Bhopal: Bhagat Singh, who turned 2 in May, is unlikely to make a mark on this world—unlike his popular namesake, the revolutionary hero from pre-independent India. The child cannot walk because his legs are too thin, unable to bear even the weight of his puny body. He usually drags himself from one spot to another.
But Bhagat Singh is not afflicted with a disease; in technical terms, he is a SAM child. SAM is the acronym for severe acute malnutrition, also known as severe wasting, which is a lethal form of undernourishment.
A boy his age should ideally weigh more than 12 kg. But Bhagat Singh weighs nearly half of that standard—6.6 kg—according to records kept at the local anganwadi, the state-run childcare centre in Muktapur village. On the Poshan tracker app, which records the parameters of enrolled children, his profile stats read: ‘SAM, moderately stunted, severely underweight. Updated: 15 June 2026.’
Bhagat Singh’s village, located next to a state highway in the Raisen district of Madhya Pradesh, is less than an hour’s ride from the state capital, Bhopal. Raisen belongs to the agriculturally prosperous Narmada valley region, known for premium basmati rice, sharbati wheat, and heirloom legumes.
But the modest house of Bhagat Singh shows no signs of that prosperity. Two rooms are lined with naked bricks, a rugged floor, and a swing conjured from ropes and a sari. A cooler, groaning at the far end of an unlit, narrow corridor, is the family’s most valued possession. The cooler also doubles as an improvised refrigerator: a leftover serving of pulses and some porridge for the child rest on top, lest the oppressive June heat spoil the food. A few rotis (wheat flatbread) from the morning are kept uncovered in a cane basket hanging from the wall, lest rodents nibble on them.
Bhagat Singh’s mother, Meena Bai, is also the mother of three other kids, aged 10, 6, and 3. Meena does not know her exact age. "Maybe 30," she guesses. The family has no agricultural land and survives on precarious seasonal work at nearby brick kilns. This work stops during the four-month-long monsoon season. At the end of June, the day Mint visited Muktapur, Meena’s husband was off to the nearby forest to collect firewood.
Bhagat Singh’s measly growth parameters are a consequence of the penury he was born into. Average day wages of ₹300– ₹350 are not enough to ensure a wholesome diet for the six-member household. Those wages have been stagnant for years and have not kept pace with the rising cost of living. Furthermore, there are times when there is no work at all. The free cereals—20 kg of rice and wheat every month from a federal food security scheme—are just enough to stave off hunger; they do not ensure nutrition.
It’s well past noon. When asked what the family has eaten since morning, Meena Bai smiles. The frugal diet makes her uncomfortable to speak about. They have had a serving of cooked pulses with rotis—no vegetables, fruits, or even a glass of milk. Bhagat Singh was given a porridge made of moong dal and rice. The next meal is hours away, around evening. It’s common to have just two meals a day in the poor villages of this region. The day usually begins with just a cup of tea made without milk.
Meena herself is frail. Is she worried that Bhagat Singh is not able to walk? “He’s been kamjor, dubla-patla (weak and thin) since birth… what to do?” she asks.
What will she cook for dinner? A potato curry and rotis, she replies. Bhagat Singh will be served the leftover porridge whenever he is hungry. He is unfamiliar with the taste of most fruits, except for a banana given to him once in a blue moon.
If he is lucky, Bhagat Singh may grow up to become a casual worker like his parents—making bricks or migrating to a metro city, where he would join the mass of inexpensive labour fuelling India’s growth story. The other possibility is grimmer: chronic undernutrition can lead to impaired cognition, lifelong disability, or death.
Malnutrition is a predominant risk factor for death in children younger than five years, accounting for 68% of total under-five deaths in India. It is also the leading risk factor for health loss across all ages, according to a 2019 study published in The Lancet Child and Adolescent Health.
An ‘adequate’ diet
The latest National Family Health Survey (NFHS-6), released in May, shows that in Madhya Pradesh, nearly 40% of children under five years of age are underweight (defined as low weight for age). The survey was conducted in 2023–24. This is a sharp rise from the 33% prevalence recorded in the previous round (NFHS-5, 2019–21).
The central Indian state, despite being an agricultural powerhouse, fares worse than Bihar (36% underweight) and pales when compared to better-performing states like Tamil Nadu (23%) and Kerala (18%).
Interestingly, between 2019–21 and 2023–24, child underweight prevalence showed sluggish improvement at the all-India level, crawling by just a few decimal points from 32.1% to 31.8%. Though this is an improvement compared to the 36% prevalence in 2015–16, nearly every third child in India continues to be underweight.
Another appalling statistic is that nearly 85% of toddlers (younger than two years) do not receive an adequate and diverse diet. The survey defines an ‘adequate’ diet as one containing items from four or more food groups—such as breast milk, cereals, legumes, dairy, animal proteins, and vitamin-rich fruits and vegetables.
Sachin Jain, a Bhopal-based social sector professional and director of Vikas Samvad (Dialogue for Development), says multiple factors are responsible for the slide in child nutrition indicators. After Madhya Pradesh implemented a cash transfer scheme for women, its ability to spend on nutrition, health, and education schemes declined. The state spends close to ₹24,000 crore every year on this cash transfer scheme, which provides ₹1,500 per month to eligible women beneficiaries. This is more than what the central government spends on anganwadis for the entire country— ₹21,000 crore in 2025–26.
