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Updated: May 8, 2012 00:02 IST

Beyond the egg and milk formula

Gopalan Balagopal
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Malnutrition among children is linked to the health of mothers. File photo: A. M. Faruqui
Malnutrition among children is linked to the health of mothers. File photo: A. M. Faruqui

The initiative by the Karnataka judiciary in combating malnourishment holds important lessons.

“How can there be only one solution of providing egg and milk to overcome the problem of malnourishment?” asked Justice N.K. Patil, while addressing the media in Gulbarga on April 26. He was speaking on the recommendations of a committee appointed by the Chief Justice of the Karnataka High Court following complaints of child malnutrition and starvation in the State.

Justice Patil, who heads the committee, followed up on these recommendations by meeting senior officials in Gulbarga where directions were issued that henceforth, the deputy commissioners of every district would take on the responsibility of taking steps to combat malnutrition. This initiative holds lessons for all parts of the country.

Linked to health of mothers

The gist of the question that he posed is that malnutrition is a complex issue and that solutions should go beyond just providing milk and eggs to children at Integrated Child Development Services (ICDS) centres.

Malnutrition among children is linked to the health of mothers. In fact the 1,000 days that include the nine months of pregnancy and the first two years of a child's life are most crucial in laying the foundations of lifelong and good health for children.

Justice Patil has demanded individual health status reports on the 68,000 malnourished children in Karnataka, as reported by the State government. This is an important first step as one of the key failures is in the ineffective monitoring of the status of children at ICDS centres. It is not because we do not have the procedures in place; they are just ineffective. An anganwadi worker is expected to fill in numerous registers and forms and send reports that wend their way through the system. The information is compiled at the project, district, State and finally at the national levels. It is hardly available to the right people at the right time to review and take act upon.

Role of technology

Today, we have the ability to replace these outdated procedures with electronic reporting using hand-held devices like cell phones that can send data on the weight and height of individual children to computerised databases. This information can be instantly converted to colour coded maps that can highlight not only the districts and centres where the problem is most acute, but also the status of individual children at risk.

The direction to the deputy commissioners also highlights another key weakness of our interventions — the lack of coordination and convergence among the several programmes that are already working for this purpose.

Recent report

In the ICDS, we have the world's biggest programme addressing the early needs of children. We have special programmes targeting adolescent girls and pregnant women that address issues like anaemia even before pregnancy starts. We have “flagship” programmes like the National Rural Health Mission (NRHM) and the Total Sanitation Campaign. Yet we have 42 per cent of children who are underweight and 58 per cent who are stunted by the age of 24 months, as the HUNGaMA report covering 112 districts in India has recently highlighted. The children most at risk are the ones who are also the most hard to reach. So the emphasis on coordination and convergence must also include a special effort in locating and reaching such children.

Importance of self-help groups

Government initiatives should involve a wider constituency. The families and communities from where the children come need to be engaged in a process that make them partners in understanding what is being done and to share in the process of making changes. Here, women's self-help groups can play a significant role. A national meeting on decentralisation and equity for children was held in Kochi in mid-April. Senior officials dealing with children's issues from a number of States went around gram panchayats studying what was being done for children. The role of Kudumbasree, the women's self-help group, in supporting ICDS centres in Kerala including in the local processing of nutritious food supplied to the children was an eye-opener for many participants.

If followed through with the priority and attention it deserves, the Karnataka initiative has the potential of showing a way out of a long-standing problem of vital national concern.

(The author is a retired civil servant. Email: gbalagopal.wayanad@gmail.com)

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This is just because of highly disparity among people of India. One person has heaps of
money in his account which is not of any use and the another person who doesn't even
afford to have food of one time.
Lectures are given but very few person come forward to help such person.
Heart weeps seeing this picture.

from:  Jessica
Posted on: May 12, 2012 at 13:55 IST

Recently I read that the Indians were outraged that slums and poverty were shown in the movie Avengers. Yeah, we are a (almost) superpower and the world dare not show us in bad light !! Why don't people feel outraged over actual slums and poverty and malnutrition ?

from:  S Kumar
Posted on: May 9, 2012 at 17:29 IST

how can we say that India would be the superpower by 2020. approximately
50 percent of our children are being malnourished and we are talking
about technology and space, it is utter insanity. we had great human
beings like gandhiji, vivekanand... with their excellent views. we can
execute their ideas on this kind of issues but the need for the hour is
will power.

from:  hardattsinh jadeja
Posted on: May 8, 2012 at 14:56 IST

It is all well and true that our governments are incompetent at best when dealing
with the scourge of poverty. However, our government is merely a mirror of our
society. What are we, the middle-class of India willing to do to combat poverty? Let
me narrate an incident I see all too often:
We have construction workers building a house in the colony and they will
sometimes come asking for water to drink. The typical response is a rejoinder to go and get water from those whose house they are building, or in the best case a tiny plastic glass with meagre water given with great aversion! This in our country where giving water to the thirsty is supposedly "punya". Evidently, it is only so when giving it to Brahmins. Why should a government elected by us, to represent us be any less callous and inhuman?

from:  Vivek
Posted on: May 8, 2012 at 14:37 IST

The article uncovers the misdeeds of the barefaced administration in
the context of combat against the malnutrition. The author is quite
right that the children deprived of nutrition are,in no way possible
to reach without the coordination between the government and NGOs
working for the same issue. Also the lack of technological advancement
in this field is proving to be a lacuna to fulfill the basic needs of
the emaciated and undernourished children.Even more persecuting fact
that the mother being considered as a first "Guru" of the child is
also facing the same situation due to dearth of adequate solution to
the problem.

from:  Jitendra Sharma
Posted on: May 8, 2012 at 13:10 IST

Why is the Judiciary involved in combating malnutrition? Isn't this
a classic case of the Justices arrogating to themselves functions
that formerly remained in the realm of the executive?

from:  Nerus
Posted on: May 8, 2012 at 11:46 IST

Apart from the above mentioned initiatives, I think there is 1 more
imperative step needed to prevent the situation to arise. If we look
back and try to find out the root cause, its pretty straight forward.
The parents should do the family planning based on the affordability.
Still in rural areas, more than 70% of couple have 3+ children. They
don't even think whether they will be able to give all the necessary
needs (here only food) to the child or not. Since they are not able
to give proper nourishment, at the end the CHILD suffers form all
aspects. If the initiate program is able to change this mentality of
the Aam Aadmi, I think then we will succeed in making a difference
and fill the loophole.

from:  Anurag
Posted on: May 8, 2012 at 11:36 IST

The malnourishment issue is a symptom of the larger issue of crumbling infrastructure and burgeoning red tape. Sub-Saharan countries fare much better than India due to the complete lack of government meddling, simply because there are fewer forms to fill, less protocols to adhere to and the understanding that any solution is a solution, rather than the government stipulating it. What we need is a complete restructure of the system. We need to find out solutions from the grass roots and build them up. We need nutritionists and agriculture scientists to go down to each village and chart out nutritious food choices with the available resources. For example, villagers can be trained to grow Moringa trees, as it is very hardy and very nutritious. Furthermore, Availability and affordability are the key issues that should be addressed. Tracking and administration are secondary but can be done by harnessing Aadhar, RFID, cheap smartphones and the available mobile network

from:  Cinish P Abraham
Posted on: May 8, 2012 at 11:30 IST

I can only weep reading articles after articles on such subjects. First of all provide "roti, kapada and makan" to the poor and then educate them on other aspects.

from:  Mani Iyer
Posted on: May 8, 2012 at 10:21 IST
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