<p>Following the horrible tragedy of poisonous mid-day meals in Bihar, the media has been full of various incidents of adverse effects of consuming mid-day meals, iron tablets and other nutrition supplements in various parts of the country. <br /><br /></p>.<p>Of course there is no sudden inexplicable increase in such distressing incidents. It is simply that with the intense debate on this issue all such incidents are now being more regularly reported. Most of these incidents relate to the poor implementation of mid-day meals.<br /><br /> Integrated Child Development Services (ICDS) and other related programmes.<br />The ICDS is the world's biggest child and maternal care programme reaching out to about 1.4 million hamlets. However serious weaknesses in its implementation were recently pointed out in a recent report of Comptroller and Auditor General (CAG) which covered 2730 ICDS units or anganwadis centres (AWCs) in 67 districts of 13 states from 2006-07 to 2010-11. <br /><br />This survey revealed that 61 per cent of AWCs did not have their own building. Between 40 and 65 per cent did not have separate spaces for cooking, storing food items or separate spaces for children's activities 52 per cent of the AWCs did not have their own toilets, and 32 per cent had no drinking water facility. Functioning weighing machines for children and adults were absent in 26 per cent and 58 per cent of AWCs respectively. Between 33 and 49 per cent did not have medicine kits. 53 per cent did not receive the annual flexible fund. There were shortages of key staff at all levels. 33 to 47 percent of the children were not regularly weighed. 33 to 45 percent of the eligible children did not receive supplementary nutritions. Preschool education kits were not available in 41 to 51 percent of AWCs. Clearly the ICDS needs much better resource availability and implementation.<br /><br />Poor implementation<br /><br />Similarly while the reach of the mid-day meals programme has expanded rapidly, its implementation in several parts of the country has been so poor that even children from poor families refuse to eat the poor quality food doled out to them. During a visit in Bundelkhand region of Uttar Pradesh known for high levels of malnutrition several panchayat leaders complained that they do not even get the basic raw material for several weeks. Elsewhere the storage and cooking conditions were so pathetic that contamination of food appeared quite likely. Women in charge of cooking had their own bagful of woes. Apart from the poor quality of food, there is also the increased risk of fire due to daily large scale cooking close to classrooms.<br /><br />Of course there are exceptions and where there is good community support or some dedicated organisations and teachers are active, good quality mid-day meals have been served and these have brought other welcome changes such as improved attendance at schools. But such examples are relatively rare compared to the sad reality of mid-day meals and ICDS in most parts of the country. Any reforms that take place must keep in mind the reality of conditions in remote villages and schools. <br /><br />Where even clean drinking water is not assured to children how can daily large-scale cooking for a hundred or more children can be done in hygienic conditions?<br />Also there is a clear need to protect these priority programmes from vested interests who want to earn some quick money from these. In Uttar Pradesh for a long time the contract for supplying nutritious food for ICDS was given to a notorious liquor mafia don. Even when checks at his food processing plants clearly revealed very poor quality of food, his contract continued for quite some time.<br /><br />Also these programmes have to guard against efforts being made to push products of highly dubious utility manufactured on a mass scale by multinational companies. The need for such caution is particularly acute now as a propaganda blitz for such foods has been launched, cloaked cleverly in medical jargon. <br /><br />This propaganda has specially targeted India due to its vast nutrition programmes. If these efforts succeed, then India's children and mothers could become the guinea pigs for testing more and more dubious products of these companies, including RUTFs (ready to use therapeutic foods) and RUSFs (ready to use supplementary foods).<br /><br />Children in the age group 6 months to 3 years often are not accommodated at ICDS centres. Efforts should be made to improve ICDS in such a way that children of this age group can also be admitted. If this is not possible, then creches should be opened not just in urban areas but also in rural areas for children of this age group with provision for proper feeding. These will be particularly useful for those families (like landless workers) where both parents have to go daily for work.<br /></p>