Chips over eggs
The growing consumption of ultra-processed junk food, which is significantly cheaper than fresh, cooked meals, is another factor, Jain adds. It’s common in these parts to see young children munching on packaged savouries. A small pack of chips or fritters costs just ₹5, which is lower than the price of an egg or a piece of fruit. Official consumption expenditure surveys (2023–24) show that, on average, rural families spend nearly 10% of their per-capita monthly expenses on processed food and beverages—more than what they spend on either education or health.
Since 2014, there has been a stagnation in the number of anganwadi centres, coupled with a decrease in the number of beneficiaries due to a reduction in the union budget share and the shifting of the financial burden onto states. This is according to a recent book titled Realising Rights: A Handbook of Welfare in India, published by the Centre for the Study of the Indian Economy at Azim Premji University.
India runs two major child nutrition programmes. In the anganwadi or Poshan 2.0 scheme, children in the 0–6 age group receive cooked meals, while pregnant and lactating mothers receive take-home rations. Under the PM-Poshan or mid-day meal scheme, children enrolled in government schools receive hot, cooked meals for lunch. The average spending on these schemes is ₹12– ₹17 per child per day, which is insufficient to ensure a wholesome and nutritious diet.
The centre and states share costs in a 60:40 ratio. A reading of union budget documents shows that spending on these schemes has declined in real terms. For instance, in 2015–16, the centre spent nearly ₹26,000 crore on these two schemes. Nine years later, the spending was just ₹31,000 crore (2024–25)—a sharp reduction if one accounts for inflation, a rising population, and the growing size of the economy.
Precious morsels
It’s lunch time at the anganwadi centre in Nayakheda village in the Narmadapuram district. Children sit in a row while Putla Sarathe, the veteran centre-in-charge, leads them in a prayer. The kids are served rotis with a helping of watery tur dal. The vegetable dish listed on the menu for the day is missing. But the focus of the children is entirely on what is in front of them, not what is missing. In less than 10 minutes, every morsel is polished off.
What about the missing vegetables? It turns out the local women's self-help group, which cooks daily meals for eight anganwadis and a middle school, often has to scrounge for ingredients. Their payments are delayed by months, and the scheme runs on the generosity of local grocers. The ₹7– ₹8 per child per meal they receive for ingredients (in addition to grains like rice and wheat obtained under the food security scheme) often falls woefully short.
“I work for more than seven hours every day and make just ₹4,500 per month. That’s ₹150 per day,” complains Sunila Verma, while rolling wheat dough for rotis. Next to her is a large pile of firewood used as cooking fuel because the group cannot afford expensive LPG gas cylinders.
Putla Sarathe, 57, has been managing the anganwadi centre for more than three decades. She shares insights from the past and present. Of the 31 children enrolled at the centre, only 11 attend regularly. Many families, despite their poverty, send their kids to private schools that charge a fee of less than ₹500 per month and do not offer meals. Sarathe believes that following the introduction of the cash transfer scheme ( ₹1,500 per month), more parents are choosing to send their kids to private schools.
Most children belong to poor, landless families from socially disadvantaged castes, Sarathe says. She recalls that in 2010, the state government introduced eggs twice a week. No one objected, since eggs and meat were acceptable to these families (though unaffordable for most). Besides, fruits and milk were served on certain days. However, the intervention was discontinued in less than a year.
States like Madhya Pradesh, Uttar Pradesh, Maharashtra, Gujarat, and Rajasthan do not provide eggs as part of school and anganwadi meals. In contrast, most southern states serve eggs, and these states also fare much better on child nutrition indicators. While Karnataka serves six eggs per week (one each day), Tamil Nadu and Andhra Pradesh provide five eggs per week. States that do serve eggs usually pay for them out of their own budgets, since the standard per-day, per-child budget is not enough to cover the cost. Eggs are a versatile yet cheap source of protein, crucial to cognitive development and physical growth in children, nutrition experts say.
After the meal, Sarathe ensures that the children are escorted back to their homes. Among them is 4-year-old Aradhya, one of five children in the Kumre household. Aradhya is underweight, but scores better than her youngest sibling, 2-year-old Adhyansh, who slid into the severe acute malnourished (SAM) category last year before recovering slightly to "underweight."
Their father, Bijay Kumre, survives on casual work that ranges from spraying pesticides on farms to driving a tractor. The nutritional standards of the Kumre family are no different from those of Bhagat Singh’s—except for the fact that Kumre spends between ₹30 and ₹50 a day on ultra-processed junk food. Do the children ever eat fruit? “Kele mele kabhi kabar (a banana maybe, once in a while),” he replies casually.
A peek into the family’s kitchen shows why Aradhya ate every morsel on her plate at the anganwadi: the only dish cooked at home, bitter gourd fried with salt and turmeric, was completely finished. Only a few rotis were left. The meal at the anganwadi is supposed to supplement the meal at home. In reality, it has become her primary source of nutrition for the day.
It’s 1:30pm. Aradhya will have to wait until evening for her next morsel of food.
- 6.6 kg: The actual weight of two-year-old Bhagat Singh. This is nearly half of the 12 kg ideal weight a toddler his age should be hitting.
- 40%: The alarming percentage of children under five who are underweight in Madhya Pradesh. This marks a sharp slide from the 33% recorded previously.
- ₹12– ₹17: The average daily amount spent per child on India’s two primary nutritional programmes—Poshan 2.0 and PM-Poshan, which experts highlight as woefully insufficient.