Strategies for Children’s Right to Food Right to Food Campaign India

Status of Child Nutrition in India 46% children under three underweight National Family Health Survey) 30% children born low birth weight 38% children under three are stunted Infant Mortality Rate is 57 (62 for rural areas), half of this linked to malnutrition 79.2% children in the 6 months – 3 years age group are anaemic

Status of Women’s Nutrition 33% women whose Body Mass Index is below normal 56.2% ever married women are anaemic 57.9% pregnant women are anaemic Poor maternal nutrition and birth weights linked

MATERNAL PARAMETERS (MEANS) ACCORDING TO BMI STATUS BMI CLASSES LBW (<2500 g)% < CED III CED II CED I (NORMAL) (NORMAL) (OBESE) > (OBESE) TOTAL 30.5 Source : NNMB Repeat Surveys (1991), Quoted by Nadamuni Naidu et al, 1994.

Calorie Gap The latest National Nutrition Monitoring Bureau (NNMB) data (2006-7) show that even today there is a deficit – of over 500 calories in the intakes of 1-3 years old and – about 700 calorie among the 3-6 years old There are bound to be additional multiple vitamin and mineral deficiencies when there is a 40% deficit in calories.

Existing Programmes Integrated Child Development Scheme (ICDS): a comprehensive programme for addressing health, nutrition and development needs of children under six. Functions through ‘anganwadi’ centres which are run by ‘anganwadi’ workers ICDS is supposed to do the following: – Supplementary nutrition (SNP) – Nutrition and health education – Health referral service – Immunisation – Pre-school education IFA supplementation for pregnant women Cash benefit for pregnant women (National Maternity Benefit Scheme), Public Distribution System, Employment Guarantee

Supplementary Nutrition Programme - GAPS Budgets very low – $1 per child per month (after it has been increased by double in 2004) Results has been cereal based, irregular supply, poor taste Centralised systems of procurement using private contractors – Resulting in corruption in the system – Poor accountability, no transparency

RECOMMENDATIONS OF THE CAMPAIGN

Universalisation Universalisation – increase the number of ICDS centres to cover all habitations Nearly 50% children are undernourished. Thus, only a small proportion of children could be “safely” excluded from nutrition programmes. The financial savings involved in targetting are unlikely to justify the efforts, costs and risks associated with targeting and risk of “exclusion” Prevention - Providing nutritious food to all children helps to ensure that most of them do not fall in the category of “moderate or severe underweight” in the first place.

Quality Food and not just cereals.... or micronutrients Problem with micronutrients being posed as the only solution especially when calorie gap is not met Micro-nutrient deficiencies in India exist because of massive macronutrient deficiencies, and if adequate food is supplied, most micronutrient deficiencies will disappear. Body needs a large number of micronutrients including phytonutrients and antioxidants – how many will we provide through supplementation/fortification? An orchestra cannot be converted to a solo. Single agents can be counter productive.

Quality Food and not just cereals.... or micronutrients Providing a hot, cooked, nutritious meal consisting of cereal, pulse, oil, eggs and vegetables is essential for the SNP to have an impact. The provision of good quality balanced meals also has a demonstration value from the point of view of nutrition education. Decentralised procurement also enables community control and accountability

Food for acutely malnourished Acutely malnourished – also food based strategy possible Nutrition Rehabilitation Centre (National Institute of Nutrition) Average intake in hospital of a 7 kg child Bread 40 gms Rice 50 gms Milk 500 ml Oil 20 ml Dal 25 gms sugar 10 gms Banana 1 Eggs cal, 35 gms protein Approximate cost of a 1000 Kcal diet – Rs 15 /- i.e. $0.4 per day

Strengthen other food entitlements – Maternity entitlements for women – Crèches for children of working mothers – Overall household food security – Public Distribution System, National Rural Employment Guarantee Act, Social Security benefits

Campaign Strategies Legal action Policy advocacy Mass mobilisation Public hearings Social audits Right to Food as a basic right

Results Expansion of ICDS ICDS budget increased manifold Banning of private contractors/centralised systems of procurement for supplementary nutrition Hot cooked meals for all school children, including under six children Resisting introduction of processed foods such as biscuits in school meals