year by 2000 AD and buffer stocks of 30-35 million (Table 8).

tonnes Howcver, improved availability of non-cereal there should be a target of at least attaining 230 Million tonnes to guard against exigencies.

such as flood and droughts food grains production by 2000 A.D. trends and the possibility of taking into account the present food items.

(Table 9).

in ordcr this purpose.


the latest and improved techniques (ii) Improvement of DIetary pattern through Production and Demonstration: .Improving the dietary pattern by promoting the production and increasing the per capita availability of nutritionally rieh foods.

The production 'of pulses.

oil~eeds and other food crops will be increased with a view to attai!'.

;~~ self sufficiency and building surplus and buffer stocks.

The production of protective food crops.

such as vegetables.
such as vegetables.

fruits, milk, meat, fish and poultry.

shall be augmented.

Preference shall be given to growing foods.

such as millets, legumes, vegetables and fruits (carrots, green leafy vegetables.

guava.

papaya and amla).

For shall be increasingly food crops developed and extensively cultivated.

applied, high-yielding varieties of adequate extension services mnd~ available to farmers.
wastage of food in transit and storage reduced to the mif!im~m, available food con~erved and effectively utilised and adequate buffcr stocks built up.

Certain imbalances and anamolies in our agricultural policy need to be redJ:essed immediately.

Our Agricultural Policy has been hitherto concerned with production exclusively and not nutrition.

which is the ultimate end.


Whiie the Green Revolution has largely remained a cereal revolution, with bias towards wheat, coarse grains and pulses, which constitute the poor man's staple & protein requirements, have not received adequate attention.

The prices of pulses, which were below cereal prices before the Green Revolution.

are now almost double the pricp..of cereals.


Our Food Policy should be consistent with our national nutritional needS find this cans for the introduction of appropriate Incentives.

pricing and taxation policies.

(iii) Policies for Effecting Income Transfers so 9S to improve the entitlement package of the rural and urban poor.
(a) Improving the purchasing the Integrated Rural Development Programme and employment generation schemes like Jawahar Rozgar Yojana, Nehru Rozgar Yojana and DWCRA are to power: Poverty programmes, alleviation (IRDP) like 9 lowest economic .nutritional benefits of income genenuion segments of objectives the population.

shall be least 100 days is created for each rural shall be scrutinized for their nutrition component.
be re-oriented and restructured to make a forceful dent on the purchasi~g power of In all poverty alleviation the programmes.

the incorporatt1d explicitly and nutritional shall be taken for granted, Existing It is necessary to programmes improve the purchasing power of the landless and the rural and urban poor by so that additional employment implemen'ting employment generation programmes of at landless family and employment are created in urban areas for slum dwellers and the urban poor.
opportunities through the system.

The Public ,distribution system shall expansiQn of the public-distribution ensure food artich:s. such a.~ coarse grains, pulses and Jaggery, beside'!

rice.

wheat.

sugar and oil; conveniently and at reasonable prices to the public.

particularly to those living below the poverty line.

"ot only in urban areas but throughout shall be given to the consumer cooperatives and fair price shops shall be opened in adequate in all areas.
.Effective price and quality control shall be exercised over the number cooked foods in restaurants I'or this purPOse.

encouragement and other eating places.

availability of essential the country.

(b) Publit Distribution System: Ensuring an equitable food distribution, The Public Distribution Systel'!'

should be strengthened especially during the monsoon months for 'giving special rations at specially subsidized rates for at least four months (July - October) risk" population.
The beneficiaries of this programJ1\eshould inclUdelandless labourers and their families and the migrant labourers and their families.

seasonally to the hat (iv) Land Reforms: Implementing land reform measures so that the vulnerability of the landless and the landed poor could be reduced.

This will include both tenural reforms-.s.

.

well as implementation of ceiling laws, (v) Health & Family Welfare: The health and family welfare programmes are an inseparable part of the strategy.
Through "Health for All by 200pAD" programme.

increased health and immunisation facilities shan be provided to all.

Improved pre-natal and post-natal care to ensure safe motherhood shall be made accessibleto all women.

The population in the reproductive age group shall be empowered.

through education.

to be responsible for their own family size.


Through intensive family welfare and motivational measures: small family norm and adequate spacing shall be encouraged so that the food available to the family is sufficient for proper nutrition of the members, (vi) Bask Health and Nutrition Knowledge: Basic health and.

nutrition knowledge.

with special focus on wholesome infant feeding practices, shall be imparted to the people extensively and effectively.
Nutrition and health education concepts shall be effectively integrated into the school curricula, as' well as into 211nutrition programmes.

