Nutrition of adolescent girls in India

Context: The findings of the National Family Health Survey-5 (2019-21) show that 59.1% of adolescent girls were anaemic. The NFHS-4 numbers also reported over 41.9% of school-going girls as underweight, numbers showcase a worrying trend.

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Health of adolescent girls

  • Adolescence is the phase of life between childhood and adulthood, from ages 10 to 19
  • It is a pivotal period of rapid physical, cognitive and psychosocial growth. This affects how they feel, think, make decisions, and interact with the world around them. 
  • It is a significant indicator of women’s labour force participation in India in the long term, as better nutrition improves every young girl’s prospect to participate in productive activities
  • Adolescent girls are particularly vulnerable to undernutrition and anaemia due to the onset of menstruation.
  • Growth retardation is one of the most important health concerns for adolescents.

Recommended dietary allowances of nutrients for adolescents in India:

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Reason for nutritional deficiencies in adolescent girls

  • Gender Discrimination: Environmental conditions to cultural norms that lack a gender-neutral environment within a household, affect the nutrition uptake in adolescent girls. 
  • Poverty: Families with limited financial resources may struggle to provide an adequate diet for all family members, and girls may be disproportionately affected.
  • Limited Access to Healthcare: Lack of access to quality healthcare services, including prenatal care and postnatal support, can contribute to nutritional deficiencies in girls. Malnourished mothers are more likely to give birth to undernourished babies, perpetuating the cycle of malnutrition.
  • Early Marriage and Pregnancy: In some parts of India, girls are married off at a young age, which can lead to early pregnancies. Adolescent girls who become mothers before their bodies are fully developed are at a higher risk of malnutrition, as their bodies may not be able to adequately support both their own growth and the growth of their infants.
  • Social and Cultural Factors: Traditional beliefs and practices, such as restrictions on food intake for girls and women, can further exacerbate nutritional deficiencies. For example, the practice of excluding certain foods from women’s diets during menstruation may result in inadequate nutrient intake.
  • Lack of Nutritional Knowledge: Lack of education and information about balanced diets, food preparation, and utilization of available resources can hinder the improvement of nutritional status. For example, bad cooking habits like over boiling vegetables and straining water, removing the husk from wheat, eating polished rice and straining rice water, etc.
  • Hookworm infestation: It is a parasitic infection and resides in the small intestine. It can cause significant nutritional deficiencies. They attach to the intestinal lining and consume blood, leading to chronic blood loss and iron deficiency anaemia. This can impair the body’s ability to absorb nutrients, resulting in malnutrition and stunted growth, particularly in children.

Consequences of nutritional deficiencies in adolescent girls

  • Malnutrition: It can lead to stunted growth, weakened immune system, increased susceptibility to infections, and higher mortality rates.
  • Impaired Cognitive Development: Essential nutrients like iron, iodine, vitamin A, and zinc, can impair cognitive development and lead to learning disabilities, reduced attention span, and decreased intellectual capabilities. This can have long-term effects on educational attainment and economic productivity.
  • Increased Disease Burden: Nutritional deficiencies weaken the immune system and make adolescents more vulnerable to various diseases and infections. For example, vitamin A deficiency increases the risk of blindness and susceptibility to infectious diseases like measles. Iron deficiency can lead to anaemia.
  • Reproductive Health Problems: Nutrient deficiencies, particularly of iron and folate, can increase the risk of menstrual irregularities, and heavy or prolonged periods, and even affect fertility in the long term.
  • Economic Implications: Undernourished adolescent girls are also at a higher risk of chronic diseases and pregnancy complications, which can lead to a higher healthcare burden on both families and communities, potentially leading to financial instability and increased poverty.

Government initiatives to address nutritional deficiencies

  • Scheme for Adolescent Girls (SAG): This scheme is for adolescent girls of the age group 11-14 years to facilitate, educate and empower Adolescent Girls and to break the intergenerational life cycle of nutritional and gender disadvantage.
  • Rashtriya Kishor Swasthya Karyakram (RKSK): For adolescent participation and leadership, equity and inclusion, gender equity, and strategic partnerships with other sectors and stakeholders. The programme envisions enabling all adolescents in India to realise their full potential by making informed and responsible decisions related to their health and well-being.
  • Targeted and regionally contextualised Social and Behaviour Change Communication (SBCC) efforts around adolescent girls’ nutrition are sure to generate greater demand and the adoption of good practices of foods.
  • Integrated Child Development Services (ICDS): The ICDS is a centrally sponsored scheme that aims to provide a package of services, including supplementary nutrition, immunization, health check-ups, and referral services, to pregnant women, lactating mothers, and children up to 6 years of age. Adolescent girls are also included in the program to ensure adequate nutrition during this critical stage.
  • National Nutritional Anaemia Prophylaxis Program (NNAPP): This program focuses on preventing and controlling iron-deficiency anemia among vulnerable groups, including adolescent girls. It provides weekly iron and folic acid supplementation to girls aged 10-19 years, along with health and nutrition education.
  • National Deworming Day: The National Deworming Day on February 10 is an initiative aimed at deworming all children and adolescents in the country to prevent worm infestation and improve overall health. Adolescent girls are an important target group for this program.

Way forward

  • Routine training of health workers for effective implementation and monitoring of various schemes.
  • Implement comprehensive nutrition education programs in schools and communities that specifically target adolescent girls. Teach them about balanced diets, essential nutrients, and healthy eating habits. This can be integrated into the school curriculum or delivered through community health workers.
  • Nutritious school meals: Enhance the quality of mid-day meals provided in schools to ensure they meet the nutritional needs of adolescent girls. Include a variety of nutrient-rich foods like fruits, vegetables, pulses, and whole grains. 
  • Conduct nutrition-focused workshops, cooking demonstrations, and awareness campaigns to empower families and communities to make informed choices regarding their nutrition.
  • Focus on addressing gender disparities that affect nutrition, such as unequal access to food, resources, and education.
  • Regular data collection and analysis can help track progress, identify gaps, and inform evidence-based decision-making for future interventions. 

Investing in girls’ nutrition is not only a moral obligation of the state but also an economic one, with potential returns in the form of greater and more sustainable economic growth of the nation. The strength of a nation is measured by its ability to nurture its future generations. There is a need for effective convergence and collaboration among all the relevant departments, to sow the seeds of a healthier, stronger India, where every girl can reach her full potential.

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