We have been combating COVID-19 for over a year and we are yet to see its back. One thing that the world has realized is that immunity is the key to good health. What’s the foundation for a strong immune system? Nutrition.

Good nutrition – access to essential micronutrients critical for growth and development – is something that India has been struggling with for a long time. The latest National Family and Health Survey (NFHS-5) showed there is still a long way to go, especially in the area of anaemia and nutrition. Several states either had meager improvements or sustained reversals on child malnutrition indicators such as stunting, wasting and underweight. In most states and union territories of India, more than half the children and women are anaemic. Despite the increase in availability of iron supplementation, especially for pregnant women, levels of anaemia continue to increase.

#YouAreWhatYouEat survey results

As part of the pressing need to address this urgent problem, Nutrition International, along with Youth Ki Awaaz, conducted a survey in November 2020 to map perceptions of Indian youth about nutrition and anaemia, and to assess the impact of the pandemic on their access to health and nutrition services. The #YouAreWhatYouEat survey reached 2,900 respondents online. Its key findings included the following:

• One-third of the respondents had limited knowledge about anaemia, while 11% had no knowledge about it.
• 69% of respondents were unaware that dizziness, cold feet and/or hands, and frequent headaches are symptoms of anaemia, and were only aware of fatigue and weakness as related symptoms.
• 51% of respondents felt COVID-19 had an impact on their health conditions and emotional well-being.
• 32% reported the inability to go to the market to buy nutritious food items due to the pandemic, while 22% reported unavailability of these items.
• 15% reported the inability to go to the market to buy medicines/supplements due to the pandemic, while 10% reported unavailability of these essentials.

India has had a nationwide program focused on anaemia control for over 30 years. Despite this, nearly 53% of women (15-49 years), 59% of children (6-59 months) and 50% of pregnant women are anaemic. Nutrition International supports anaemia prevention by working with government at the national and state levels to increase access, coverage and consumption of iron and folic acid (IFA) supplements for adolescents girls, pregnant women and lactating women. However, the survey highlighted that knowledge about anaemia’s consequences and prevention tactics among youth remains limited. Further, access to health and nutrition services has worsened during the pandemic.

Gender and nutrition

While women in India are still largely in charge of the family kitchen − directly making them the supervisor of their family’s nutrition − when it comes to intake of proper diet, girls and women eat last and least in the family. They are twice as likely to suffer from malnutrition as compared to boys and men. The key to bridging these gender gaps is to ensure the participation of men, especially those in influential positions or who will become community leaders. Educating young men on issues of nutrition and health early on, as well as overcoming stereotypes around who is the ‘provider,’ will help shape how a generation of youth perceive gender, which in turn has great potential to influence behaviour.

Survey recommendations

There is a dire need to strengthen the supply chain, with a focus on delivering preventive nutrition and health services. This requires collaboration across multiple sectors and stakeholders, including the government, health agencies at the national, state and local level, civil society organizations, and the private sector.

Findings from the survey brought to light structural gaps that impact what food makes it on our plate. This includes lack of awareness and understanding around nutrition, diverse socio-economic stratifications, existing problems in our food systems, and restricted access to nutrition and healthcare. These gaps make a strong case for the critical need for investing in preventive health and nutrition. We cannot wait for treatment. The right nutrition at the right time can mean the difference between life and death for the most vulnerable, especially women and children. That nutrition can’t wait, can’t be emphasized enough.

With vaccinations ramping up across the country, there is hope in the midst of the pandemic. However, the ‘new normal’ needs to be rebuilt bridging the systemic gaps that came to light during the pandemic and keeping India’s youth top of mind. COVID-19 highlighted the importance of nutrition to one’s health and development. We need to support our youth to make healthy decisions now that will have lasting impacts into their futures.

The survey was conducted online among youth living in urban or close-to urban areas and hence the findings are representative of such audiences with access to online modes of communication. Nutrition International is conducting a similar survey among rural adolescents residing in Chhattisgarh, Gujarat, Madhya Pradesh, Uttar Pradesh and West Bengal.

 About the authors: The authors work with Nutrition International. Jigyasa Nawani is the Regional Communication Officer, Asia, Ameet Babre is the National Program Manager, India, and Mini Varghese is the Country Director, India.

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