Nutrition and Health Education are very important the problems of Overnutrition also.

in the context of (vii) Prevention of Food A~ulteration: Prevention of food adulteration must be strengthened by gearing up the enforcement machinery.

(v.iii)Nutrition Su"eiUance: Nutritio:'l surveillance is another weak area requiring immediate attention.
The NNMBININ of ICMR nC('!is to be strengthened so that periodical monitoring of the nutritional status of children.

adolescent girls, and pregnant and lactating mothers below the poverty tine takes place through representative samples and results are transmitted to all agencieS"concerned.

The NNMB should not only try and assess the impact of ongoing nutrition and development programmes but also serve as an Early Warning System for initiating prompt action.
Since the Department of Women & Child Development is the nodal Department for National Nutrition Policy, it is necessary for the NNMB to be accountable &0this Deptt.

in so far as.

Nutrition Surveillance is concerned.

10 (ix) Monitoring of Nutrition Programmes: Monitoring of Nutrition Programmes (viz ICDS), and of Nutrition Education aQdDemonstration by the Food & Nutrition Board, through all its 67 centres & field units, should be continued.
The transfer of Food & Nutrition Board to the Department of Women & Child Development has already been approved by the Prime Minister.

This will ensure an integrated set up to deal with the problem of nutrition with adequate technical & field~level set up.

(x) Research:.Research into various aspects of nutrition, both on the consumption side as well as the supply side, is another essential aspect of the strategy.
Research must accurately identify those who are suffering fr~m various degrees of malnutrition.

Research should enable selection of new varieties of food with high nutrition value which can be within the purchasing power of the poor.

(xi) Equal Remuneration: Special efforts should be made to improve the effectiveness of progr"mmes related to women.

The wages of women shall be at par with that of men in order to improve women's economic status.
This requires a stricter enforcement of the Equal Remuneration ~ct.

Special emphasis will have to be given for expanding employment opportunities for women.

(xii) CommunIcation:Communication through established media is one ()f the most important strategies to be adopted for the effective implementation of the Nutrition Policy.

The Department of Women,and Child Development will have a well-established, permanent Communications Division.

with adequate staff and fund support.


While using the communication tools.

both mass communication as well as group or inter-personal communication should be used.

Not only the electronic media but also folk and print media should be used extensively.The existing facilitiesin the Song and Drama Division and the Directorate of Advertising and Visual Publicity (DAVP) in the Ministry of Information and Broadcasting could help in a big way to improve nutrition and health education.
To give a new direction to communication and media, efforts will be made for promoting sound feeding practices, which are culturally acceptable and /based on local food habits.

Alongside the information gap, existingsocial attitudes am1prejudices, inherent in our milieu, whiCh discriminate against girls and I women and affect their health and nutrition, need to be countered through educational programmes.
Further, the media policy shall focus on ways and means to combat malnutrition among girl children, adolescent girls and women in the reproductive age group.

Educational programmes will be made meaningful and interesting to meet the growing needs of the population.

The role of information is crucial for nutrition.

Such information is not only important with regard to improved health and nutrition practices but can also have a vital influence on the market, particularly during natural calamities, war etc.
The role of information during such exigencies is to ensure that the market remain stable without any panic being created.

This also needs to be carefully monitored.

(xiii) Minimum Wage Administration: Closely related to the market, is the need to ensure an effective.

minimum wage administration to ensure its strict enforcement and timely revision and linking it with price rise through a suitable nutrition formula.

A special legislation should.


be introduced for providing agricultural women labourers the minimum support, and atleast 60 days leave by the 'employer in the last trimester of her pregnancy.

ExcessIveloss of energy during the working seasons has serious nutritional implications.

The legislation should take care of this problem also.
(xiv) Community Participation: The active involvement of the community is essential not only in terms of being aware of the services available to the community but also for deriving the maximumbenefit from such servicesby giving timely feedback necessary at all levels.

After all, communication must form an essential part of all services and people themselves are the best communicators.
Community participation wUl Include: (a) Generating awareness among the community regarding the National Nutrition Policy and its major concerns; ~ 11 (b) involving the community through their Pimchayats or.

where Panchayat do not exist, througl1beneficiary committees in the management of nutrition programmes.

and interventions related to nutrition.

such as employment generation.

land reforms, health, education etc.

: (c) actua) partic~pation,particularly of women.


in food production and processing acthdties, (d) promoting schemes relating to kitchen gardens, food preservation.

preparation ot weaning foods and other food processing units.

both at the home level as well as the commdnity levels;.

and (e) Generation of effective demand at the level of the community for all services relating to nutrition.
(xv) Education lit Llterac:y: It has been shown that Education & Literacy particularlythat of women, is a key determinant for better nutritional status.

