Implications of Young Child Malnutrition on Health and Development: Prioritize Nutrition Interventions in the First 1000 Days of Life

Abstract

Implications of child undernutrition is not limited to adverse impact on physical growth but on optimum brain growth, mental health and cognitive development. The adverse effects of micronutrient deficiencies in mothers and children are serious with impact on morbidity, mortality, anemia, school performance, overall productivity and national development. Only in the last two decades, studies on the month-wise trend in the prevalence rate of child undernutrition in under five years has drawn attention to the fact that the stunting and underweight rate increases steadily up to 24 months, peaks at about two years of age and then stabilises. Efforts are therefore being directed to the significance of concentrating on implementation of child undernutrition preventive measure in the first 1000 days of life. As per the globally accepted conceptual framework of child malnutrition and the evidence available of effective interventions, emphasis is to ensure universal coverage of selected package of essential nutrition interventions (ENIs) and coupling these with nutrition sensitive interventions. Priority interventions in the first 1000 days comprise nutrition care package linked to antenatal care services, intensive efforts for universal adoption of appropriate infant and young child feeding practices and context specific nutrition sensitive measures .For effective implementation, special attention to mapping of the ’at risk’ households having a member falling in the 1000 days window needs special attention. The contacts of health workers with antenatal care and routine child immunization services need to be effectively used for promoting appropriate maternal nutrition care and breastfeeding and complementary feeding practices in the first 1000 days of life. Along with universal coverage of ‘at risk’ households with ENIs, it is imperative to ensure that the context specific nutrition sensitive interventions are simultaneously addressed, as reflected in the design of India’s National Nutrition Mission/Poshan2.0.