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When schemes turn anaemic -Anumeha Yadav
-The Hindu

Despite government programmes, nutrition supplements for women and children are not to be found in Jharkhand’s villages

More than two years after she gave birth to her youngest daughter, Shanti Oraon, an adivasi farmer in Bhandara village, Khunti district has been unable to resume working in the fields. “She has breathing trouble, and could not start walking even after she turned two and a half years old. I must stay at home with her all the time,” she says of her infant daughter lying wrapped in a bedsheet on the floor. Across the road from Shanti’s house, Pooja Devi watches her one-year-old play with a plastic bangle in her mouth. “She weighed less than three kgs when she was born. She falls ill often even now,” she says.

Bhandara, a little over 30 kms from State capital Ranchi, is on the outskirts of Khunti’s district center and market. Despite good road connectivity and easy accessibility, Bhandara and the adjoining villages of Belahatu and Chikor have not received supplies of Iron Folic Acid (IFA) tablets since three years. These tablets are essential for reducing anaemia and birth defects which affect 69.5 per cent women and girls between 15 and 49 and over 70 per cent of all children below five in Jharkhand – the highest levels of anaemia according to National Family Health Survey 2 and 3 done in 1999 and 2006. Over six lakhs, or nearly 12 per cent of children below six years of age in Jharkhand suffer from severe malnutrition. Children born underweight due to anaemia among women is a significant factor.

Under a Central scheme, 100 IFA tablets are to be given to all pregnant women and weekly IFA supplements are to be provided to all adolescent girls between 16 and 19 years of age. Recently, adolescent boys have also been included in the scheme.

Shanti Oraon recounts that during her four pregnancies she received IFA tablets, each costs less than 20 paise, only before the birth of her second child more than four years ago but none before the birth of three of her children. “There are eight pregnant women and several adolescent girls in the village but we do not have any stocks of tablets,” says Rukmini Devi, the anganwadi sevika in Bhandara as she prepares a meal of rice and soyabean nuggets for the seven children below six years of age who turned up for lunch that afternoon from among the 89 enrolled as per the anganwadi charts. “Earlier the ANM didi (Auxiliary Nurse Midwife) brought the tablets but now since over a year she says there is no supply,” says Shobha Devi, anganwadi worker in Belahatu. In Chikor, between 11am to noon when food preparation is supposed to be on, the anganwadi had still not opened.

In Khunti, the civil surgeon Dr V N Khanna says his department is holding a stock of 18 lakh IFA tablets since more than two weeks. “Social Welfare officials did not come forward to take the tablets. Neither they nor the Education Officers who distribute the tablets in schools submitted the requirements and other details.” There are over one lakh adolescents in Khunti.

“We recently met health officials and asked them for IFA tablets and middle-upper-arm circumference bands to measure malnutrition among children. They provided neither,” says PK Paul the District Social Welfare Officer who supervises the 840 anganwadis in Khunti.

Since the last three years, this has been the story in most districts in Jharkhand after the Central government discontinued supplying medical kits containing IFA, vitamin A, zinc tablets and Oral Rehydration Solution packets under National Rural Health Mission (NRHM) to States. “In 2010, state governments were asked to do this. Here, district civil surgeons were asked to procure this but some bought expensive non-generic IFA tablets and exhausted funds. A month back the tender process was completed and now those will soon be supplied to all districts,” said Dr Praveen Chandra, Director NRHM in Ranchi. In 2011, former health minister Bhanu Pratap Shahi, former health secretary Pradeep Kumar and other department officers were named as accused in a Rs 130-crore NRHM scam related to purchase of medicines. The CBI is now investigating the case.