For instance, Kerala State which has the highest literacy level, also has the best nutrition status despite the fact that calorie intake in Kerala is not the highest among all States in the country.
(xvi) Improvement ot the Status of Women:- The most effective way to implement Nutrition with mainstream activities in Agriculture, Health, Education and Rural Development is to focus on improving the status of women, particularly the economic status.

After all, women are the ultimate providers of fiutrition to householt;lsboth through acquisition of .1ood as well as preparation of food for consumption.
There is evidence that women's employment ,does beneficial household nutriti0n, _both through increase in household income as well as through an increase in women's status, autonomy and decision-making power.

Morever,.

female education also has a strong inverse relationship with IMR.

Educated women have greater roles in household decision making, particularly those relating to nutrition and feeding practices.
Therefore emphasis on women's employment and education particularly nutrition and health .educationshould provide the bedrock of the nation's nutritional intervention.

If a self sustaining development model is to be pursued in which the community is able to manage its nutrition and health needs on its own.

The socio-economic security of women is sine qua non.

This underscores the importance of improving the employment status of womeil.

The groundswell of voluntary action created through the.
National Literacy Mission should be harnessed and channelised into the areas of child survival and nutrition.

VI.

Administration and Monitoring 1. implementation of National Nutrition Policy: (a) The measures enumerated above have to be admi'1isteredby several ministries/departments of the Government of India and various governmental and non-governmental organisations.

There should be a close collaboration between the Food Policy, the Agricultural Policy.
the Health Policy, the Rural Development Programme and the Nutrition Policy as each the Education Policy, complements the other.

The NNP should immediately be translated into forceful.

viable and realistic sectoral action programmes.

Special working groups-shall be constituted in the Deptts.
of Agriculture, Rural Development, Health, Education, Food and women & Child Development to analyse the nutritional relevance of scctonll proposals and to incorporate nutritional considerations in the light of the Nu.rition Policy wherever necessary.

Each concerned Central Ministry shall implement the measures for which it has direct or nodal responsibility.
(b) An Inter-Ministerial Co-ordination Committee will function in the Ministry of Human Resource Development under the Chairmanship of Secretary, Department of Women and Child Development, to oversee and review the implementation of nutrition intervention measures.

Sectoral MinistriesIDeptts.

concerned, like health and Family Welfare, Education and Agriculture, Food and Civl supplies etc., will be represented pn the Inter-Ministerial Co-ordination Committee.

The Committee will meet once or twice a year.


The Co-ordinati0n Committee would be constituted with the sectoral representatives or administrators essential for decision making on policy matters.

To analysc.

discuss and resolve the technical i!i~Uesand nutrition aspects of all plans and strategies during the implementation stage, technical experts from concerned areas would be associate members'.
12 (c) A National Nutrition Council will be constituted in the Planning Commission, with Prime Minister as President.

Members will include concerned Union Ministers, a few State Ministers by rotation, and experts, and representatives of non-governmental organisations.

The Council will be the national forum for policy co-ordination, review and' direction at the n-ational level.

The Council will meet once a year.


The National Nutrition Council will be the high~st body for overseeing the implementation of the National Nutrition Policy through the various sectoral plans of action and will issue poli~y guidelines based on latest nutritional 2.

Monltorina or .Nutrition situation: Nutritional the shall be the responsibility of the National country's population Institute of Nutrition!
especially children and mothers, NNMB who in turn may involve the ,National Institute of flealth and Family Welfare, Central Health Education Bureau, Home Science, Medical Colleges and NGOs.

There shall be a mechanism to utilize the services of Food/Nutrition Science and Medical graduates trained every year, to manage the national nutrition programmes.

NIN/NNMB should be accountable to the Deptt.

of Women & Child Development in so far as Nutrition surveillance.

is concerned.

, surveillance feedback.


surveilloance of The paucity of reliable andcompal'able data from all parts of the CQuntry is a definite obstacle towards a realistic and, disaggregated problem definition.

This calls for a nation-wide monitoring system.


To achieve this, it is necessary to restructure and strengthen the existing National Nutrition Monitoring Bureau (NNMB) and to develop a mechanism for generati~g nation-wide disaggregated data within a short period for use by the Centre and the States for taking corrective action wherever necessary.
This would ensure a regular monitoring and surveillance system and develop a reliable data base in the country not only to assess the impact of on going nutrition and development programmes but also to serve as an early warning system for initiating prompt action.

3.

Role or State Governments: In a federal polity like ours, interventions commences Policy is largely dependent on the effective role of the state Governments.

from the state level.

