India’s 10.5 crore tribal population from about 705 distinct Scheduled Tribes (STs) representing 8.6 per cent of the total population is hardest hit by the menace of hunger, malnutrition, and pandemic. Estimates show that about 40 per cent of under-five tribal children in India are chronically malnourished (stunted). Chronic malnutrition impacts survival, growth, learning, performance in school and productivity as adults. More than half of preschoolers and more than one-third of school-age children and adolescents belonging to scheduled tribes were reportedly anaemic. Almost 85 per cent of children in the age group of 6-23 months do not receive a minimum acceptable diet that includes a minimum of four or more food groups. Reportedly, 40 per cent of women consume fried food, and 18 per cent consume aerated drinks. The prevalence of overweight and obesity is 10 per cent among scheduled tribe women which is unusual and alarming. This is of serious concern, indicating that the food system is failing to deliver and supply safe and nutritious diets.
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Food systems aggregate the food value chain, nutrition, livelihoods and climate systems, range of actors that provide a right to life and a life to live with dignity. The tribal food system is dependent on dryland agriculture, forests, common property, water resources, and biodiversity. The tribals have been fighting for Jal (water), Jangal (forest) and Jameen (land). Agricultural and food policies have largely focused on increasing food production and mitigating hunger and energy inadequacy. The food subsidies on rice and wheat, urbanisation, globalisation and the consumption of highly refined and processed foods given the societal changes have impacted tribal food systems. In particular, traditional food systems in the tribal areas, the local diversity from plants and crops that are rich food sources of macro and micro-nutrients, notably the millets, wild edible foods, leafy vegetables, nuts, seeds and fruits are being largely eroded and losing their rightful place.
The diluted food systems have caused multiple burdens of malnutrition, namely, undernutrition, micronutrient malnutrition as well as overweight/obesity which are conditions favourable for emerging non -communicable diseases. Malnutrition is not only impairing the cognitive potential, demographic dividend, growth, and productivity but is also increasing the burden of the disease.
High levels of exclusions, poor sanitation, hygiene and lack of safe drinking water, worm infestation, co-infections, and diseases like malaria, lymphatic filariasis, sickle cell anaemia and tuberculosis exacerbate morbidity and mortality. The reported prevalence of mortality among children and women, starvation and chronic illness have been haunting for generations. It is perpetual. The COVID -19 pandemic has aggravated the situation, with the tribal food systems being drastically affected.
To contain the spread of the infection, mitigate hunger and malnutrition, the Government has responded readily to various measures. The provisions under India’s target-driven Poshan Abhiyaan, free food grains under the Targeted Public Distribution System (TPDS) along with the supplementary nutrition at the doorstep are benefitting all vulnerable populations. The ‘One Nation – One Ration Card Scheme’ allows people to access food entitlements from anywhere in India irrespective of the place where the ration card is registered. There is a growing interest in the promotion of Nutri-cereals and biofortified crops. Odisha Millet Mission and Andhra Pradesh Millets Board are significant steps towards nourishing the tribal food systems.
Reforms in the Food Systems
Investment in tribal food systems will supercharge demographic dividends. It calls for a leadership agenda of action. To increase the availability, accessibility, affordability, and consumption of safe and nutritious foods; the undernourished tribals need a caring, resilient, inclusive, nutrition-sensitive and sustainable food system. The suggested reforms are as follows:
1. Structural Reforms- A new legislation on food systems that can take care of a) sustainable food and nutrition, b) food safety and c) preserving biosafety and biodiversity is necessary for a dignified living and just and equitable governance. Effective implementation of the provisions under the Forest Rights Act- 2006, Panchayat Extension to Scheduled Areas (PESA) Act and the NITI Aayog’s Model Agricultural Land Leasing Act- 2016 will go a long way in increasing entitlements. There is a high incidence of physical violence and early marriage among tribal women. Investment in women’s empowerment and rights and workable institutional arrangements will be key drivers in addressing exclusions and gender-based disparities. Special food systems strengthening measures for aboriginal extinctive primitive tribes is needed as they suffer from multiple marginalisations.
