When the results of the Comprehensive National Nutrition Survey (CNNS) released last month showed high levels of malnutrition and nutrient deficient in India’s school-going children and adolescents, it raised the question: does India need a better, truly universal school lunch programme?

The Mid Day Meal is a significant part of the diet of Indian children. The meal is available to all primary and upper primary children (classes 1 to 8) in government schools, government-aided schools and Education Guarantee Scheme (EGS) schools. Two out of three Indian children go to government schools alone (according to the 2011-12 India Human Development Survey). Not every child entitled to the mid-day meal receives it; the survey shows that 82% of children in government schools reported getting a mid-day meal. In all, at least half of all children in classes 1-8 in India get a mid-day meal.

For many, the mid-day meal is invaluable. The 2011-12 National Sample Survey (NSS) data shows, 10% of the meals that all primary school-age children (5-9) in rural India receive in a month are from school. The Mid Day Meal’s self-selection works; the poorest children in both rural and urban India get more meals per head from school than richer children, the NSS data shows.

There is evidence that the Mid Day Meal has contributed to the gradual improvement in child malnutrition indicators. The Mid Day Meal scheme explained at least one-tenth of the total reduction in stunting in India in between 206 and 2016, researchers at the International Food Policy Research Institute found. Adolescent girls, now 12-17, who got meals under the Mid Day Meal Scheme in 2004 were taller, they found. The effects on health were multi-generational; children born to young women who had received school meals in 2004 were less likely to be stunted. [Paper forthcoming, published extract]

Yet, the nutritional value of the meal is far from perfect. On paper, each hot cooked meal is meant to provide a primary school child with 450 calories and 12 grams of protein, and an upper primary child with at least 700 calories and 20 grams of protein. This is often not the case; earlier this year, journalist Pawan Jaisal recorded a government school in Uttar Pradesh’s Mirzapur serving the children rotis and salt only. In 2012-13, 90% of school lunches served to primary school students in Delhi did not meet the energy and protein norms.

This becomes important in the context of general under-nourishment among school-going children. The CNNS shows that the diets of school-age children are highly deficient, and they consume lower than recommended amounts of most healthy foods.

The outcomes are evident. 22% of children 5-9 were stunted (low height for age), and 23% were thin (low Body Mass Index for age). 24% of adolescents (age 10-14) were thin. The prevalence of stunting was higher among children who were out of school.

For those from richer families, availability of healthy foods is a lesser problem (though it exists) compared to obesity and related non-communicable diseases, which stem from poor nutritional awareness.

Here too, there is a role for the school and the state. Even in high-income Finland, school lunches which are free for all children are the healthiest meal that children eat in a day.

For children whose home diets are poor, a working Mid Day Meal’s value can be stunning; in Madhya Pradesh, researcher Farzana Afridi found that an improved mid-day meal reduced the daily protein deficiency of a primary school student by 100%, the calorie deficiency by almost 30% and the daily iron deficiency by nearly 10%. “At least in the short-run, therefore, the program had a substantial effect on reducing hunger at school and protein-energy malnutrition," she found.

These shortcomings in the diet of both poor and rich Indian school students leads to the question: would India benefit from an improved, universal school lunch programme, available across both government and private schools, to the rich and the poor, with more variety, more protein and greater micro-nutrient coverage? In the United States, where malnutrition on a lower scale and obesity on a much larger scale is a reality among school-going children, Democratic Presidential hopeful Bernie Sanders introduced a Bill that would provide for school meals for all children irrespective of income. India’s MPs should be listening.

Rukmini S. is a Chennai-based journalist. This is the final part a three-part series on insights from the Comprehensive National Nutrition Survey.

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