ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Delivering Nutrition to Pregnant Women

Fiscal Bottlenecks in Purnea, Bihar

To reduce the burden of maternal undernutrition in India, select nutrition interventions are delivered to pregnant women at scale through the National Health Mission. But in Purnea, a district in Bihar, delivery is constrained by poor planning and budgeting, delayed fund flow, and shortage of infrastructure and human resources; and funds are underutilised.

The article is based on the CBGA working paper published in 2017.

The authors are grateful to the anonymous reviewers.

Maternal nutrition is important due to its critical and complex association with womens well-being and implications for child development (Jose and Navaneetham 2008). Evidence suggests that deficiencies in both macronutrients and micronutrients can cause severe maternal morbidity and mortality (Villar et al 2003). During pregnancy, an inverse relationship exists between calcium intake and development of hypertension (Black et al 2013), and iron deficiency anaemia in pregnancy increases the risk of haemorrhage and maternal mortality (Results UK 2016; Stoltzfus et al 2004). A womans nutritional status before and during pregnancy also impacts foetal development and child malnutrition. Maternal undernutrition can lead to intra-uterine growth retardation, low-birth-weight babies, preterm birth, childhood stunting, and emergence of chronic diseases (Villar et al 2003; Vir 2016). Poor maternal nutrition also results in low energy reserves in mothers and affects their functional outcomes.

According to the National Family Health Survey (NFHS-4), the state of Bihar has the worst maternal nutrition indicators in India. Almost 30% of women have low body mass index (BMI), and around 60% are anaemic (they have less than 11.9 g/decilitre of haemoglobin in their blood). Disparity between districts in Bihar is significant; Purnea is one of the districts where undernutrition is high (IIPS 2016). Almost 72% of pregnant women in Purnea are anaemic. Nearly 39% of women have below-normal BMI (less than 18.5 kg/m2), much higher than the average percentage of women with below-normal BMI in the state. Access to prenatal and postnatal care is limited. As per NFHS-4, only 33% of women registered during the first trimester of their pregnancy and only 4.6% received full antenatal care (ANC).

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Published On : 20th Jan, 2024

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