The well-being of mothers has the power to determine the health of future generations and can be a useful tool to predict future public health challenges within the community. Yet there is still an alarming number of mothers and children dying from causes that are largely preventable. Every day, approximately 800 women die from preventable causes associated with pregnancy and childbirth. And 99% of those deaths occur in developing countries1. In India nearly 45,000 mothers die due to causes related to pregnancy and childbirth- which accounts for 17% of such deaths globally2.
Child malnutrition in India is a complex chronic problem as malnourished children are unable to attain their full potential in regard to growth, development and the ability to work and be economically productive. To tackle it one requires a multipronged approach which involves improving maternal health, education, levels of sanitation access to healthcare etc. It is important to mention that stunting in children is time sensitive because the mental and physical damage caused within the first two years of life are irreversible.
So the question arises as to why the numbers are so high?
In the context of family health, studies have shown that the nutritional handicap accumulated in the life of a woman is passed on to the next generation, perpetuating an inter-generational cycle. This cycle is further compounded when young adolescent girls begin childbearing before they have developed sufficiently, thereby passing on several nutrition deficits to their offspring.
India faces a real and extreme food crisis and was ranked 101 out of 116 countries on the Global Hunger Index4. Statistics also show that less than 50% of women consume a wholesome diet regularly, due to which 53% of women and 50% of pregnant women are anaemic3,4
The First 1000 days:
The first 1000 days is defined as the period between a woman’s pregnancy and the child’s second birthday. It is a very crucial window as the foundations for optimum health and development across the child’s lifespan is established. Studies have shown that the mother’s health and wellbeing during this window has great influences on the child’s ability to survive, grow and learn. Therefore, adequate maternal nutrition during this window is vital to enhance nutritional status and reduce the danger of poor birth outcomes.
For children to reach their full potential, the focus needs to be on healthy birth outcomes, early identification of malnutrition and treatment of developmental delays and disabilities. Good nutrition and care during the mother’s pregnancy and after the child is born can help prevent malnutrition.
Promising solutions to improve the outcomes during the first 1000 days:
Educating families, especially women: In Indian societies women are taught to care for the family by being the sole food providers by virtue of which they become ‘health managers’ for the family. Women, therefore, play a strategic role in ensuring sustainable food and nutrition security for the family. So, it is crucial that women are educated on the nutritional needs for both themselves and their families as their knowledge (or lack thereof) can affect the health and nutritional status of the entire family in these societies.
Source: The First 1000 Days: Shaping Children’s Future-G7 International Symposium on Food Security and Nutrition
Improving the health of women: When it comes to brain development, preventing nutritional deficits is far more effective than depending on replacement therapy of nutrients later on in life. Hence the requirement for good nutrition begins with adolescent girls and young women, and their access to basic nutrition and healthcare. During the prenatal period, the consumption of a balanced diet is essential to ensure both maternal wellbeing, lactation and pregnancy outcomes. Therefore, aspects like responsive care, social and group support, immunisations, support for early child development are extremely significant to prevent factors like maternal deprivation, low birth weight, premature births, malnutrition and poor growth and multiple child safety issues.
Hygiene practices: Diarrhea is one of the leading causes of malnutrition in children under 5. Poor hand hygiene & sanitation and the lack of access to clean water is responsible for an estimated 88% of childhood diarrhea in India5. While the availability of soap and water must be taken care of- educating the community about washing their hands prior to the preparation and serving of meals is critical.
World Health Organization, 2014
Times of India, 2016
Global Hunger Index, 2018
Childhood Malnutrition in India (Abhishek Singh 2019)