Mission Poshan 2.0 - Nurturing the Future of India

Overview
The Poshan Abhiyaan or Prime Minister’s Overarching Scheme for Holistic Nutrition is the Indian government’s flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers. This was launched in March 2018 by the Prime Minister in Jhunjhunu, Rajasthan.

Multiple forms of malnutrition have been rampant across all age groups in India for several decades now. Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of nutrients. It places a burden heavy enough for India to make it a critical national priority.

• The National Family Health Survey, which was released in December 2020, presented a grim scenario. According to this, malnutrition increased significantly among children in 22 states and union territories between 2015-16 and 2019-20
• According to the Comprehensive National Nutrition Survey carried out by UNICEF in 2019, about 50% children (under five years) were found to be stunted (too short) or wasted (too thin) for their height
• According to a Lancet study in 2019, a staggering 68% (1.04 million) deaths of children (under five years) was due to malnutrition
• The ‘Food and Nutrition Security Analysis, India, 2019’ report highlighted the intergenerational transmission of poverty and malnutrition in the country

Covid-19 has further exacerbated this challenge in the country with reduction in income and disruption of essential services. The economically disadvantaged population found themselves more vulnerable to malnutrition and food insecurities during lockdown, reversing some of the progress made by government schemes in the pre-pandemic phases of the Poshan Abhiyaan.

Mission Poshan 2.0 Scheme
Mission Poshan 2.0 was launched by Finance Minister Nirmala Sitharaman in February 2021 to prevent any further backsliding of nutrition indicators. The announcement was made as the government decided to devote attention and resources towards integrating numerous nutrition schemes in the country. Mission Poshan 2.0 brings together the Integrated Child Development Services (ICDS)—Anganwadi Services, Supplementary Nutrition Programme, Poshan Abhiyaan, Scheme for Adolescent Girls and National Crèche Scheme. 

The ICDS Scheme is primarily designed to bridge the gap between the Recommended Dietary Allowance (RDA) and the Average Daily Intake (ADI). The ICDS Anganwadi Services or the Saksham Anganwadi Scheme was designed to upgrade the Anganwadi infrastructure and transform them into learning and healthcare centres for children. The supplementary nutrition programme is one of the six services provided under the ICDS Scheme to improve the health and nutrition status of pregnant & lactating women and children aged 6 months–6 years.  The ICDS has been implemented by the Ministry of Women and Child Development. The role of the Scheme for Adolescent Girls and the National Creche Scheme in Mission Poshan 2.0 is yet to be defined.

The objective is to implement a comprehensive, unified strategy to strengthen nutritional content, delivery, outreach and outcome, with renewed focus on developing practices that nurture health, wellness and immunity to disease and malnutrition in the country. The goal is to have a collaborative effort in executing these programmes to counteract regression in the health and nutrition index.

Outreach and Implementation
For this mission, the government has identified 112 aspirational districts for the initial phase. Implementation of this programme will be done by the Ministry of Women and Child Development in collaboration with the Ministry of Health and Family Welfare and the Ministry of Education under the aegis of Early Childhood Care and Education (ECCE) within the National Education Policy (NEP).

The Finance Ministry has earmarked an estimated budget of Rs. 20,105 crore (US$ 2,741 million) for the programme for FY2021-22. This is the overall estimate for five schemes that have been merged for Mission Poshan 2.0. Segmented budget estimates have not yet been disclosed in the public domain. In the last fiscal cycle, actual expenditures on these five schemes stood at Rs. 18,927 crore (US$ 2,581 million).

Key Executive Commentary
Healthcare experts and NGOs have welcomed the launch of Mission Poshan 2.0, stating it will help tackle the complex issue of malnutrition. Sujeet Ranjan, Executive Director of the Coalition for Food and Nutrition Security, hailed the government’s decision to roll out the mission, calling it a ‘positive move’. “While the budget seeks to strengthen the country’s public health in a mission mode, Mission Poshan 2.0 intends to enhance the nutritional content, delivery and outreach. That was the expectation and need of the hour,” stated Mr. Ranjan in an interview with Outlook India.

In a conversation with NDTV, Basanta Kumar Kar, recipient of the Global Nutrition Leadership and Transform Nutrition Champion Award, called it “an excellent policy initiative on addressing inequity and social injustice in nutrition”.

On the other hand, some experts are wary of allocations of the new scheme. Purnima Menon, a senior research fellow at the International Food Policy Research Institute (IFPRI), provided a balanced, wait-and-watch perspective in the same interview with NDTV. She shared that “the programmatic aspects of the Mission Poshan 2.0 can be analysed for its efficacy only when it comes in the public domain. What appears from the budget is that it is just bundling various schemes. The merger of the supplementary nutrition programme with the Poshan Abhiyaan is business as usual. There is no increase in the allocations.”

The Head of Nutrition Research at the Public Health Foundation of India (PHFI), Shweta Khandelwal, echoed Menon’s opinion in an interview with FirstPost India. She said, “This tight budget appears disappointing during these challenging times when we need robust health and nutrition services, motivated frontline workers, capacity building exercises, outreach and delivery, filled vacant posts and improved quality nutrition for all citizens, especially for our underprivileged children. It is important to note that Poshan 2.0 leaves two of the schemes earlier covered under the ICDS—Pradhan Mantri Matru Vandana Yojana or maternity benefit programme and child protection services. These two schemes have been moved to a different umbrella. The key objective of these schemes was to provide partial compensation for wage loss (in terms of cash incentive) so that women can take adequate rest before and after delivery of the first child and lead to improved health outcomes for women and their children. The ICDS scheme only makes the list of pregnant women and lactating mother eligible for the cash incentive.”

The Way Forward…
In conclusion, it is evident that Mission Poshan 2.0 is a critical step towards solving the challenge of malnutrition in India. However, its success depends largely on the way it is implemented. Conversion of multiple schemes and ministries is a mammoth task and can prove to be successful only if there is clarity in roles, objectives and targets for all stakeholders involved.