The GHI is an important indicator of nutrition, especially in children, as it examines stunting, wasting and mortality in children, as well as calorie deficiency in the general population. And this is by no means an international conspiracy – India’s National Family Health Survey (NFHS-5) 2019-21 reported that among children under five, 35.5% were stunted. growth, 19.3% were wasted and 32.1% were underweight. .
Government programs don’t work
Experts have suggested several approaches to solving the problem of chronic malnutrition, many of which feature in central government-sponsored programs that already exist. However, gaps remain in the way they are funded and implemented, in what might be called the plumbing of these schemes.
For example, the Indian government is implementing the Saksham Anganwadi and Prime Minister’s Overarching Scheme for Holistic Nutrition (POSHAN) 2.0 program (which now includes the Integrated Child Development Services (ICDS) program), which aims to work with adolescent girls, women pregnant, nursing mothers and children under three years of age. However, the budget for this program for FY 2022-23 was ₹20,263 crore, less than 1% higher than the actual expenditure for FY 2020-21, an increase of less than 1% over two year.
The other flagship program of the Government of India is the PM POSHAN, or Pradhan Mantri Poshan Shakti Nirman, previously known as the Midday Meal Program (National School Midday Meal Program). The budget for the financial year 2022-23 at ₹10,233.75 crore was 21% lower than the expenditure for the financial year 2020-21. Even though we admit that 2020-21 has been an exceptional year (due to the COVID-19 pandemic), it is clear that the budgets allocated fall far short of the scale of funds needed to improve nutrition in the country. .
An Accountability Initiative budget note reports that the per capita costs of the Supplemental Nutrition Program (one of the program’s largest components) have not increased since 2017 and remain grossly underfunded, representing only 41% of funds needed. The budget brief also mentions that more than 50% of Child Development Project Officer (CDPO) positions were vacant in Jharkhand, Assam, Uttar Pradesh and Rajasthan, pointing to severe labor constraints. to successfully implement the program of such importance. And while PM POSHAN (or MDM) is widely recognized as a groundbreaking program that has improved access to education for children nationwide, it is often embroiled in controversies over what should be included in meals. noon that are provided in schools. Social audits intended to allow community monitoring of the quality of services provided in schools are not carried out routinely.
In summary, not only are major nutrition programs underfunded, but it is also true that available funds are not being spent effectively. Correcting these diets is the obvious answer to address India’s multidimensional nutritional challenge.
Cash transfers and the dependency factor
Cash transfers appear to be a preferred solution for several social sector interventions in India today, and this includes the health and nutrition sectors. Much is said about the JAM trinity (Jan Dhan, Aadhaar, Mobile bank accounts). Equally appealing is the characteristic of cash transfers as a mechanism that yields rich political dividends. By leveraging the digital infrastructure available in India, it is said to be possible to target the right beneficiaries (i.e. pregnant women and families with children under five). Cash also has the advantage of increasing choice at the household level, as they decide what to put on their plates.
But evidence on the impact of cash transfers on child nutrition in India is limited so far. Evidence from elsewhere also mainly suggests that while cash transfers improve household food security, they do not necessarily translate into improved nutritional outcomes for children.
The effect of cash transfers is also limited in a context where food prices are volatile and inflation depletes the value of cash. Similarly, there are social factors such as ‘son preference’, which unfortunately continues to be prevalent in India and can influence decisions at the household level when it comes to meeting the nutritional needs of sons and girls. This requires a comprehensive social education program – money alone cannot solve this problem. In addition, a study of the Mamata program in Odisha that targeted pregnant and lactating women found that there were persistent socio-economic gaps in the receipt of cash transfers, particularly compared to entitlements received through the public distribution system ( PDS). So money can be part of the solution, but on its own it is not the panacea.
Back to basics
Malnutrition has plagued India for several years now. Political battles over malnutrition will not help; nor does it continue to think in silos. It is clear that malnutrition persists due to the depressed economic conditions in large parts of the country, the poor state of agriculture in India, persistent levels of unsafe sanitation practices, and more.
Cash transfers have a role to play here, especially in regions in great distress, where the purchasing power of households is very depressed. Cash transfers can also be used to induce behavior change in terms of seeking greater institutional support. Food rations through the SPD and special supplements for the target group of pregnant and breastfeeding women, as well as infants and young children, are essential.
Persistently underfunded and poorly implemented government programs (such as the old ICDS and MDM programs) must be largely responsible for India’s malnutrition problem. But implementing these programs requires greater involvement of local government and local community groups in the design and implementation of tailored nutrition interventions. A comprehensive program targeting adolescent girls is needed to address the intergenerational nature of malnutrition.
Global Hunger Index | Only 3.9% of children suffer from malnutrition, according to the government
The need of the hour is to make the fight against child malnutrition the top priority of the government apparatus, throughout the year. A month-long POSHAN Utsav can be a good optics, but does not replace careful daily work.
Suvojit Chattopadhyay works on governance and public sector reform projects in South Asia and Sub-Saharan Africa