The Global Hunger Index (GHI) 2022 has brought more unpleasant news for India, when it comes to its global ranking in a vital indicator of human development. India was ranked 107 out of 121 countries. The Indian government immediately tried to discredit the index in its attempt to deny the report’s findings, even going so far as to call it a conspiracy against India.
The GHI is an important indicator of nutrition, particularly among children, as it looks at stunting, wasting and mortality among children, and caloric deficiency in the entire 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, 19.3% presented emaciation and 32.1% were underweight. .
Government schemes are not delivering
Experts have suggested a number of approaches to tackling chronic malnutrition, many of which feature in existing centrally sponsored schemes. However, gaps remain in the way they are funded and implemented, in what could be called the plumbing of these schemes.
For example, the Government of India implements the Saksham Anganwadi Scheme 2.0 and the Prime Minister’s General Scheme for Holistic Nutrition (POSHAN) (which now includes the Integrated Child Development Services (ICDS) scheme), which seeks to work with girls adolescents, pregnant women, lactating mothers and children under three years of age. However, the budget for this plan for FY 2022-23 was Rs 20,263 crore, which is less than 1% more than the actual spending in FY 2020-21, an increase of less than 1% in two years.
The other flagship scheme of the Government of India is the PM POSHAN, or Pradhan Mantri Poshan Shakti Nirman, formerly known as the Midday Meal scheme (National School Midday Meal Scheme). The budget for FY2022-23 at ₹10,233.75 crore was 21% lower than the spending in FY2020-21. Even if we accept that 2020-21 was a banner year (due to the COVID-19 pandemic), it is clear that the budgets being allocated do not come close to the scale of the funds required to improve nutrition in the country.
An Accountability Initiative budget report reports that the per capita costs of the Supplemental Nutrition Program (one of the largest components of this scheme) have not increased since 2017 and remain severely underfunded, meeting only 41% of required funds. The budget report also mentions that more than 50% of Child Development Projects Officer (CDPO) posts were vacant in Jharkhand, Assam, Uttar Pradesh and Rajasthan, indicating severe manpower constraints to successfully implement the scheme. of such importance. And while PM POSHAN (or MDM) is widely recognized as a revolutionary scheme that improved access to education for children across the country, it is often embroiled in controversy over what should be included in the midday meals that are served. they provide in schools. Social audits that are intended to allow community oversight of the quality of services provided in schools are not routinely carried out.
In short, not only are key nutrition schemes underfunded, but also available funds are not being spent effectively. Fixing these schemes is the obvious answer to address India’s multidimensional nutritional challenge.
Cash transfers and the trust factor
Cash transfers appear to be a preferred solution for various social sector interventions in India today, and this includes the health and nutrition sectors. There is a lot of talk about the JAM trinity (Jan Dhan, Aadhaar, Mobile bank accounts). Equally attractive is the feature of cash transfers as a mechanism that produces large political dividends. Taking advantage of the digital infrastructure available in India, it is said that it is possible to target the right beneficiaries (ie pregnant women and families with children under five). Cash also has the advantage of expanding options at the household level, as they make decisions about what to put on their plates.
But evidence of 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 better child nutrition outcomes.
The effect of cash transfers is also limited in a context where food prices are volatile and inflation reduces the value of cash. In addition, there are social factors such as ‘son preference’, which unfortunately is still prevalent in India and can influence decisions at the household level in responding to the nutritional needs of sons and daughters. This requires a comprehensive social education program – cash alone cannot solve this. Furthermore, a study of the Mamata scheme in Odisha, targeting pregnant and lactating women, showed that there were persistent socio-economic discrepancies in the receipt of cash transfers, especially when compared to entitlements received through the Public Distribution System (PDS). So cash may be part of the solution, but by itself it is not a panacea.
back to basics
Malnutrition has been the scourge of India for several years. Political battles over malnutrition are not going to help; nor is it to continue thinking in silos. It is clear that malnutrition persists due to depressed economic conditions in much of the country, the poor state of agriculture in India, persistent levels of unsafe sanitation practices, etc.
Cash transfers have a role to play here, especially in regions experiencing severe difficulties, where household purchasing power is severely depressed. Cash transfers can also be used to incentivize behavior change in terms of seeking greater institutional support. Food rations through PDS and special supplements for the target group of pregnant and lactating mothers, and infants and young children are essential.
Persistently underfunded and poorly implemented public programs (such as the old ICDS and MDM schemes) must take much of the blame for India’s malnutrition problem. But getting these schemes right requires greater involvement of local government and local community groups in the design and delivery of personalized nutrition interventions. A comprehensive program targeting adolescent girls is required if the intergenerational nature of malnutrition is to be addressed.
Global Hunger Index | Only 3.9% of children are malnourished, says the government
The need of the hour is to make tackling child malnutrition the top priority of the government machine, and all year round. A month-old POSHAN Utsav may be a good optician, but it is not a substitute for painstaking daily work.
Suvojit Chattopadhyay works on governance and public sector reform projects in South Asia and sub-Saharan Africa
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