New Delhi: Despite India having a basket of food safety programmes like Mid-day Meal (MDM), Integrated Child Development Services (ICDS) Scheme and Public Distribution System (PDS) there has been an increase in the percentage of children under the age of 5, who are overweight and severely wasted, as per the National Family Health Survey-5 (NFHS-5). The level of hunger in India has been called serious with an overall score of 27.5. India now ranks at 101 out of 116 countries assessed in the Global Hunger Index 2021. The impact of the COVID-19 pandemic on hunger and malnutrition is still unfolding. As per surveys by the Right To Food Campaign, alternatives to school and Anganwadi meals in the form of dry rations and/or cash transfers reached only about half the beneficiaries and have been very irregular and insufficient. Now, as all eyes are on the Union Budget for the financial year 2022-23, set to be presented on February 1, the Banega Swasth India team spoke to experts to know what are their expectations and demands from this year’s budget to improve nutritional outcomes.
Saksham Anganwadi And POSHAN 2.0
To strengthen nutritional content, delivery, outreach and outcome, last year, the government announced the convergence of Supplementary Nutrition Programme and POSHAN Abhiyaan and launched Mission POSHAN 2.0. Saksham Anganwadi and POSHAN 2.0 cover the Integrated Child Development Services (ICDS) Scheme – Anganwadi services; national nutrition mission or POSHAN Abhiyaan; scheme for adolescent girls; national crèche scheme. Additionally, it was called to adopt and intensify strategy to improve nutritional outcomes across 112 aspirational districts. Rs. 20,105 crore was estimated for Saksham Anganwadi and POSHAN 2.0.
Explaining if the merger of schemes reaped any result, Dr Antaryami Dash, Head – Nutrition, Save the Children, said,
Nutrition is inherently multi-sectoral, covering maternal, child health, infant and young child feeding, micronutrient supplementation, food security, social protection, agriculture, WASH and many more sectors. That makes calculating the financing need extraordinarily difficult. However, in past years, releases and expenditures for POSHAN Abhiyaan have been low. Merging and restructuring of schemes may have the advantage of ensuring integration across ministries, but while allocating budget the sum total must be more than the individual components. The budget allocated for Saksham Anganwadi and POSHAN 2.0 was lower than the sum of its individual components from the previous year (2020-21).
Sharing some interventions to increase nutrition levels among children, Dr Sujeet Ranjan, Head – Nutrition, TATA Trusts suggested a provision of food-based interventions (Nutrient-Dense Foods) to treat at least 80 per cent of wasted children at the community level. He added,
The Budget 2022 must increase allocation towards fortified mid-day meals, take-home ration, hot cooked meals to the children and mothers for the prevention and control of micronutrient deficiencies.
Maternal And Child Health
Pradhan Mantri Matru Vandana Yojana along with other women empowerment programmes now come under the umbrella of ‘SAMARTHYA’. Under the Pradhan Mantri Matru Vandana Yojana or Maternity Benefit Programme announced in 2016 a pregnant woman or lactating mother is entitled to Rs. 5,000 for the first live birth.
Child protection services have been clubbed with Child Welfare Services and added under the header ‘Mission VATSALYA’. Child protection services, a Centrally Sponsored Scheme is implemented to create a safe and secure environment for comprehensive development of children who are in need of care and protection, children in conflict with law and other vulnerable children. The programme components include Institutional Services by the way of Child Care Institutions and Family-based non-institutional care through sponsorship, foster care and adoption.
Talking about the two schemes, Dr Dipa Sinha from Dr. B. R. Ambedkar University Delhi said,
Hot cooked meals should extend to children under three years of age through crèches and to pregnant and lactating women through community kitchens. Maternity entitlements should be universalised and made unconditional. The amount of benefit should be increased to at least Rs. 6,000 per child and should be provided on the birth of first two children instead of just one.
Sharing some recommendations to improve the well-being of women and children through various schemes, Basanta Kumar Kar, International Development Professional and Recipient of the Global Nutrition Leadership Award, said:
1. Enriching and diversifying supplementary nutrition with eggs, vegetable oil, pulses, millet, and other food groups
2. A budget for JAN Andolan to JANANI Andolan: 2.5 million hamlet level women nutrition change leaders to be called as JANANIs (Join Angan Nutrition Awareness for New India) across 6.5 lakhs villages. These nutrition warriors can address multiple exclusions and usher in a behaviour change revolution. These JANANIs through quality home contacts will spread nutrition literacy and improve feeding behaviour
3. Special budget for adolescent nutrition and investing in adolescent girls as the second window of opportunity is key and critical
Public Distribution System
Public Distribution System (PDS) offers food and non-food items like wheat, rice, salt, pulses, spices, kerosene oil to the poor at a subsidised rate. In its demand note, the Right To Food Campaign has called to universalise the PDS to give subsidised rations to everyone who demands it.
