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Lok Sabha polls 2014: Malnutrition, a problem ignored by every party-Rema Nagarajan
-The Economic Times


In January 2012, PM Manmohan Singh declared half of India's children were malnourished and that was a national shame. Yet since then, not a single comprehensive national survey was conducted to determine the acuteness of the problem or measure progress, if any, of steps initiated to address malnutrition. Worse, the issue figures in a token manner in the election discourse of political parties and candidates. The 2005-06 National Family Health Survey was the last one conducted and it found 48% of children suffered chronic malnourishment — of them, 20% acute malnourishment. The survey concluded that over half the women were anaemic and 36% underweight. The Global Hunger Index, released in October 2013, placed India among a group of countries with 'alarming' levels of hunger, figuring at the bottom of the heap, below China, Sri Lanka, Pakistan and several in sub-Saharan Africa. Key interventions to boost nutrition levels include the targeted public distribution system (TPDS), Integrated Child Development Services (ICDS) and the school midday meal scheme (MDMS).

Despite increased food production and procurement for TDPS, food insecurity persists and is a chronic problem linked to poor delivery. The large number of ineligible or fake ration cards issued — a serious problem in some states, usually those that need TPDS the most — has caused huge leakages. The TPDS has glaring exclusion errors.

About 20% of the estimated 90 crore eligible beneficiaries are denied subsidized grain as they have no ration card, while 20% of the not-poor do. TPDS remains restricted to wheat and rice that would alleviate hunger, but not address malnutrition. No recommendation to include pulses, oil and nutritious millets has been implemented. Even the food security Act — that UPA counts among its mega achievements — focuses on rice and wheat. Had the Act included higher procurement of millets, pulses, fruits and vegetables, it would have incentivized production of these, instead of just rice and wheat that are water-intensive crops.

ICDS was meant to counter malnutrition in children between 0 and 6 years and pregnant women. Government allocation, including states' share, increased from over Rs 5,200 crore in 2007-08 to Rs 13,700 crore in 2013-14 and the number of anganwadi centres (AWCs) has increased from 10.1 lakh to 13.1 lakh in 2012-13. Though almost 90% anganwadis are operational, the ICDS scheme reaches about 47% of eligible children, reported a CAG audit. Coverage in states varies from about 75% in Odisha to 18% in Bihar.

Most AWCs lack infrastructure. In 2011-12, only 57% had drinking water on the premises, 47% had toilets and only 25% had a kitchen. ICDS is meant to provide supplementary nutrition 300 days a year, or 25 days a month. But the number of days the programme worked ranged from 180-250, a CAG audit found. The audit revealed irregularities such as insufficient monitoring, suspected misappropriation of supplies, badly-trained anganwadi workers and shortfall in expenditure on supplementary nutrition, which meant lower per beneficiary expenditure. For a flagship programme that addresses a "national shame" the ICDS programme leaves much to be desired.

Allocation for the midday meal scheme is up from Rs 6,700cr to over Rs 10,300cr between 2007-08 and 2011-12. But many states aren't meeting yearly targets of number of meals served. The scheme's plagued by reports of children falling ill from eating poor quality or spoiled food. Many states are yet to achieve standards set to run it: constructing a kitchen shed, timely lifting of grains, proper food storage.

Women employed as midday meal cooks remain underpaid. While proportion of malnourished children has fallen since 2005-06, not only has the decline been slow, from 46% malnourished to about 33% by 2013, it's been uneven with a few states and districts getting worse. But with poor tracking of the schemes' implementation, or of the population's nutritional status, no one seems sure if the situation has become any better or worse. And that's the national shame.