VANDANA PRASAD AND DIPA SINHA
Courtesy: The Hindu
Cooked meals enhance child attendance at the anganwadi, foster egalitarian social norms, providE employment to poor women, and act as a form of nutrition education.
Over 1000 people, mostly women, from 15 states gathered and rallied in the capital on September 2 to press long standing demands for better services for their children in the context of the ‘new’ 11th Plan. Parents, anganwadi workers, pan chayat representatives, and grassroots workers spoke — through songs, slogans and stories — of their anger and despair at the state of their children and the anganwadis that were meant to support the critical age group of children under six. They also came fully prepared to say what needs to be done.
Women shared and compared experiences between the advanced Tamil Nadu, rejoicing in greater and greater gains for the ICDS and through that for women and children, and the dismal realities of the same programme in states like Uttar Pradesh. Why, they asked, can children of the same country not have the same basic services under the same programme?
Meanwhile, metres away, the nodal ministry for children, the planning commission, finance ministry and the PM’s office are still pondering upon the fate of our children in a bizarre impasse on what exactly needs to be done to achieve the urgent goals of reductions in malnutrition and child mortality. A paper on the “Strategies For Children Under Six” has recently been prepared by a working group of the Right to Food campaign and Jan Swasthya Abhiyan stating a common understanding based on field experiences and academic research. It builds on four complementary interventions: (1) ‘Universalisation with quality” of the Integrated Child Development Services (ICDS); (2) crèches and day care facilities; (3) maternity entitlements; and (4) support for “infant and young child feeding” (IYCF), particularly breastfeeding.
The participants of the public meeting and rally once again endorsed each of these as being absolutely essential for children under six and presented a memorandum of demands to the Prime Minister. While some recommendations have been incorporated in the 11th Plan, there is still no comprehensive policy framework for children under six. Even the basic issues have not been squarely addressed.
For instance, the 11th Plan makes no clear recommendation about supplementary nutrition for children in the ICDS. Instead it argues that there could be two approaches to feeding children: one being hot cooked meals and the other ready-to-eat food and that the decisions between the two options “could also be left to decentralised decision making”.
It is indeed disappointing that this critical decision has been avoided by passing it on to “decentralised decision making” while many other policies have been made centrally.
Various steering committees and working groups of the Planning Commission as well as various fora of international and national experts have recommended nutritious cooked meals based on local foods as the best means of providing nutrition support to this age group.
Cooked meals also serve many important purposes, such as enhancing child attendance at the anganwadi, fostering egalitarian social norms, providing employment to poor women, and acting as a form of nutrition education. Moreover, about 10 states are quite successfully already serving hot cooked meals at their anganwadis with community support.
Those advocating distribution of ready-to-eat fortified food envisage special therapeutic products as being the key solution. This necessitates a relatively centralised procurement and distribution, and its attendant risks of corruption.
In fact it is due to a recognition of the corruption caused by contractor-based centralised procurements that the Supreme Court passed an order (in the ‘right to food’ case) banning private contractors in ICDS and directing that “funds should be spent by village communities, self-help groups and Mahila Mandals”.
The provision of cooked meals at the anganwadi for children aged 3-6 years must become a national policy. Nutritious supplements based on local foods must also be developed for children under three. Despite all technical and experiential wisdom, the Ministry of Women and Child Development steadfastly refuses to declare a nutritional policy that stands in favour of good quality meals offering nutrient sufficiency and diversity.
Another urgent issue is the prevention of interference from commercial interests in policies and programmes related to child health and nutrition, e.g. through advocacy of ‘ready-to-eat’ food or ‘public-private partnerships’. This is a growing threat, requiring the formulation of a comprehensive and coherent policy to guide and regulate PPPs through a democratic and transparent process rather than allowing every private partner to implement its own policies regarding IYCF through public programmes. In fact, the attempts for companies to try to influence infant and young child feeding are not new and have necessitated laws such as the IMS Act to keep them at bay.
Recent attempts by biscuit manufacturers and other processed food companies to find large markets in the arena of state-support to child feeding are reminiscent of the unethical influences of the drug industry in the sector of health.
These influences are even being routed through respectable and influential technical agencies and attempts by civil society organisations to insist upon a declaration of “no conflict of interest” by them has met with considerable resistance since some of them have food processing companies among their governing boards.
Other concerns such as providing for two anganwadi workers for each centre, expanding the coverage of crèches, having a separate allocation for breastfeeding promotion, counselling and support, providing minimum space and infrastructure, radically improving training, and regularisation for anganwadi workers have also not been sufficiently addressed.
One probable reason for this is the reluctance to increase the resources required for this, at the cost of over a hundred million poor and malnourished children under the age of six. Although substantial increases in the allocations for ICDS have been recommended in the 11thplan, they are still inadequate. It is estimated that about 0.5 per cent of the GDP should be allocated to ICDS and other related interventions for the overall care and well being of children under six.
While that is much higher than the present allocations, it is not much considering that children under six constitute 16 per cent of our population and that their lives are, or should be, invaluable.
The authors are members of the Working Group for Children Under Six (of the Jan Swasthya Abhiyan and Right to Food Campaign)