CHILDREN AND A STEPMOTHERLY STATE

How short-sighted policymaking leaves children nutritionally vulnerable

India’s abysmal nutritional outcomes become newsworthy for about two days every year, coinciding with the release of the Global Hunger Index (GHI) report. This year was no exception: for two days, a handful of media outlets bemoaned India’s further slide in the rankings, a predictable highlight of which was that it had done worse than even Pakistan—India’s ‘Gabbar Singh’.

Little attention is paid to two important caveats: one, the GHI ranking is rarely comparable across years and two, an aggregation of four indicators of hunger and nutrition, the GHI includes a questionable ‘calorie consumption’ measure from the FAO, which confuses food supply with calorie intake. These two caveats play in favour of the government, allowing it to dismiss the GHI findings. The focus on GHI, in fact, deflects attention from a long-standing, widely acknowledged issue that nutrition outcomes have been improving very slowly.

The Comprehensive National Nutrition

Survey, conducted by Unicef, finds little change in the rate of improvement of key indicators. During 2016-18, around a third of Indian children were stunted; a similar proportion were underweight. Because they measure nutrition outcomes, these anthropometric indicators are considered more meaningful than calorie consumption.

Why is it that the improvement has been so slow, in spite of impressive GDP growth rates? Apart from niggardly budgets, the policy neglect was partly due to the late realisation that undernutrition has an inter-generational dimension, and that special attention is required in the first 1,000 days of a child’s life (starting in the mother’s womb). Government programmes that reach women and children in this window of opportunity include maternity benefits and the Integrated Child Development Services (ICDS) scheme, the main programme for children under six and pregnant and lactating mothers. Both have been under threat in recent years.

The introduction of eggs in the anganwadi menu has been an important battleground. Eggs are a nutrientdense ‘superfood’, logistically feasible in rural areas that lack refrigerated storage facilities, and unlike milk or dal, cannot be diluted. In Jharkhand, the supply of eggs in anganwadis, introduced by the current government, has been discontinued for unstated reasons for the past few months and there is no guarantee that it will resume.

In other states (notably Madhya Pradesh and Chhattisgarh), the introduction of eggs has been actively resisted by upper-caste vegetarian lobbies. For a decade, whenever a proposal was made to provide eggs to children and pregnant and lactating women, the government in the state rejected it under the influence of this pressure group. Recently, when the women and child development minister said she was willing to introduce eggs, keeping in mind the poor nutrition outcomes in Madhya Pradesh, one BJP leader said children who are fed eggs become man-eaters when they grow up. Fortunately, the current chief minister has looked the other way, and announced that from April 1, 2020, eggs will be given thrice a week.

Another area of serious neglect is maternity benefits. The National Food Security Act (NFSA) in 2013 recognised universal maternity entitlements for the first time. The Act provides Rs 6,000 per child for women in the unorganised sector (for comparison, women in the organised sector get 26 weeks of paid leave). In 2017, when the Pradhan Mantri Matru Vandana Yojana (PMMVY) was launched to operationalise this legal entitlement, benefits were arbitrarily cut to Rs 5,000 for the first child only. Even this meagre provision in three instalments, we learnt from a recent RTI application, reached only 12 per cent of all pregnant mothers in 2018-19.

The assault on children’s rights extends beyond nutrition interventions. Many states are still insisting on Aadhaar to enrol children at anganwadis, in clear violation of Supreme Court orders. Children most in need might be denied basic healthcare (including vaccinations) and pre-school services.

In Assam, the state government has unleashed a mindless disruption of the very popular mid-day meal programme. Recently, the central government allowed centralised kitchens to supply mid-day meals, even in rural areas. Centralised kitchens (even those run by not-for-profit groups) are harder for teachers and parents to monitor, creating accountability issues. They make little sense in rural areas where the density of schools is low: costs increase as do the chances of food going bad. Yet, within days of the notification, mid-way through the academic year, Assam ordered a switch to an NGO-run central kitchen for the supply of school meals. Unsurprisingly, just days after the move, more than 500 children were reportedly hospitalised.

“Bachche toh sanjhe hote hain (children are a social responsibility)”—we hear this often in the course of our field studies. Pity our policymakers don’t seem to agree. ■