Therefore, .


the cutting edge of governmental the successful actualisation of Nutrition' , The formal structure 'at the State level should be similar to that envisaged under the Government of India.
There should be an apex State level nutrition council to be chaired by the Chief Minister and to comprise concerned Minister of the State Government, representatives of leading NGOs working in the state, experts and'representatives of related professional bodies,--Tliereshould be aJ1 Inter-Departmental Coordinating Committee to function.

under the Chief Secretary which will coordinate, oversee and monitor the implementation of the National Nutrition Policy.
The Committee would also focus on the State level targets for the various nutrition-related indicators.based targets set under the NNP.

The Secretary of the Department dealing with women and children should be the convenorof this Committee.

.
.

Special working groups will be set in the Departments of Agriculture, Rural Development, Healt~, E~ucation, Food .and Women and Child Development and this group will be responsible for vetting the various sectoral schemes from the point of view of nutrition before they are finalised.

4.

Given the problem of mounting delivery cost of various nutrition interventions, it' is necessary to mobilise resources from within the community in order to ensure sustainability of these interventions.
This is a major area of concern and the State Governments, local bodies (including Municipal ahd Panchayat bodies); NGOs, cooperatives and professional organisations and pressure groups must take this up as a challenge.

In a pluralistic society like ours, a concerted effort by all of them is the only way to build community support and ultimately community participation in these sc~emes.

Successfyl examples of the community contributing the nutrition component of ICDS Scheme exists in certain States.
It is poSsibleto replicate these examples.

Many State Governments have started a major mid-day meal programme funded out of the State resources.

The other State GovernmentslUnion Territory Admns.

may also consider such an introduction in their primary and secondary schools.

The private schools and schools which are capable of mobilising their own resources may be encouraged to introduce such schemes out of their own resources.

The State Governments may consider constituting similar bodies, i.e.
State Co-ordination Committees and State Nutrition Councils, as well as such bodies at the district levels.

In a massive country .like India, with autonomous states, each with its characteristic problems, priorities, approaches and resources, the state level nutrition policies would be better able to deal with the problems.
After the NNP of India is operationaHsedwith specificobjectives, plans ofaetion, strategies, targets and time frame, development of state- level policies shall be encouraged., ..... " ANNEXURE I INTERVENTION PROGRAMMES TO COM8AT MALNUTRITION Inteanted Child Development Services 1.

The Government of India is making concerted efforts to reduce the prevalence of malnutrition in the country.

In co.nson!lnce with tbis, the scheme of Integrated Child Development Services (ICDS) was launched in 1975.
This programme is implemented b~ the Nodal Department i.e.

tt.e DepartQ1ent of Women and Child Development.

Starting with 33 experimental projects in 1975-76, the ICDS programme has be.en expanded to 2765 p'rojects upt<> December 1992 The package of services provided to the beneficiaries of the programme are supplementary nutrition, Immunization, Health check~up.

Referral services, Non-formal pre-school ~ducation and Nutrition and health Education.

Supplementary the programmes.


The coverage of the major components of beneficiaries for supplement"ary nutrition in ICDS as on December 1992, are as follows: nutrition is one of Children below 3 years Children in the age group of 3-{) years Women beneficiaries 69.40 lakhs 83.13 lakhs 30.08 lakhs The .strategy adopted in ICDS is one of the Integrated delivery of early childhood services so that their synergistic effect will fulfill the objective of the programme.
The beneficiaries of the programme arc children below 6 years, pregQant and lactating mothers and women in the age group 15-44 years.

This programme supplements the health, nutrition and family welfare activities with appropriate cooperation and coordination between functionaries of the Health Department and nodal department.

2.
2.

The other programmes in this direction are the Special Hutrition Programme, Balwadi Nutrition Programme, Wheat Based Supplementary Nutrition Programme, Tamil Nadu Integrated Nutritibn Programme, Mid Day Meals- Programm~ for school children and other intervention programmes such as Nutritional Anaemia Prophylaxis Programme, 6oitre Control Programme and Programme for Prevention of Nutritional Blindness due to Vitamin A Deficiency.
for combating specific nutritional Deficiency Diseases Special Nutrition Programme 3.

The special Nutrition Programme (SNP) was launched in the country in 1970-71.

It provides supplementary feeding to the extent of about 300 calori~s and 10 gm.

of proteins to pre-school children and about 500 calories and 20 gm.

of protein to expectant and nursing mothers for 300 days a year.

At present SNP is operated, as a part of the Minimum Needs Programme in the various states.
The nutrition component of the ICDS programme is funded by States and Union Territories from the SNP budget.

At present about 21.5 million beneficiaries are covered under this programme.

Balwadi Nutrition Programme 4.

The Balwadi Nutrition Programme (BNP) is being implemented since 1970-71 through five level voluntary organisations.

