Milky Matters: Addressing malnutrition through school milk programme, writes NDDB Chairman Dilip Rath

In September 2014, the UN General Assembly approved the Report of the Open Working Group on Sustainable Development Goals (SDGs) as the main basis for integrating the SDGs into the post-2015 development agenda. Of the recommended 17 SDGs, SDG 2 (“End hunger, achieve food security and improved nutrition, and promote sustainable agriculture”) contains direct provision for nutrition. SDG Target 2.2 is directly related to malnutrition: “By 2030 end all forms of malnutrition, including achieving by 2025 the internationally agreed targets on stunting and wasting in children under five years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons”, said the report.

India alone represents 23.1% of the total achievement gap on SDG 2 (Zero Hunger). If India eradicates undernourishment (currently 14.8% of the Indian population), the world will be 25.2% closer to having achieved the SDG target on undernourishment.

Of all Indian children under five, one in three (35.7 per cent) is underweight (low weight for age), one in three (38.4 per cent) is stunted (low height for age); and one in five (21 per cent) is wasted (low weight for height). Every second child is exclusively breastfed for the first six months. About 3,000 children die every day from poor diet-related illness. Overall, India accounts for more than three out of every 10 stunted children globally. The chronic impact of stunting on lifelong learning and adult productivity, in addition to increased disease susceptibility, is well known. Going by National Family Health Survey results, it appears that 40 per cent of our future workforce will be unable to achieve their full physical and cognitive potential. Many children are born to anaemic and malnourished teenage mothers. Indeed, 33.6 per cent of Indian women are chronically undernourished and 55 per cent are anaemic.

The well-known development economist Jean Dreze argues that the most serious nutrition challenge in India is to reach out to children under three years of age: “It is well known that if a child is undernourished by age three, it is very difficult to repair the damage after that.” The costs of failing to do so, both in human and economic terms are huge. Pervasive long-term malnutrition erodes the foundations of the economy by destroying the potential of millions of infants. Children stunted on account of malnutrition are estimated to go on to earn an average of 20 per cent less as adults.

The milk production in the country has substantially increased and the per capita availability of milk has risen from 112 grams/day in 1970-71 to 394 grams/day in 2018-19. With sustained supply of milk in India, one possible intervention that can address the aforesaid situation is inclusion of milk in the feeding programmes for children in schools. Nutrient needs increase in adolescence to meet the demands of pubertal growth and brain maturation. Addressing nutrition problems and adopting healthy dietary habits during adolescence can be important for potential ‘catch up’ growth, improved cognition and reduced risk of non-communicable diseases (NCDs) later in life. Inadequate nutrient intake during childhood leads to under nutrition, which results in growth retardation, reduced work capacity and poor mental and social development.Between the ages of 2 and 12, children more than double their weight and height and lay the foundation for a body that will last a lifetime. Children who consume milk with lunch are more likely to meet their bone-building needs, as it is rich in calcium. Milk and milk products are a good source of protein, zinc and vitamins A, B2 (riboflavin) and B12, and make a valuable contribution to the intake of iodine, niacin and B6. Thus, milk is preferred as "a nutrient dense food", which means it provides a large amount of nutrients essential for growth, yet with relatively few calories. Milk is a complete food and a vital constituent of a balanced diet.

Numerous studies have shown that regular milk consumption by children improves their health and cognitive parameters and reduces nutritional deficiencies as well.

The Government of India has launched various programmes to curb incidences of malnutrition:

1. Under the Pradhan Mantri Matru Vandana Yojana (PMMVY), Rs. 6,000 is transferred directly to the bank accounts of pregnant women for availing better facilities for their delivery.

2. “POSHAN Abhiyaan” launched in 2017-18 aims to reduce stunting, under-nutrition, anaemia and low birth weight in babies through synergy and convergence among different programmes, better monitoring and improved community mobilisation.

3. The National Food Security Act (NFSA), 2013, aims to ensure food and nutrition security for the most vulnerable through its associated schemes and programmes, and making access to food a legal right.

4. Mid-day Meal (MDM) scheme aims to improve nutritional levels among school children which also has a direct and positive impact on enrolment, retention and attendance in schools.

Taking a cue from the enormous benefits of consuming milk, NDDB Foundation for Nutrition (NFN), a trust/society created by National Dairy Development Board, has been distributing milk to children in selected government schools across the country under its “Giftmilk” programme. The programme runs by channelizing the CSR allocations of companies. NFN has distributed around 70 lakh units of milk (200 ml of flavoured pasteurised toned milk) to about 48,000 school children in seven states till September 2019.

NDDB has been impressing upon the State Governments for introduction of school milk programme in their states. This will have the twin advantage of improving child nutrition on the one hand and providing a market access to millions of dairy farmers whose livelihood is highly dependent upon dairying on the other.Milk can play a complementary role for complete nutrition.

It is essential to have a healthy and balanced diet consisting of fruits, vegetables, legumes, nuts, whole grains, etc., in such quantities and proportion that the need of all nutrients are adequately met.Thus, any initiative in addressing malnutrition through school milk programme would benefit and transform lives of millions of children and help build a strong nation.