India lacks a national vision on infant and child nutrition and this is preventing the creation of better environments in which women can optimally feed their babies, according to the latest assessment by the World Breastfeeding Trends initiative. The Fifth Report of Assessment of India’s Policy and Programmes on Infant and Young Child Feeding shows that the country has barely made any progress on key indicators since the last assessment three years ago.
The report notes that the the Ministry of Health and Family Welfare and the Ministry for Women and Child Development have taken several piecemeal initiatives on infant and child nutrition but has not adopted an overall official policy, which is hindering action plans and budgets.
Another shortcoming the report finds is the replacement of the Baby Friendly Hospitals Initiative, which is a worldwide programme of the World Health Organisation and the United Nations Children’s Fund, with the health ministry’s programme called Mother’s Absolute Affection. The health ministry programme does not provide accreditation to hospitals that are baby friendly and is not applicable to private sector institutions where a large percentage of deliveries and caesarean sections take place.
India has also slipped in regulating the marketing of breastmilk substitutes since the last assessment. India has had a strong law on infant milk substitutes since 1992. However, enforcement of the law is losing ground, the report says, noting that companies are marketing breastmilk substitutes more aggressively since monitoring of the law is weak. India has no authorised government officers and depends on NGOs to check if the law is being followed. Legislative proceedings against violators have also been tardy, the report finds.
Other key indicators where India has performed badly are support for mothers and community outreach, disseminating information on infant and child feeding, feeding children with HIV and feeding children during emergencies.
The one area where India has made a leap forward is maternity protection. This is because of the government passing the Maternity Benefits Act, 2017 that has increased maternity leave for women from 12 weeks to 26 weeks. However, the report notes, that this law does not cover the large number of women who work India’s informal sector. The report also notes that the government has not universalised its maternity assistance scheme – the Pradhan Mantri Matritva Vandana Yojana – but has contravened provisions of the National Food Security Act by not providing the Rs 6000 mandated, as the minimum quantum of benefits.
The report recommends that, to improve nutrition standards, India elevate its Infant and Child Feeding guidelines to policy. The government should also effectively enforce the Infant Milk Substitutes Act with better monitoring and action against violators. It calls for specific attention to the Maternity Benefit Act to support women in the informal sector and universal application of the Pradhan Mantri Matritva Vandana Yojana.