The Central grant is given for.

supplemerltary feeding of It consists of 300 calories and 10 gm.

of p' Aein per child per day for 270 days a year.


years in 5640 balwadis were national children.

During 199r-92, about 0.23 million children in the age group 3-5 covered by the scheme.

13 Wheat Supplemeat8ry Nutrition PrOlramme S. A ceJ<ttaUysponsored scheme called Wheat-based Supplementary Nutrition Programme (WNP) was introduced in 1986.

This programme follows the norms of SNP or of the nutrition component of the ICDS.
Central aSsistancefor the proara~me consists of supply of free wheat and supportive costs for othet ingredients, cooking, transport ctc.

At present around 3 million children .and expectant and nursine mothers arc covered under this programme.

This scheme is now being transfclJcd to the Sta&e Sector.

T"" N- 'atear_tedNutritionPrOlramme .

6.

Tamil Nadu Integrated NtUrition Programme (TINP) is being implemented in the State of Tamil Nadu sind 1981.

At present the scheme covers 316 blocks in Tamil Nadu.
Under this project nutritional surveillanceand supplementary nutrition is being provided to children below six years and expectant and nursing mothers.

The project is assisted by World Bank.

Thc total outlay for the project is Rs.J21 crotes.

Mid 0., Meal Proanmnae 7.


In 1956the erstwhile Madras State launched the mid-day meal programme of providing free meal'to the elementary school children with a view to (a) enrolling poor children who generally remain outside the school due to poverty; 'and (b) giving one meal to the children attending the school.

The MDM operated a.~a Centrally sponsored scheme from 1962-63in all the states.
The objectiveswere (a) to improve nutritional status of the school children; and (b) to attract children to enroll themselves into school and to encourage regular attendance by providing supplementary nutrition, It..1 A ,..,laxls PrOlnmme 8.

Taking cognizance of this problem, the Government of India launched a Prophylaxis prosram~e in 1970 to prevent nutritional anaemia in mothers and children.
Under the programme, thc expectant and nursing mothers as well as women acceptorsof familyplanning are given one tablet 01 iron and folic acid containing 60 mg elemental iron (180 mgof ferrous sulphate and 0.5 mg of folic acid) and children in the age group 1-5 years are given one tablet of iron containing 20 mg elemental iron (60 mg of ferrous sulphate and 0.1 mg folic acid) daily for a period of 100days, This programme covered children and pregnant women with haemoglobin level less than 8 gm per cent and 10 gm per cent respectively.
.

9.

There has been an increase in the number of beneficiariesunder this programme from 3.52 millionin 1975-76to 41.20 million in 1988-89.About 30 million women and 50 million children have, however.

been identified as eligible beneficiaries for the prophylaxisprogramme.

During 1988-89,the programme envisaged to cover 22 million women and 30 million children.

10.

Fortification of salt with iron.

a universally consumcd dietary article.


has been identified as a in both rura~ and urban communities was measure to eo~trol anaemia.

Efficacy of fortified salt assessed by a multicentric study and revealed that iron fortified salt when consumed over a period of 12-18 months reduced prevalence of anaemia significantly.

Accordingly.

fortification of salt with iron as a public health approach is.

piloted in Tamil Nadu and Rajasthan, Prophylaxis ~roaramme Against Blindness Due tfi Vitamin A Deficiency 11.
The programme was/lnitiated by the Government this programme children in age group 1 ,.5 years are given an oral dose of 0.2 million LU.

of Vitamin A in oil'evet.y 6 months, The number of beneficiaries covered under this programme has increased steadily from 4.48 million in 1975-76 to 30.12 million in 1986-81.

It is hoped to achieve universal coverage of the target population of about 50 million children in the age group 1-5 years by 1990. in 1970.

Under 12.
Under 12.

An interim evaluation in the States implementation of the programme showed that of Kerala two years of the coverage was over 75 per cent and there was a 75 and Karnataka after 14 15 per cent reduction in the prevalence of conjunctivill signs of Vitamin A 'deficiency.

The evalua~ion feasibility of this approach within the existing health infrastructure.

also confirms the,administrativc 13.


During 1980, the Department of Food introduced a scheme of Fortification of Milk with Vitamin A to prevent in the country implementing this scheme.

During 1988-89, the total quantity of milk fortified with Vitan)in A through these dairies was 3.2 miltiolT litres p'cr day, blindness.

At present are 42 dairies nutritional there on anaemia prophylaxis.
and prophylaxis 14, MCn Division of the Ministry of H~alth & Family Welfare has been implementing the programmes against Vitamin 'At deficiency.