To begin with, the quotas under the National Food Security Act (NFSA) can be immediately expanded on the basis of the population projections for 2022 to include all vulnerable persons especially migrant workers, homeless, sex workers, trans people and all vulnerable communities even without ration cards. Using the latest population data has also been directed by the Supreme Court, said the Right To Food Campaign’s demand note.
During the COVID-19 pandemic in 2020, Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY) was started to provide an additional ration of 5 kg of wheat or rice per person and one kg of pulses per household every month for free of cost to over 80 crore beneficiaries under the NFSA. However, in 2021, when the scheme was restarted, only wheat/rice was provided. Hence, the Right To Food Campaign is demanding an extension of the scheme till May 2022 with the provision of edible oil and pulses (a source of protein) to each household.
Additionally, the Right To Food Campaign demands an expansion of the PDS to provide millets and other nutritious commodities such as pulses and oil while procuring these at the Minimum Support Price (MSP).
Mid-day Meal Scheme/National Scheme for PM POSHAN in Schools
The mid-day meal (MDM) programme, run by the Ministry of Education is considered to be the world’s largest school meal programme, serving hot and freshly cooked meals to emaciated children. From Rs. 13,215 crore allocated to MDM scheme in 2013-14 to Rs. 11,000 crore in 2020-21, the budgetary allocation has seen a decline. For the year 2021-22, the budget estimate was Rs. 11,500 crore.
It might look like the government increased the monetary allocation for the MDM scheme but the reality is different from what meets the eye. In 2020-21, the budget estimate was revised from Rs. 11,000 crore to Rs. 12,900 crore. If the estimated spending was higher in 2020-21 then why did the government reduce the MDM spend allocated for 2021 by Rs. 1,400 crore to Rs. 11,500 crore.
Important to note, in May 2021, an additional sum of Rs. 1,200 crore was approved to provide monetary assistance to 11.8 crore students through Direct Benefit Transfer (DBT) of the cooking cost component of the Mid-Day-Meal Scheme, to all eligible children, as a special welfare measure.
Despite this increase, allocations remain 48 per cent lower than the Ministry of Education’s total demand of Rs. 22,308. Release of funds to states significantly slowed down in FY 2021-22. On average, only 48 per cent of the funds approved were released till December. The figure for the corresponding period in FY 2020-21 was 73 per cent, said Avani Kapur, Fellow Centre for Policy Research and Director Accountability Initiative.
The Right To Food Campaign (RFC) has called for the revival of hot cooked meals under the MDM scheme. The budgets for these programmes should make adequate provisions for the inclusion of eggs and a nutrient-dense diet in the meals, read the initiative’s demand note.
On September 29, 2021, MDM was renamed as PM POSHAN Scheme and the scheme was approved for the next five years – from 2021-22 to 2025-26. The scheme is proposed to be extended to students studying in pre-primary or Bal Vatikas of Government and Government-aided primary schools in addition to all the 11.80 crore children from elementary classes studying in 11.20 lakh schools across the country.
In Budget 2022-23 the scheme must expand to include pre-primary students. As per the estimates by Accountability Initiative, Centre for Policy Research, additional funds ranging between Rs. 345-374 crore would be required to cater meals to 32 lakhs students in pre-primary and Bal Vatikas of government and government-aided primary schools, says Mini Varghese, Country Director, Nutrition International India.
Also Read: What Ails India’s Mid-Day Meal Programme?
Bringing focus to the implementation and success of nutrition gardens, Ms Varghese suggested increasing demand generation on growing locally available food. She said,
To realise the goals of nutri-smart schools, the progress in setting up nutrition gardens has been slow. While Punjab and Odisha are nearing completion of setting up nutri-gardens in 80 per cent of their schools, at an all-India level the progress is still at 30 per cent. The allocation of sustained food grains and providing a nudge to students to eat nutritious and local food will increase awareness, improve availability, and accessibility to diverse foods groups.
Experts are looking at increased budgetary allocation across schemes and sectors to improve nutritional outcomes and also overcome the challenges posed by the pandemic. While it’s important to invest in nutrition-specific schemes, nutrition-sensitive interventions like water, sanitation and hygiene (WASH), the environment also demands equal importance. Dr Ranjan also recommended the refurbishment of Anganwadi Centres, a go-to place for many new mothers and children. He said,
We are very much hopeful that the budget will ensure allocation to have well-functioning Anganwadi centres, which act as a pivot around which the entire program functions. The infrastructure of these centres especially in areas such as refurbishment, flooring, roofing, and kitchen and sanitation facilities is thus of prime importance.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. 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 will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that 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 the country can become a Swasth or healthy India.