With malnutrition among children at around a stubbornly high 46%, the Indian government has decided to change the focus and structure of the Integrated Child Development Scheme.
“The prime minister is very concerned about high incidence of malnutrition among children and, after discussions with the concerned ministries and the Planning Commission, the government has decided to restructure the scheme,” said A. Ramadoss, minister of health and family welfare, in an interview with Mint.
About 70 million of the country’s 160 million children are currently covered under the scheme, which deals with raising nutrition levels of children below six years, as also pregnant and lactating women. Though the scheme has run for 32 years and spent more than Rs10,000 crore, decline in incidence of malnutrition has barely budged, down to 46% in 2006 from 47% in 1999. It was 51% in 1993, according to a series of government-conducted national family health surveys.
In 22 states, including West Bengal, Karnataka, Maharashtra, Punjab, Chhattisgarh and Manipur, 21-45% children had stunted growth in 2005-06.
The Planning Commission has recommended giving cash benefit to pregnant and lactating women falling in the below poverty line category for six months—three months before and after childbirth—to improve their nutritional levels.
“The monthly allowance is still to be finalized and it can be Rs500 or Rs1,000. However, these will have to go through processes such as immunization, birth registration as also regular check-ups,” said a Planning Commission official who did not wish to be named. This programme will cover 28% of the estimated 26 million births every year.
The Union government would also contribute Rs940 crore for promotion of exclusive breastfeeding in the 11th Plan. The objective is to raise the nutritional and immunity levels of breastfed children and create awareness about the benefits of breastfeeding.
The government is also ensuring that nutrition supplied to children under the scheme has better outcomes. While children aged six months to three years will get take-home rations, those between three and six years of age will get only hot cooked meals. Severely malnourished children will get dietary supplements in addition to hot cooked meals.
Under the new scheme, more anganwadis, the centres that disburse nutritious food supplements and provide pre-school education, immunization referrals and other services, can be created if the Panchayats so demand. This will be in areas where atleast 40 children in plains and 20 children in tribal areas are not covered by an anganwadi. The total number of sanctioned anganwadis are 1.1 million.
The Planning Commission has also recommended raising central allocation of the Scheme to Rs52,000 crore in the 11th Plan (2007-2012), which is nearly four times more than the 10th Plan.
The scheme has been criticized by several groups as well as the Supreme Court. As first reported by Mint on 20 August, the court in July issued contempt of court notices to chief secretaries of five states (Rajasthan, Kerala, Bihar, Orissa and Himachal Pradesh) that it said were the worst performers on the anganwadi front.
Nutritionists, however, say no amount of restructuring will help tackle malnutrition unless there is commitment among those executing the scheme.
“The scheme is conceptualised well, allocations are good, food security is there but what is lacking is bringing people to do what they should under the scheme with integrity. One keeps hearing of pilferage of food and funds and that’s where the problem lies,” said Ishi Khosla, a New Delhi-based clinical nutritionist.