These programmes were reviewed by two groups' of experts and accordingly certain modifications have been made with concentrated efforts on all pregnartt mothers receiving 100 tablets of Iron Folic Acid and universalisation of Vitamin 'A' to be provided to all children between 9 months and 3 years of age.
The lactating women and those who have accepted certain family planning devices will continue to get the drugs as per earliest sched'ule.

Suitable linkages have also been developed for these programmes regular monitoring through the sanw have been made for wilh immunisation and arrangements programme.

Goilre Control Programme 1~.

A National Goitre Control Programme was initiated by"he GQ'Vcmment of lo9ia in 1962 to identify goitre endemic regions and to assess the impact of goitre control measures.
The availability and production of iodized salt.

strengthening of administrative machinery controlling the -entry of non- iodized salt the regions have been recommended in the implementaion of the programme.

as measpres to improve endemic in a phased manncr 16.

There is an increasing awarenC$S about the broad spcctrum of Iodine Deficiency Disorder (lOD) in the country.

The Goitre Control Programme has gained momentum ili recent years.
The Government -of India has started a scheme with' effect from 1.4.1986 envisaging Uni,vcrsal lodisation to cover the whole country by 1992.

It has liberalised production of EdibleSaltt of iodized salt under the private sector by issuing license to 700 salt manufacturer!\-out/of which 307 have commenced production.

As a rtsult in the country has steadily increased to 25.06 lakh M.T.

in 1986-87.
in 1986-87.

Since the inception of this programme in 19 StateslUnion Tcrritories have so far established Goitre Control Cells in their for effective implementation an~ monitoring of the programme.

Till date 20 State Health Directorates StateslUTs have prohibited the sale of edible salt other in their respective States!

UTs under the Prevention of Food Adulteration Act.

The remaining StateslUTs have been requested for to issue a similar ban expeditiously.
The SlateslUTs distribution of,iodised salt'through It is estimated that about 200 million people will have to be protected against goitre by 2000' A.D. have also been requested to arrange their Public Distribution System.

in 1990-91 from 7.72 lakh,M.T.

the production of iodiscd salt than io~sed salt thereof.
National Diarrhoeal Diseases Control Programme 17.The programme was launched in 1981 to reduce the mortality in children below five years due to diarrhoeal diseases through introduction of Oral Rehyderation Therapy (ORT).

The high priority accorded to t~e Programme is part of the package of services rendered under the MCH programme which was initiated d.uring 1980-85 has now been strengthened extensively.
The Anganwadi Centres of the ICDS Scheme have serv.cd as nucleus for the propagation of Oral Rehydration Therapy (ORT) which has been found to be an effective measure of preventing dehydration caused by diarrhoea.

Functions ,of the Food & Nutrition Board 18.


The Food & Nutrition Board', as reconstituted and reviews coordinates development, production & popularisation of nutritious Foods and Beverages; measures required to combat deficiency diseases; and 'Consetvation and efficient utilisation as well as augmentation of food resources by way of food pres£rvation .and processing.
in regard activities the on 26 July 1990, advises Government, to food and nutrition ~ extension/education; GRAPH-I -- ,..-""" -- ,,--- /' r---~ " / / ,( / / " '",/ v ",,--- ",/ ' ,~ ',~ " '" "', '.v/ ~ ;'" /'" I,,"""" /,," --- -- .""""

"""""""' // - " '", ,\ " , ""\ 3-5 , 'M 1-2 less than ACI / 75 76 77 78 79 80 81 2600 2400 2200 2000 1800 1600 8- ~'-" ~ ;a ~u Graph-I Calorie intakes in different income groups druing 1975-81.
SOURCE:- NUTRITION PROFILE IN INDIA OVER A DECAD.E: N. Prahlad Rao & J. Gaurinath Sastri, National Institute of Nutrition.

"Towardsthe implementationof a National Nutrition Policyin India."

Pub: ICMR, 1986 16 17 TAOLE 1: Average intake of-Jood sluffs (iVcu.
{day) in urban and rural areas Fo,)() Urban -- 1975--79 Rural Leat Cost HIG MIG LlG IL SD 1975 L76 - 1977 1978 1979 1980 1981 1982 1988.89Balanced (I) (2) (3) (4) (5) (6) (7) (8) Cereals Pulse Leafy Vegetables Other Vegetables Milk --- Fats and Oils H Recommendedby ICMR (1981) for adult sedentary male' 633 641 43 32 12 11 51 51 SO.

103 9 II 361 49' 21 89 250 35 .478 42 16 55 95 22 416' 33 II 40 42 13 316 57 21 113 424 46 420 41 13 56 98 23 HIG .

High Income Group MIG .

Middle: Income Group LlG .


Low Income Group IL .

