Tuesday, March 18, 2008

No package deal

Rajib Dasgupta and Rama V. Baru

Health and education are fundamental rights of every child and it is imperative that the state and civil society ensure that these services are available, accessible and of good quality. Data from the National Nutritional Monitoring Bureau and the National Family Health Survey 3 indicate that child malnutrition continues to be a serious concern.

The government is now considering the replacement of cooked meals with packaged foods and biscuits in its Mid-Day Meal (MDM) and Integrated Child Development Services (ICDS) programmes. It is argued that this shift would improve efficiency and help overcome fiscal and managerial constraints faced in the implementation of these programmes. Reports also point to the role of the packaged food and biscuit industries that see the potential for furthering their business interests through these government programmes. The proposed policy shift has evinced concern from the academic community of senior scientists, medical professionals, educationists, nutritionists, public health experts and civil society organisations.

The objective of the mid-day meal programme was to increase enrollment and ensure better nutritional status among children. Several studies have demonstrated the positive impact of mid-day meals on school enrollment. The extent of impact on the health and nutrition of children is largely dependent on whether the meal that is provided is supplementary or a substitute for a full meal.

Several civil society alliances, professional networks like the Indian Association for Preventive and Social Medicine (IAPSM) and academics came together at a consultation that was initiated by the University School Resource Network project at Jawaharlal Nehru University. This consultation sought to review the scientific evidence that favoured cooked meals in the nutritional support programmes. Those present at this consultation unanimously opposed the idea of replacing cooked meals with packaged foods. A review of available evidence showed the value of cooked meals over dry rations or biscuits. Several studies have shown that not only is the quality variable but the nutritional impact of dry snacks is also questionable.

A fresh meal offers a better range of nutrients and is less costly in terms of per rupee nutrient yield when compared to packaged food. Calorie deficiency is by far the single most important challenge and its correction through wholesome balanced diets will go a long way in tackling micronutrient deficiencies as well. The other benefits of cooked meals are that they address ‘classroom hunger’ and also provide protection against acute hunger among children in drought affected areas.

A wholesome cooked meal makes the school attractive for the child and along with improved enrollment and attendance helps the learning process. Children learn to sit and eat together and that contributes to breaking caste and class barriers.

Despite overwhelming evidence regarding the positive contribution and demand for these schemes, these programmes are not without problems. These are related to resources, infrastructure, problems in delivery and issues of quality and quantity. Different states have different experiences related to the cooked meal programme that need to be properly studied.

The consultation was of the view that the constraints of finances and management that are faced by these programmes need to be addressed by context-specific fiscal and managerial solutions. In the context of hunger and malnutrition, the MDM and ICDS programmes have contributed significantly but they need to be strengthened further. Therefore those present at the consultation argued against any shift in policy without acknowledging the overwhelming scientific evidence regarding the value of cooked meals at feeding programmes.

In response to a public interest litigation on the right to food, the Supreme Court had in 2001 ordered that each child was entitled to a cooked meal that had 300 calories and 8-12 gm of protein per day for a minimum of 200 days a year. Malnourished children were entitled to 600 calories and 16-20 gm of protein. At present, the allocation per child does not allow for variety in the menu and therefore it is necessary to enhance financial allocation. This would ensure an increase in both quantity and nutritional quality of the food that is being served.

Instead of a supplementary feeding programme, the children would get a full meal that takes into account locally available foods with nutritional adequacy. Infrastructure in schools — water supply, toilets, kitchen area and hiring of cooks — often does not receive adequate attention. Monitoring systems to check quality and possible corruption and leakages in food grain supply need to be strengthened.

The strategy for implementation needs a decentralised approach taking into account the regional and local contexts. This would also result in greater accountability and transparency at every level of the programme.

Rajib Dasgupta is assistant professor and Rama V. Baru is associate professor at the Centre of Social Medicine and Community Health, JNU

March 18, 2008
Indian Express