By Dr. Gyan Pathak
India has been implementing the Integrated Child Development Services (ICDS) Schemes for decades for addressing severe malnutrition among children aged 6-36 months and pregnant and lactating women (PLW). However, the malnutritions numbers, which are unacceptably high, point to the fact that there is a lot to achieve. India clearly needs even going beyond the ‘Take Home Ration’ (THR) programme and strengthen the ‘good practices’ across the states and Union Territories.
THR is just one of the two modalities in Supplementary Nutritions Programme (SNP) under ICDS which provides ration in place of Hot-Cooked Meal at Anganwadi Centres (AWCs). SNP is presently delivered to more than 9 crore beneficiaries registered at AWCs. Delivered THR is intended for use by beneficiaries in their homes, and this programme takes up a major share of the ICDS budget with the Central and State governments spending more than Rs 13,500 crore annually. In the aftermath of COVID-19 crisis THR has broadened reach across the most communities and hence become more important than ever before, because in presents an opportunity to deliver fortified, nutritious, non-perishable food that goes beyond simply providing calories. By strengthening it the growth and development of children and PLWs can be supported. However, wide gap remains between the requirement and the efforts that need to be scaled-up.
In this overall background, the joint report of World Food Program and NITI Aayog titled “Take Home Ration: Good Practices across State/Union Territories” should serve as eye opener for the Modi government as to how its target of reducing undernutrition only by 2 per cent per year under National Nutrition Mission, or POSHAN Abhiyan, is insufficient to successfully mitigate the problem.
Over the past decades, India has been making consistent progress towards ensuring food and nutrition security and reducing malnutrition levels among its citizens through several initiatives, policies, schemes, and programmes including the world’s largest food safety nets under the umbrella of the National Food Security Act, 2013. In 2019, the United Nations World Food Programmes conducted a mapping of THR across India and is current supporting three state governments – Utter Pradesh, Rajasthan, and Odisha on improving the composition and establishing decentralized production of fortified nutrition THR. Nevertheless, malnutrition remains critical in all 36 States and Union Territories that requires greater effort to eradicate the problem in shortest possible time.
Though the report presents a set of good and innovative practices adopted in the implementation of the THR value chain by the States and UTs, these are clearly insufficient to fill the gap in nutrition among children and PLWs. Even the NITI Aayog Vice Chairman Suman K. Bery admitted, “There is a need to further strengthen THR program to achieve the nutritional targets in a time-bound manner.”
POSHAN Abhiyan is Modi governments flagship programme to improve nutritional outcomes for children, PLWs, and adolescents. Distribution of THR through Anganwadi Centres under this programme is a key component which played an important in safeguarding food security during COVID-19 lockdowns. However, “There is a need to develop and maintain highest standards for ensuring quality in THR, where the entire THR value chain must ensure quality, transparency, and efficiency,” said Dr V K Paul, a member of NITI Aayog.
The message of CEO NITI Aayog published in this report is also worth mentioning who felt that “the country still grappling with child malnutrition, as reflected in high prevalence of low birth weight, stunning, wasting and server wasting.” This situation is prevailing in the country in spite of the fact that India has one of the largest child nutrition programmes in the world.
It is in this backdrop, as a way forward the report has suggested that in order to realize the full potential of the THR, all components of this value chain need to function at optimum. This requires building a robust system for procurement, supply chain management and monitoring that ensures complete transparency, standardized process, sustainability, full coverage, leverages local ties, foster a culture of collaboration and builds trust within a community.
As for procurement of THR, the report says, “Given the huge amount of funds used, it is important that the suppliers are selected based on a transparent and well-defined method.” In place of centralized production for blended THR, the report has suggested a decentralized production model involving SHGs, since this model promotes income generation activities, empowers poor women by enabling them to become active earners, improves THR access in rural areas and enhances community ownership of THR production.
Supply chain management is an important and complex process within ICDS Scheme. By utilizing technological advancements it can be ensured that there are open lines of communication and data analysis throughout the chain, which increases transparency and efficiency in the scheme, the report suggests.
Right nutritional composition is important which should be carefully selected for appropriate target groups from variety of THR product formulations norms of ICDS for energy and proteins, globally defined norms for products meant for infants and young children, and the WHO norms on nutrition for pregnant and lactating women, the report has recommended.
As for the quality assurance and quality control, the report says that despite being a critical step in production process, not much is known about the measures undertaken by different States and UTs. Though enumerated some good practices by some, it has a general recommendation for quality check for THR products, and corrective action taken, and a real time monitoring of the scheme. (IPA Service)