Industrial Labour SD .

Slum Dwellers -- Diet (9) 614 34 11 58 88 12 (10) (II) (12) (13) (14) .

(15) (16) 617 36 14 56 66 9 570 37 13 58 90 12 613 33 I 75 88 10 553 35 I 51 70 9 4911 311 23 53 711 10 521 .37 I.

53 88 14 4611 .w 4(1 60 ISO 40 se~"CI': Ii) National Institute of Nutrition.

National Nutrition Monitoring Bureau.

Repon on Urban Population.

Hyderabad.

1984.

Iii) National the year 1981.

1982.

Hyderabad.


Iiii) 'National Institute of Nutrition.

National Nutrition Monitoring Bureau.

Repon of Institut~ of Nutrition.

Nutriti<1n News 7(2).

March 1986.

I-fyderabad.

(iv) Nationalillstitute of Nutrition.

Nmional Nutrition Monitoring Bureau.

In(rim Reran of Repeat Survey.

Phase.

I".

1.989.

18 TABLE 2: Average intake of DUtrhts (per/cu/day) ADA lCMR (1981) UrbaD 1975-79 HIG MIG LlG IL SD Rural 1975.
1976 1977 1978 1979 1980 1981 1982 1983" 1988-89 2400 2603 2364 2230 2243 2008 2296 2369 2306 2341 2366 2404 2409 2243 2481 2419 55.0 73.4 63.2 57.8 59.4 53.4 63.6 65.4 61.9 «' 3f11 270 313 373 366 300 352 Nutrients Calories (K Cat) Proteins (g) Iron (ms) Vito A ( I' g. Retinol) Allowanc:e .During 1983; the surveys were conducted on a sub-sample of NSSO in only 4 states RDA - Recommended Dietary Soruu: (i) National Institute of Nutrition, National Nutrition Monitoring Bureau, Report on Urban Population, Hyderabad, 1984.
(ii) National Institute of Nutrition, National Nutrition Monitoring Bureau, Repcjn of tbe year 1981, 1982,Hyderabad.

(ill) National Institute of Nutrition, Nutrition.News 8(6), Nov. 1987, Hyderabad.

(iv) India.

Ministry of Planning, Central Statistical Organisation, Second Seininar on Social Statistics, February 4-6, 1988.

New Delhi, 1988.

(v) National Institute of Nlotrition,National Nutrition Monitoring Bureau, Interim Repon of Repeat Survey.

Phase-I.

1989.
Phase-I.

1989.

TABLE:3 Intake of Nutrients in different Demographic Groups No Land.
Less then 5 Acres 5-10 More than Labourers Cultivators Acres 10 Acres others Calories (Per consumer unit per day) Keraia Tamil Nadu Kamataka Andhra Pradesh Maharashtra Gujarat Madhya Pradesh West Bengal Uttar Pradesh 1824 2108 2312 2274 .2006 1999 1977 1866 1991 1904 2320 2576 2480 2178 2042 1939 2346 2116 (gm per consumer unit -per day) Kerala Tamil Nadu Kamataka Andhra Pradesh Maharashtra Gujarat Madhya Pradesh West Bengal Uttar Pradesh 44.2 52.3 63.3 53.8 58.8 57.2 58; 77.7.
Source- Annual Report (1979)of NationalNutritionMonitoringBureau, NationalInstituteof Nutrition,Hyderabad.

Reportedby RajaramDasgupta,Economic&.PoliticalWeekly,Vol.

XVIII No.

28, July.9, 1983.


I ~ -.. t , 19 TABLE-4 PERCENT DISTRIBUTION OF CHILDREN (1-5 YEARS) ACCORDING TO NUTRITIONAL GRADES.
State 'Kerala Tamil Nadu Karnataka Andhra Pradesh Maharashtra Gujarat Madhya Pradesh Orissa Pooled Period 1975-79 1988-90 1975-79 1988-90 1975-79 1988-90 1975-79 1988-90 1975-79 1Q88-90 1975-79 1988-90 1975-79 1988-90 1970-79 1988-90 1975-79 1988-90 n 737 882 1183 3337 1065 2035 809 2838 760 1666 718 1262 $85 237 571 1175 6428 13432 Normal Mild Moderate Severe .Based on NCHS standards Source: National Nutrition Monitoring Bureau Report of Repeat .Surveys (1988-90) published by National Institute of Nutrition.
Indian Council of Medical research, Hyderabad.

