From UPSC perspective, the following things are important :
Prelims level : NFHS and GHI
Mains level : Malnutrition in India
- The Global Hunger Index (GHI) 2022 has brought more unwelcome news for India, as far as its global ranking on a vital indicator of human development is concerned. India ranked 107 out of 121 countries. Malnutrition still haunts India
- The GHI is an important indicator of nutrition, particularly among children, as it looks at stunting, wasting and mortality among children, and at calorific deficiency across the population.
Findings according to the National family health survey findings (NFHS-5)
- India’s National Family Health Survey (NFHS-5) from 2019-21 reported that in children below the age of five years, 35.5% were stunted, 19.3% showed wasting, and 32.1% were underweight.
Status of budgetary allocation for Government Schemes
- Gaps in the funding: Experts have suggested several approaches to address the problem of chronic malnutrition, many of which feature in the centrally-sponsored schemes that already exist. However, gaps remain in how they are funded and implemented, in what one might call the plumbing of these schemes.
- Saksham Anganwadi:
- The Government of India implements the Saksham Anganwadi and Prime Minister’s Overarching Scheme for Holistic Nutrition (POSHAN) 2.0 scheme (which now includes the Integrated Child Development Services (ICDS) scheme),
- It seeks to work with adolescent girls, pregnant women, nursing mothers and children below three.
- However, the budget for this scheme for FY2022-23 was ₹20,263 crore, which is less than 1% more than the actual spent in FY2020-21 an increase of less than 1% over two years.
- PM POSHAN:
- PM POSHAN, or Pradhan Mantri Poshan Shakti Nirman, known previously as the Mid-Day Meal scheme (National Programme of Mid-Day Meal in Schools).
- The budget for FY2022-23 at ₹10,233.75 crore was 21% lower than the expenditure in FY2020-21.
- It is clear that the budgets being allocated are nowhere near the scale of the funds that are required to improve nutrition in the country.
What are the hurdles for effective Implementation of such large-scale schemes.
- Underfunded Nutrition Programme: An Accountability Initiative budget brief reports that per capita costs of the Supplementary Nutrition Programme (one of the largest components of this scheme) has not increased since 2017 and remains grossly underfunded, catering to only 41% of the funds required.
- Vacant posts of Projects officers and insufficient manpower: The budget brief also mentions that over 50% Child Development Project Officer (CDPO) posts were vacant in Jharkhand, Assam, Uttar Pradesh, and Rajasthan, pointing to severe manpower constraints in successfully implementing the scheme of such importance.
- Regular controversies over the food served under MDM: While PM POSHAN (or MDM) is widely recognized as a revolutionary scheme that improved access to education for children nationwide, it is often embroiled in controversies around what should be included in the mid-day meals that are provided at schools.
- Irregular social audits: Social audits that are meant to allow community oversight of the quality of services provided in schools are not carried out routinely.
- Volatile food prices effects: The effect of cash transfers is also limited in a context where food prices are volatile and inflation depletes the value of cash.
- Social factors: Equally, there are social factors such as ‘son preference’, which sadly continues to be prevalent in India and can influence household-level decisions when responding to the nutrition needs of sons and daughters.
Suggestions for the effective delivery of the government schemes
- Tracing the reasons behind existing malnutrition: It is clear that malnutrition persists due to depressed economic conditions in large parts of the country, the poor state of agriculture in India, persistent levels of unsafe sanitation practices, etc. Political battles over malnutrition are not going to help; nor is continuing to think in silos.
- Cash transfers where purchasing poverty is less: Cash transfers have a role to play here, especially in regions experiencing acute distress, where household purchasing power is very depressed. Cash transfers can also be used to incentivize behavioural change in terms of seeking greater institutional support.
- Targeted supplementation: Food rations through PDS and special supplements for the target group of pregnant and lactating mothers, and infants and young children, are essential.
- Community participation: Getting these schemes right requires greater involvement of local government and local community groups in the design and delivery of tailored nutrition interventions.
- Comprehensive social education programs for girls: A comprehensive programme targeting adolescent girls is required if the inter-generational nature of malnutrition is to be tackled. There is a need of comprehensive social education programme.
- Malnutrition has been India’s scourge for several years now. A month-long POSHAN Utsav may be good optics, but is no substitute for painstaking everyday work. The need of the hour is to make addressing child malnutrition the top priority of the government machinery, and all year around.
Q. Despite large government nutrition programs, malnutrition still haunts India. Discuss the problems and suggest solutions.