Winning a battle against malnutrition

Winning a battle against malnutrition

Welfare programmes like MDMS and ICDS with over 100 million beneficiaries each are of great importance.

In 2013-14, the Ministry of Women and Child Development collaborated with United Nations International Children’s Emergency Fund (Unicef) to conduct the first-ever Rapid Survey on Children (RSoC) to study the prevalence of malnutrition in children in the country. One of the positive finds of this survey was that malnutrition in children had dropped from 42.5% during the third National Family Health Survey (NFHS) in 2005-06 to 30%.

The RSoC did reveal that there is a long way to go, but more importantly, it indicated that things are headed on the right path. The improvement in nutritional standards of children observed in the RSoC can be attributed to many factors, including economic growth, welfare schemes, improved literacy rate etc. The good thing is that this progress has prompted all the stakeholders to fight malnutrition with a new vigour.

The efforts put in by the Central and state governments are laudable, especially with regard to the implementation of food security programmes. In 2013, the National Food Security Act was signed into a law, thus paving the way to provide subsidised food grains to two-thirds of the country’s population.

This Act also made it binding for the Centre and states to provide nutritional support to the population by means of welfare schemes like the Mid-day Meal Scheme (MDMS), Integrated Child Development Services (ICDS) and Public Distribution System (PDS). Of these, MDMS and ICDS programmes have children as direct beneficiaries; the latter being the world’s largest programme to deal with the issue of malnutrition.

While the MDMS entitles a nutritious meal to children studying in class I to VIII in government schools (up to 14 years age), the ICDS programme – among other things – focuses on health and nutritional level of children below 6 years of age and adolescent girls. Additionally, the ICDS also has lactating mothers and pregnant women as target groups. The idea behind it is that educating them about different aspects of nutrition and providing them nutritional food will have a positive effect on the child’s health.

In a country where nearly 40% children are malnourished, welfare programmes like MDMS and ICDS with over 100 million beneficiaries each, are of immense importance. These programmes are devised to meet the nutritional requirements of the target population.

According to the MDMS guidelines, the meals served should provide 450 calories and 12 gm protein for children in primary schools and 700 calories and 20 gm protein for children in upper primary schools, plus a steady supply of micronutrients like iron, zinc, folic acid, vitamin A etc. Similarly, the ICDS guidelines stipulate 300 calories and 8-10 gm of protein to children below 6 years of age and 500 calories and 25 gm protein for adolescent girls.

Other welfare schemes
Besides the ICDS, the Ministry of Social Welfare also runs Balwadi Nutrition Programme in rural areas, as a part of which food supplements are provided to children in 3-6 years age group. The nutritional value stipulated for this programme is 300 calories and 10 gm protein. Then, there is the National Nutrition Mission, which provides subsidised foodgrains to adolescent girls, pregnant women, and nursing mothers belonging to BPL families.

In order to meet the requirements of these programmes, state governments have set specific guidelines which the schools must adhere to. In Karnataka, for instance, it is mandatory to rotate vegetables that are used in preparation of sambhar on a daily basis. In Haryana, schools have been provided a list of dishes and they can choose one every day as long as the same is not repeated in a week.

In a country as vast as India, implementation of welfare schemes can pose economic and logistical challenges. Therefore, state governments can resort to the Public-Private Partnership (PPP) model and enter into a tie-up with NGOs to make these schemes viable. In this case, instead of schools preparing mid-day meal for children, the NGOs prepare hygienic food and deliver it to government schools in their catchment area.

In the ICDS programme, Anganwadi Centres (AWCs) are mainly used to reach out to the target group. It is the AWC where all the activities related to healthcare are carried out. However, to facilitate community mobilisation, the programme is run in partnership with local NGOs.

There are several advantages to the use of the PPP model in these programmes: it reduces the burden on teachers, who would otherwise have to get involved in cooking; it makes school premises safe as the site of cooking is elsewhere; it takes care of financial problems with several big companies coming forward to help as a part of their CSR initiative; and so on.

For several decades now, the narrative on children’s health in India has been dominated by malnutrition, wasting and stunted growth. It is good to see that things are finally changing for the better. At this rate, there is hope that the deadline to end all forms of hunger and malnutrition will be met. The key is to work hard and work together.

(The writer is CEO, The Akshaya Patra Foundation)
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