Table 5 : Incidence 01 Bitot's spot among chUdren in rural Areas (percentage) I~ 1975 Year 1976 1977-78 1979 1980 1981 1982 pre-school children (l~5 years) School going children (5-14 years) 0.6 1.4 1.4 0.9 1.5 2.7 1.8 1.7 4.1 4.2 1.3 3.1 5.1 3.1 Figures indicated are the median values of the prevalence levels in the surveyed states, Sources: Rao, N. Pralahad and Gowrinath, S.l.
Diet and Nutrition Profile in Ten States of India over a Decade in the implementation of a National Nutrition Policy in India, October 28-30, 1985, Srinagar.

Tabl~: CIaIIdM , rate ("'" yn.)

bJ lex 8Ddrani nsIdeDce 20 Yean 1971 1981 1982 1983 1984 1985 1986 Rural Utban Combined Male Female Pen.

Male Female pen.

Male Female Pen.

53.2 43.1 40.


421 44.2 41.4 36.6 59.3 48.0 45.7 43.1 48.2 45.3 43.3 S6.2 Source:.
, Office of the 1971, 1981-1986. aistnr General, Vital Statistics Division, SaaaapleRegistration System, Table.7: , ... IIIt8kebJ M8IesaDd..1III8Iesf1lDHrereatAle Groups Age Group CIIIIdr8 1-3 Yean 4-6 years 7-9 years .112 yean Adolesceatl 13-15 years 16-18 years AdultS (sedentary) Energy, Kcail d Protein, g I d RDA Intake RDA Intake female male female male female male female male 773 10SO 1200 1500 1097 1700 2OSO 1320 1800 19SO 21SO 1483 780 22.5 28.5 1112 43.0 1325 15SO 62.0 23.5 30.0 43.0 59.0 2OSO 2400 2OSO 2600 1800 1620 1721 23SO 1789 1773 1937 2169 76.0 65.0 66.0 81.0 SO.O 60.0 21.9 30.9 36.0 41.0 42.9 47.7 SO.4 22.0 31.5 39.0 42.9 49.1 58.6 62.0 Intake based on NNMB 'Survey in 10 States, 1975-80 21 Table 8: Crop pndudioa perfGrmuce8DdProdIlCtloaProjedloalfor 1919-901994-95 .. A.D. .
crop ,......... 1. i) Rice ii) Wheat iii) Coarse Grains iv) Pulses Total 2. oilseeds 3.

Sugarcane 1988-89 Act, Ach.


1989-90 Target 1994-95 Projections 2000 Projections (million Tonnes) 70.47 54.12 32.65 14.92 172.16 17.50 210.00 72.50 54.00 34.00 14.50 175.00 18.00 217.00 88.0 67.0 37.0 18.0 210.0 22.5 270.0 106.0 80.0 42.0 22.0 250.0 27.0 320.0 S8ura: Ministry of Food It Civil Supplies, Food and Nutrition Board, Department of Food, National Workshop on Dietary and Nutritional Guidelines for food and agriculture planning, October 4-6, 1989, New Delhi.

.
.

22 Table-9 CURRENT LEVEL OF J»RODUCTION 1988-89AND PROJECTIONS FOR 2000 A.D.

The demand and supply balances for 2000 AD in respect of commodities shown below alongwith production figures for 1988-89.

Items Sl.

No.

t. Total Foodgrains Cereals Pulses 2.

Oils (Oilseeds equivalent) 3.

Milk 4.

Meat 5.

Eggs (million nos.)

6.

Fish 7.

Vegetables 8.

Fruits .N.A.-Not Available Production.. in 1988-89 (MillionTonnes) 170.25 156.55 13.70 - 17.88 49.10 N.A.

18,666 3.15 N.A.

N.A.

Demand".


(Million Tonnes) Low 205 8.3 - 49.4 1.57 17,419 4.6 50.00 N.A.

High 225 10.2 - 64.4 2.11 28,513 5.5 55.00 N.A.

Supply."

(Million Tonnes) 230 195 35 9.7 (26.0) 64.40 2.10 27,882 8.0 N.A.

N.A.

Comments: 1.

The nutritional needs require consumption ~f vegetables of 200 gm per adult per day.

The requirement would be 55 million tonnes, of vegetables.

considering the potential for internal demand as well as for export.
production could be planned for 80 mi:lion tonnes for vegetables for 2000AD on an area of 4 million hectares, assumingan average target yield oL20 tonnes per hectare.

.

Source: 2.

The total production of oils from field crops and other sources i.e.

exploitation of cotton seed, rice bran, maize, coconut, oil palm etc.

is estimated at 9.7 million tonnes in 2000 A.D. .. Arinu8I Repon 1989-90, Deptt.

of Agriculture, Govt.

of India.

.

"Repon Agriculture, Govt.

of India, New Delhi.


of the National Commission on Agriculture, 1976 (abridged) Ministry of