<p>Following the horrible tragedy of poisonous mid-day meals in Bihar, the media has been full of various incidents of adverse effects of consuming mid-day meals, iron tablets and other nutrition supplements in various parts of the country. <br /><br /></p>.<p>Of course there is no sudden inexplicable increase in such distressing incidents. It is simply that with the intense debate on this issue all such incidents are now being more regularly reported. Most of these incidents relate to the poor implementation of mid-day meals.<br /><br /> Integrated Child Development Services (ICDS) and other related programmes.<br />The ICDS is the world's biggest child and maternal care programme reaching out to about 1.4 million hamlets. However serious weaknesses in its implementation were recently pointed out in a recent report of Comptroller and Auditor General (CAG) which covered 2730 ICDS units or anganwadis centres (AWCs) in 67 districts of 13 states from 2006-07 to 2010-11. <br /><br />This survey revealed that 61 per cent of AWCs did not have their own building. Between 40 and 65 per cent did not have separate spaces for cooking, storing food items or separate spaces for children's activities 52 per cent of the AWCs did not have their own toilets, and 32 per cent had no drinking water facility. Functioning weighing machines for children and adults were absent in 26 per cent and 58 per cent of AWCs respectively. Between 33 and 49 per cent did not have medicine kits. 53 per cent did not receive the annual flexible fund. There were shortages of key staff at all levels. 33 to 47 percent of the children were not regularly weighed. 33 to 45 percent of the eligible children did not receive supplementary nutritions. Preschool education kits were not available in 41 to 51 percent of AWCs. Clearly the ICDS needs much better resource availability and implementation.<br /><br />Poor implementation<br /><br />Similarly while the reach of the mid-day meals programme has expanded rapidly, its implementation in several parts of the country has been so poor that even children from poor families refuse to eat the poor quality food doled out to them. During a visit in Bundelkhand region of Uttar Pradesh known for high levels of malnutrition several panchayat leaders complained that they do not even get the basic raw material for several weeks. Elsewhere the storage and cooking conditions were so pathetic that contamination of food appeared quite likely. Women in charge of cooking had their own bagful of woes. Apart from the poor quality of food, there is also the increased risk of fire due to daily large scale cooking close to classrooms.<br /><br />Of course there are exceptions and where there is good community support or some dedicated organisations and teachers are active, good quality mid-day meals have been served and these have brought other welcome changes such as improved attendance at schools. But such examples are relatively rare compared to the sad reality of mid-day meals and ICDS in most parts of the country. Any reforms that take place must keep in mind the reality of conditions in remote villages and schools. <br /><br />Where even clean drinking water is not assured to children how can daily large-scale cooking for a hundred or more children can be done in hygienic conditions?<br />Also there is a clear need to protect these priority programmes from vested interests who want to earn some quick money from these. In Uttar Pradesh for a long time the contract for supplying nutritious food for ICDS was given to a notorious liquor mafia don. Even when checks at his food processing plants clearly revealed very poor quality of food, his contract continued for quite some time.<br /><br />Also these programmes have to guard against efforts being made to push products of highly dubious utility manufactured on a mass scale by multinational companies. The need for such caution is particularly acute now as a propaganda blitz for such foods has been launched, cloaked cleverly in medical jargon. <br /><br />This propaganda has specially targeted India due to its vast nutrition programmes. If these efforts succeed, then India's children and mothers could become the guinea pigs for testing more and more dubious products of these companies, including RUTFs (ready to use therapeutic foods) and RUSFs (ready to use supplementary foods).<br /><br />Children in the age group 6 months to 3 years often are not accommodated at ICDS centres. Efforts should be made to improve ICDS in such a way that children of this age group can also be admitted. If this is not possible, then creches should be opened not just in urban areas but also in rural areas for children of this age group with provision for proper feeding. These will be particularly useful for those families (like landless workers) where both parents have to go daily for work.<br /></p>
