CRY webinar highlights need for better budgets to improve nutrition of children and women
In the last few years, there has been an improvement in child nutrition and health. Statistics show that India enjoys the status of a food-surplus country, yet one in every three children in the country is still malnourished (CNNS, 2016-18) and only 9.6 percent of children between six and 23 months receive an adequate diet (NFHS-4, 2015-16).
As this data pertains to the pre-pandemic period, it can be gauged that COVID-19 has aggravated the situation, especially with respect to immunity, availability of quality food, and nutrition.
While government programmes such as the Targeted Public Distribution System, Mid-day Meal Scheme (MDMS), Integrated Child Development Services (ICDS), and Poshan Abhiyaan are in place to address food insecurity and malnutrition, they have been disrupted by the pandemic and the subsequent lockdown last year.
Ahead of Union Budget 2021 on February 1, Child Rights and You (CRY), along with Centre for Budget and Governance Accountability (CBGA), organised a national webinar that brought together academicians, subject-matter experts, and NGOs to discuss issues and challenges related to nutrition and health of children and pregnant and lactating women.
The panel consisted of Shruti Ambast, Senior Policy Analyst at CBGA; Mini Varghese, Country Director for Nutrition International; Avani Kapur, Director of Accountability Initiative; Shweta Khandelwal, Head of Nutrition Research at Public Health Foundation of India; and Dipa Sinha, Assistant Professor at Ambedkar University, Delhi. The session was moderated by Puja Marwaha, CEO of CRY.
The webinar highlighted some insights and suggestions that will help CRY, civil society organisations, and stakeholders including government bodies to address the issues collectively.
Marwaha started the session by elaborating the challenges in ensuring health and nutrition security for children and adolescent girls, based on on-ground experiences from CRY’s intervention areas in India.
“CRY’s efforts focus on providing nutritional security to vulnerable families by providing seeds and manure to develop household-level kitchen gardens. These efforts paid off especially during the pandemic, as they have helped make vegetables more affordable, improved dietary quality, and is a sustainable source of nutrition,” she said.
“While interventions at the micro-level are critical, we feel that unless challenges related to adequacy in budgetary allocations and bottlenecks in utilisation are addressed, we will be unable to mitigate the loss caused due to pandemics such as COVID-19,” she added.
As Anganwadis and schools were closed due to the lockdown imposed in March, two large-scale programmes delivering food entitlements to children in India have been disrupted — the Supplementary Nutrition Programme under Anganwadi Services (erstwhile ICDS) and the Mid Day Meal (MDM) scheme.
Highlighting the various facets of Public Finance for Child Nutrition, Ambast said: “CBGA’s district-level budget analysis of five districts and four states shows high fund utilisation in important centrally sponsored schemes like SSA (Sarva Shiksha Abhiyan), ICDS, MGNREGS in 2017-2018 and 2018-2019.
“But fund utilisation was relatively lower for MDM and NHM (National Health Mission), indicating that resource absorption capacity is good in certain schemes and some districts/states perform better than others. Sustaining demand for higher allocations therefore becomes crucial.”
Kapur shared insights into public financing. “Fund release, approval, reporting, and allocation need to be streamlined for better public financial management. We can start small, but I feel that in schemes like nutrition, decentralization is always key,” she said.
She also highlighted the role played by women frontline workers such as Anganwadi, ASHA, and ANM workers and lauded their roles in reaching out to households during the pandemic.
“Out-of-school adolescents is a group which is vulnerable to under-nutrition amid the pandemic,” said Varghese. “And it is not just girls, out-of-school adolescent boys are equally vulnerable and there are no mechanisms to reach out to boys. Evidence suggests that in low-income countries, supplementation, dietary diversity, and food fortification are possible solutions to address nutrition challenges.”
To minimise the impact of the pandemic on health services, sufficient allocations should be made to ensure stock of iron, calcium and Vitamin A supplements, as well as essential medicines for children, are available at primary health centres for distribution by frontline workers.
On the need to invest in improving nutrition, Khandelwal said: “Women in India face multiple challenges including poor food, health and care environments, along with early marriage, early conception, multiple pregnancies and social status. Hence, it is critical to ensure pre-pregnancy well-being for good maternal and child outcomes. We also need to strengthen the social safety nets for women and relook at the nutrition component.”
Sinha shared her thoughts on food insecurity. “Most people in our country cannot afford a healthy diet,” she said. “We have not attained the level where we can access wholesome food. On-ground research highlights that hunger is increasing post-COVID. Whatever nutritious food people were consuming before COVID, has been decreasing. We need to understand that malnutrition has different determinants and solving one is not going to address the whole issue, but it is vital to do all.