Defeating malnutrition in the kitchen ‘nutri’garden

Aside from existing government schemes, Maharashtra’s malnutrition crisis requires a more practical and sustainable model, that addresses immediate needs and challenges and also has the potential to be replicated countrywide. Anjali Parasnis, Senior Fellow & Associate Director, TERI shares her views on defeating malnutrition

 

On September 13th 2017, the Maharashtra government put on hold its plans to supply ready-to-use therapeutic food (RUTF) products to severely malnourished children in rural government-run crèches called anganwadis. Based on data for the treatment of Severe Acute Malnutrition (SAM) in children, the Global Alliance for Improved Nutrition (GAIN) has suggested that the difference in the health benefits of commercial RUTF and those augmented at home is very minimal. Moreover, critics argue that it is a temporary curative measure that replaces take-home food supply and is an expensive and unsustainable solution for improving food availability and dietary diversity. Hence, the government should promote local solutions such as locally-created foods or home-cooked ones rather than packaged commercial ones.

 

According to Deepak Sawant, state health minister, efforts to reduce malnutrition-caused deaths in Palghar and Melghat are ongoing. In the last year, approximately 20 million children have been immunized. Regular immunization and screening camps were held in the tribal hamlets of Melghat, Palghar Jawhar and Mokhada, known for high incidence of malnutrition. In Jawhar and Mokhada, infant deaths have fallen from 93 in 2016 to 38 until now.

 

The state government spends crores of rupees for the supply of nutritious food material to the malnourished children. Under the PDS, each family must get 35kg of grains however, many shops remain shut or provide only 15-20kg of grains. Additionally, some tribals do not have ration cards. Under the Dr. Abdul Kalam Amrut Ahar Scheme, 25 rupees is allocated to each pregnant/lactating woman per meal but the amount is too little for adequate nutritious food in the face of a severe lack of purchasing capacity among the people. It is estimated that in Maharashtra there are around 85,000 severely malnourished children who would require immediate attention and supplies.

 

Aside from existing government schemes, Maharashtra’s malnutrition crisis requires a more practical and sustainable model, that addresses immediate needs and challenges and also has the potential to be replicated countrywide. Such a model focuses upon using local resources to make communities “food and nutrition sufficient”. This approach relies on the following simple steps: (i) determining the baseline of nutrition status (ii) local resource assessment (iii) enriching traditional dietary plans using nutrition rich ingredients through novel food fortification (iv) sensitizing the community about diets, deficiencies and implications of ignoring food quality and nutrition (v) encouraging frequent integration of wild edibles, traditional local grains, corns, tubers and mushrooms in daily diet and finally, (vi) building capacity of women and the youth to take up food and nutrition related livelihood options.

 

Maharashtra’s Palghar district that has been severely affected by malnutrition can benefit from such an approach. Due to the prevalent issue of water scarcity, low-cost grey water treatment systems can provide irrigation water to help villagers grow nutri-gardens in their backyards itself. This way, a diverse range of vegetables and fruits that are packed with nutrition, can be made readily available for consumption by the affected population.

 

Given that women usually have the primary responsibility of providing meals, the involvement of women’s Self-Help Groups can ensure further integration of nutrition into daily food habits to form a holistic diet for community members. For example, as part of a pilot programme, one Self-Help Group prepared a special kind of ‘khakra’ that was fortified with nutrients like dried spinach and mushroom.

 

This product became extremely popular among children as soon as it was introduced. Out of the 900 children that were targeted, 68% of the Severe Acute Malnutrition (SAM) children were restored to normal category within three months. In addition, 32% children moved up from SAM to Moderate Acute Malnutrition (MAM). The women are now trying to promote this product as a commercial enterprise at the local level in order to supplement their income.

 

Such approaches demonstrate the faith that villagers extend to local entrepreneurs, as well as anganwadis and primary health care centres. These are unique and sustainable in the sense that they require limited external support in the form of funding. What needs to be done is figure out how existing government programmes can be oriented to act as effective facilitators for such models. The underlying aim is to make vulnerable communities aware of the required nutrients, locally source them and achieve self-reliance by empowering them to combat malnutrition successfully.