Eleventh Five Year Plan

148 Eleventh Five Year Plancommunity level where they are more likely tobe sustainable and cause enduring behaviourchange in micronutrient consumption. Suchefforts are primarily to be taken up by the Ministriesof Health and Family Welfare, WCD, andInformation and Broadcasting.(ii) Nutrient Supplementation: It concerns the Ministriesof Health and Family Welfare, WCD, andDepartment of School Education and Literacyand could be achieved through biannual campaignsfor administration of vitamin A to childrenbetween nine months to five years, providingiron and folic acid supplements to children fromsix months to two years and to adolescent girlsof 10–19 years, administering iron tablets to allpregnant and lactating women and by emphasizingbreastfeeding of infants up to six monthsunder the NRHM implementation plans. Whilesingle supplements for various deficiencies arebeing used world over, evidence for a shift tomultiple micronutrient supplementation isconflicting.(iii) Horticulture Intervention: Although India is oneof the leading producers of vegetables; GLV constituteonly 16% of the total vegetable production.Horticulture intervention will include increasingthe nutrient-rich crops to meet the requirements.Promotion of home gardening is important toincrease availability at the household level. Emphasisshould be put on perennial varieties ofGLVs that are relatively easy to grow. It includestraining farmers in agriculture technologies toimprove production and also providing them incentivesto move away from cash crops. There is aneed to develop a mechanism of coordinationbetween the various departments involved in horticulturaland educational activities for optimumbenefit of the community. The activities also includeincreasing both production and productivitythrough adoption of improved technologiesfor ensuring quality, post-harvest activities, andfood processing. Horticulture Intervention willalso involve the Ministry of Agriculture for thesupply of seeds, extension, and storage support.(iv) Public Health Measures: These will involve theMinistries of Health and Family Welfare, WCD,Commerce, Rural Development, and Urban(v)Development. This would require streamliningprocedures of procurement and supply, buildinginstitutional capacity in organizations for monitoringand mapping micronutrient deficiencies,deworming children at regular intervals, andproviding safe drinking water and sanitation.Food Fortification: The activities involve the additionof one or more essential nutrients to a food,whether or not it is normally contained in it, forthe purpose of preventing or correcting a demonstrateddeficiency of one or more nutrients inthe population or specific population groups.Examples of food fortification include addingspecific micronutrients to commercially processedstaple foods, such as vitamin A in sugarand margarine, iron and B vitamins in wheatand corn flour, and iodine in salt. The activitieswould involve the Ministries and Department ofHealth, Food Processing Industries, Food andPublic Distribution, Consumer Affairs, Finance,Panchayati Raj, and State Governments. Whilefortification of foods supplied by the PDS hasbeen suggested by some, the implications of thisare not yet clear. The effects of fortification whenthere is a calorie gap are suspect. There are definitelysome issues regarding the proposed formsof food fortification such as providing fortifiedatta instead of grain under the PDS; as grain canbe stored for a longer period. Clearly, there needsto be much greater research into the strategy ofproviding fortified foods to address micronutrientdeficiencies. The Eleventh Plan will supportfood fortification based on scientific evidence.4.1.97 During the Eleventh Plan importance wouldbe given to the following strategies and measures:• High priority to micronutrient malnutritioncontrol, specifically so to tackle anaemia, will beaccorded at Centre and State levels. The goal is toreduce anaemia among women and girls by 50%by the end of the Eleventh Plan. State-specific goalshave also been suggested (Annexure 4.1.1).• DLHS of RCH Programme will recognize malnutritionincluding micronutrient as a serious publichealth problem and monitor prevalence of micronutrientdeficiencies on priority.