MUMBAI: According to its own report, Maharashtra is doing little about the ‘stark reality’ of malnutrition in children in tribal areas. The report reveals that in the seven tribal belts it studied, more than 40 per cent of the children are affected by some form of malnutrition. In comparison, in Maharashtra’s best performing block, Harsul in Nasik, 27.3 per cent of children suffer from malnutrition, down 42.3 per cent in 2012, mainly due to improvement in nutritional status.
Just 24 hours before the report was presented, in reply to ‘calling attention’ motion raised on Thursday by 86 MLAs in the State Assembly — citing around 8,000 child deaths due to malnutrition between April and August 2016 — the state had claim that all is well with its preventive approach to tackle malnutrition.
According to the report, Malnutrition Status in Tribal Belts, the state’s shortcomings include supplying of grains infested with insects, worms and other contamination to meal schemes, and children getting neither the public distribution system (PDS) benefits they are entitled to, nor sufficient calories under the Supplementary Nutrition (SN) and Take-Home Ration (THR) schemes. Aside from these, the report says, other contributing factors are poor health care facilities and constant migration. The report was prepared by the Rest of Maharashtra Legislative Development Board, and presented last week to State Governor C.V. Rao, who commissioned the study last year. The Hindu has a copy of the report.
Senior official who were part of the study told The Hindu the caloric requirement provided under both the SN and THR was found to be questionable and both schemes remain grossly inadequate in their functioning. “In one such visit to a THR production unit, it was found care was not taken to clean the grains before milling it. Insects, small stones and unwanted material were found in the grains,” the report says.
The team found that food scarcity did not seem to be a contributing factor as much as balanced diets, i.e., the lack of inclusion of the right food groups. Except for carbohydrates and proteins, other food groups — milk and dairy products, fruit and vegetables, and fats and sugars — were missing from the daily diet of the people in the region. Apart from the administrative lacunae and the social factor, the report found that the Rs. 5.92 per child provision under the SN scheme was ‘insufficient’
The THR food given to children was ‘bitter / smelly / salty / raw / coarse’ at many places. Even that was not given to deserving beneficiaries, officials say. The report says, “We found high incidence of some ration being fed to the livestock.”
In Nandurbar, the PDS distribution was irregular, being delivered with two-month gaps, and “the quota was not as per entitlement,” the report says. Such grain as was delivered was of poor quality, and often sugar and kerosene were not delivered at all. In addition, the recipients were overcharged for the supplies. “20 per cent of the families did not have ration cards, and many had to walk five to three kilometres just to get their daily quota of ration.”
Of the self-help groups (SHGs) surveyed, 63 SHGs received grains only once every three months during the five-month survey period (Jan 2016 to May 2016]; 27 SHGs in Palghar and 36 in Nandurbar did not receive their rations at all.
In 44 Anganwadis Centres (AWCs), the team found that either snacks were not served with meals or that they were of ‘poor quality and quantity.’ “Many AWCs have become politically affiliated resulting in their deterioration,” an official of the board says. The report also found that state-supplied educational material, teaching aids and toys were in poor condition or missing altogether in in at least 45 AWCs. 47 AWCs did not have toilets or had toilets in unusable condition.
A silver lining
One area did show signs of improvement: health.
There has been a dramatic increase in the use of health centres, regular counselling, increased awareness of pre-natal and ante-natal care, breast-feeding norms are widely followed, and immunisation schemes were implemented. Kakarpati and Mungabri blocks, the worst-performing regions on all other parameters — 1.24 on AWC, 1.39 on THR, 1.50 on PDS, 1.67 on nutrition — scored a greatly improved health score of 2.63, around double their scores on the other factors.
The report has also blamed some prevalent social practices such alcoholism, open defecation, using the same water source for all uses, including drinking, general lack of hygiene, and rampant migration among other reasons for rise in cases of malnutrition in tribal areas. The report says that in some places, “the wheat from PDS was widely sold by beneficiaries in return for salt and liquor.”
Milind Thatte, member, Tribal Advisory Council of the Maharashtra Government, says, “This report proves government is not facing the real problems to tackle tribal malnutrition; it is just looking to reduce the annual death count by trying to force feed tribal children artificial food under THR/SN schemes. Unless and until sustainable livelihood is provided and forest food revived, migration will continue and the problem of malnutrition will never go away fully.”
Experts agree that Maharashtra’s short-sighted approach to malnourishment is creating more hurdles than solutions. Some point out that while the State is pulling all stops to tackle malnutrition, it needs to change the approach in implementing schemes and integrate the welfare programmes with a focus on community outreach, “For example, the top-down approach cannot work when trying to change people’s nutritional habits. Globally, community and volunteers have played a greater role in tackling these issues,” said Leni Chaudhuri, vice-president, Narotam Sekhsaria Foundation. “Maharashtra’s fire-fighting approach must change,” said Dr Abhay Bang, chairman of National Expert Committee on Tribal Health, Government of India. “The government, non-profit bodies must all look at the long-term solutions: sustainable economic development of tribal areas, improving livelihood, sanitation, among others.”
Over 40% children found malnourished
Insects, small stones and unwanted material found in grains
Unbalanced diets followed in some places, with only some food groups being consumed; tradition and lack of relevant information to blame
Around 20% of families have no ration card and access to PDS
Caloric intake through various state programmes inadequate
Implementation and challenges faced in Take Home Ration (THR) program.
Public distribution system (PDS)
Type, quality, quantity of grains supplied
Status of supplementary nutrition scheme (SN)
Challenges faced by self-help groups and anganwadis in providing nutrition
Accessibility to health centres
Occupation and migration pattern
Total deaths in 2015-2016 : 21,985
Infant deaths : 17,944
Death between April-August 2016: 9,563
Infant death April-August 2016 : 7,868
Source: Women and Child Development Department, Maharashtra