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Let Them Eat Schemes -Ruhi Kandhari
-Tehelka

Why is India struggling to feed its girls and women, who are in desperate need of nutrition, asks Ruhi Kandhari

One out of three women or adolescent girls who come through that door are anaemic," says Dr Savita Agarwal, who runs a charitable clinic at a slum in north Delhi, pointing at the door of her clinic. "They cannot afford to eat meat, eggs, fruits and vegetables that provide iron."

Fifty percent of Indian women are short on red blood cells. In other words, they suffer from anaemia or iron deficiency. About a third are underweight and a same number suffer from chronic energy deficiency. The lack of food not only affects their productivity and makes them lethargic - the most common symptom of anaemia - they are most likely to die during childbirth. A quarter of the 50,000 women who succumbed during childbirth in 2013 died because they suffered from anaemia.

According to the Nutrition in India report, part of the National Family Health Survey conducted in 2005-06, 36 percent of women are undernourished, with a BMI(body mass index) less than 18.5, indicating a high prevalence of nutritional deficiency, and 55 percent are anaemic.

It is universally accepted that hunger remains the No. 1 cause of death in the world. India is home to the largest number of the hungry and undernourished. The situation acutely impacts the well-being of women, who suffer more from malnutrition than men as their food needs are overlooked in favour of males when they are young, and they become more vulnerable when they pregnant.

"Since the 1990s, food availability per head has been consistently declining in India," says Dr Utsa Patnaik, Professor Emeritus, Jawaharlal Nehru University, and author of the book Republic of Hunger. "While the rich started eating more, the poor are eating less and less. They are semi-starved, especially women, who are undernourished, underweight and have a low BMI."

Chart 1

She adds that India is the hungriest country in the world with 176.5 kg of foodgrain available per person every year, lower than Africa and other regions (see table).

The government's response to undernutrition has been targeted initiatives such as the Integrated Child Development Services (ICDS) scheme, Sabla Scheme and the Indira Gandhi Matritva Sahyog Yojana (IGMSY) for children, adolescents and pregnant women, respectively. But are these making any difference?

The Supreme Court had asked the government to ensure that all children below the age of six as well as all pregnant and lactating mothers and adolescent girls are provided nutritional and health services under the ICDS scheme by December 2008. The orders dated 28 November 2001 and 13 December 2006 specifically state that all adolescent girls should be given supplementary nutrition through anganwadis. However, a September 2009 report of the court-appointed commissioner pointed out that only an estimated 2.3 percent adolescent girls were covered under the scheme.

More recently, a report on the Status of Food and Welfare Schemes in Madhya Pradesh, submitted to the commissioners of the Supreme Court in May 2010, highlighted the bias against adolescent girls while providing supplementary nutrition packages.

"Despite the clarity in the Supreme Court direction ordering coverage of all beneficiaries, the Madhya Pradesh government has set a limit in anganwadi centres with regard to the number of beneficiaries covered under the supplementary nutrition programme," said the report. "This limit has been set against the state government's own policy, which itself states that there is no limit. In the state, there are 61,80,117 adolescent girls of which only 9.39 percent are being covered under this scheme."

According to Biraj Patnaik, Principal Adviser of the Office of the Commissioners to the Supreme Court and a Right to Food campaigner, adolescent girls remain a low priority for the government. It is evident from the fact that they are not listed as a vulnerable category in the Food Security Act.

"Nutrition for adolescent girls is so low on the priority list of the Ministry of Women and Child Development that the main scheme for nutrition for them, the Sabla scheme, was not even considered for inclusion in the Food Security Act," he says.

Chart 2

The Rajiv Gandhi Scheme for Empowerment of Adolescent Girls, which is now called the Sabla scheme, is aimed at girls aged between 11 and 18 years. The scheme requires each adolescent girl to be given supplementary nutrition containing 600 calories. An analysis by the New Delhi-based Centre for Budget and Governance Accountability (CBGA) reveals that the scheme is so underfunded that it is able to provide nutrition worth just Rs. 5 per head on a daily basis.

One of the Sabla scheme's focus areas is to provide iron and folic acid supplements to girls to prevent anaemia. According to Patnaik, addressing anaemia is not just about providing iron supplements, but also a dietary diversity requiring a range of wholesome, nutritious foods that are rich in iron, which the girls cannot afford.

"The shameful figures of anaemia are a reflection, yet again, about the low status of women and widespread gender discrimination in our society," says Patnaik.

The Food Security Act had mandated that 2.25 crore pregnant and lactating women will get Rs. 6,000 every year as maternity benefit for nutrition and medicinal supplements. If every woman availed of the benefits guaranteed, the resultant cost to the exchequer would be Rs.15,000 crore. However, the government has allocated only Rs. 400 crore in the current fiscal.

"If the government intends to take care of pregnant and lactating women, how can it undermine the need by allocating just Rs 400 crore?" asks Nilachala Acharya, a researcher with the CBGA.

The IGMSY is a pilot scheme aimed at providing cash benefits to pregnant women. Once again, the government's misplaced priority is evident from the funds allocation. In 2012- 13, the projected allocation for the scheme was Rs. 520 crore. It was reduced to Rs. 500 crore in 2013-14 and the current allocation is Rs. 400 crore.

In addition, the scheme is discriminatory. Neither a woman who is pregnant for the third time nor a woman who gives birth to a stillborn child, is covered under the scheme. Until 30 December 2014, pregnant women below the age of 19 were not given any benefits.

As India struggles to feed its hungry girls and women, who are vulnerable to disease and death, Minister for Women and Child Welfare Maneka Gandhi refused to respond to Tehelka's queries. Despite an RTI application, the ministry also refused to share details of the most recent (2013) report on nutrition.