2. First and Second Windows of Opportunity- The food systems for tribals need to prioritise actions for the First 1000 Days of life- The First Window of Opportunity and adolescent girls-The Second Window of Opportunity. During the first 1000 days, through inter-personal counselling and home contacts by the grassroots functionaries, initiatives should be taken to promote appropriate infant and young child feeding. Prevention and control of adolescent anaemia and improving reproductive health and life skills of adolescent girls will pave the way for a safe and healthy outcome in newborns.
3. Atmanirbhar POSHAN (Nutritional Self Reliance)- It is one of the critical policy measures on revitalising food systems. Each district must be self-sufficient in at least six food groups- this can bring food and nutritional self-sufficiency at the sub-national level. These food groups constitute cereals and millets, pulses, milk and milk products, roots and tubers, green leafy vegetables, other vegetables, fruits, sugar, fat/ oil and meat, fish, poultry, and eggs.
4. Integrated Strategy to Address Disease Burden- There must be an integrated strategy on addressing issues of malnutrition, lymphatic filariasis and malaria, childhood TB, sickle cell anaemia and HIV reduction. In this regard, India needs to establish a centre of excellence. In the endemic areas, screening of filaria and malaria need to be incorporated specifically in routine antenatal care, village health nutrition and sanitation days (VHNSD) and in the gram sabhas.
5. Addressing All Forms of Hunger- Addressing protein, calorie and hidden hunger, known as micronutrient malnutrition, would require investing in the tribal cultural endowments, traditional diets, dryland agriculture and crops with high nutrition (millets, pulses, wild edible foods among others) which were traditionally consumed by the tribals. It calls for expanding food programs and income safety nets, diversifying both production and farming system to include poultry, fishery, and dairy. Increasing dietary diversity, promoting food fortification and bio-fortification, and streamlining the existing supplementation programs would control hidden hunger. Working with India’s Jal Jeevan Mission to increase access to safe water and making the water a source of nutrients would be a significant milestone.
6. Prevention and Control of Overweight and Obesity- It would require multiple strategies on addressing the local food system to improve access to safe and nutrient-dense foods and discourage the intake of high salt, sugar, and fat-rich foods. Food-based dietary guidelines need to be used as a tool in agriculture, food, and health planning to set targets in healthy food production and consumption. India’s food regulating body FSSAI, Micro Small and Medium food Enterprises and Farmer’s Cooperatives can play an enabling role in reducing the impending double burden on malnutrition.
7. Survive and Thrive-An Emergent Initiative- Survive and thrive of wasted and severely affected malnourished children is an emergent initiative. The children need a safe and dignified living. Each state needs to establish a Child Task Force. The rising wasting is a challenge during the pandemic. Revitalising home visits and inter-personal counselling following COVID norms, activating Nutrition Rehabilitation Centers (NRCs) and nutrition surveillance will be important measures during the pandemic.
8. Promoting and Protecting Livelihoods- Tribals need a sustained income that can address seasonality, perpetual poverty and increase affordability. Promotion of women smallholder farmer-led resilient nutrition-sensitive agriculture, nutrition entrepreneurs under “Stand Up India Scheme” and incentivising tribal micro-small and medium enterprises (MSMSEs) will be important measures. India’s flagship Mahatma Gandhi National Rural Employment Guarantee Scheme can be linked to Nutri-garden, watershed programs, diversifying production and farming system. Household-level non-farm enterprises may be encouraged through a cooperative system. Protecting income from conspicuous consumption and sustained savings would be a key determinant for sustainable livelihoods.
COVID-19 provides an opportunity for new world order. It is a critical wake-up call to redesign the food systems that promotes and protects biodiversity, delivers a nutritious and affordable diet for all. All the stakeholders need to come together to systematically solve the food and nutrition divide for sustainable food systems and the planet.
Also Read: Opinion: Public Health Nutrition Priorities- Disrupted But Not Defeated By COVID-19
(Basanta Kumar Kar is an international development professional, recipient of the Global Nutrition Leadership and Transform Nutrition Champion Award.)
Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.
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