Nutrition, An Orphan, Should Receive Attention It Deserves

It is a proven fact that the availability and interrelationship between food security and health security leads to nutrition security. Both food security and health security are strongly linked to available household income, the presence of various social safety nets, and availability of a variety of nutritious foods at the local, regional and national level. Thus, a stable and sustainable food supply system is essential for ensuring food security at the regional, national and global level.

Inconsistent and insufficient access to adequate amounts of nutritious food can have a negative impact on the health of individuals of all ages. Although food insecurity is harmful to any individual, it can be particularly devastating to children because they are more vulnerable to potential long-term consequences for their future physical and mental health and academic achievement. It is pertinent to mention that India ranks 74 out of 113 major countries in terms of Food Security Index (published in 2017), with an overall score of 48.9 points.

National Food Security Act, 2013

The National Food Security Act (NFSA), 2013 has the objective to provide for food and nutritional security by ensuring access to adequate quantity of quality food at affordable prices to people to live life with dignity. Some of its salient features were considered a game changer to strengthen food and nutrition security in India.

These include:

-         Coverage of two thirds of the population to get highly subsidised food grains.

-         Food security allowance in case of non-supply of food grains.

-         Special focus on nutritional support to women and children. It recognises maternity entitlements.

-         Eligible households to be identified by states in framing own inclusion and exclusion criteria or SECC (Socio Economic and Caste Census) data.

-         Reforms in door step delivery of food grains, digitization of beneficiary database, use of ICT and end-to-end computerization, leveraging Aadhaar and diversification of commodities.

-         Women Empowerment -- Eldest woman to be the head of the household.

-         Grievance redressal mechanism at the District level.

-         Social Audits and Vigilance Committees to ensure transparency and accountability and penalty for non-compliance.

Some other initiatives under the NFSA, 2013 include installation of Point of Sale devices at Fair Price Shops, SMS alerts to beneficiaries, Ration Card Management System at block level to expedite process of ration card issuance and modifications and toll-free helpline numbers. Such initiatives have helped to identify and remove bogus and ineligible beneficiaries and given more powers to Self Help Groups/Panchayati Raj Institutions and other local institutions in the programme operations.

This historic initiative has converted the normative allocations under the food security programmes of Government of India into lawful entitlements. It includes the Mid-Day Meal (MDM) Scheme, Integrated Child Development Services (ICDS) scheme and the Targeted Public Distribution System (TPDS). The MDM scheme and ICDS scheme are almost universal in nature, whereas the TPDS is supposed to reach out to about two-third of the population (75% in rural areas and 50% in urban areas). The eligible persons are entitled to receive 5 kg of food grains per person per month at subsidised prices, while the poorest among the poor continue to get 35 kg of food grains per household.

The NFSA provides that every state government shall constitute a State Food Commission for the purpose of monitoring and review of implementation of the Act. As per the Act, the State Food Commission shall have quasi-judicial powers and shall give advice to the state government on effective implementation of the Act, inquire into violations of any entitlements, give advice to state government agencies, autonomous bodies as well as non-governmental organisations (NGOs) involved in delivery of relevant services, monitor and evaluate the implementation of the Act and hear appeals against the orders of the District Grievance Redressal Officer (DGRO).

The State Food Commission is empowered to inspect the non-compliance of policy decisions of the government relating to the Act. The states and union territories where State Food Commissions are functional are Odisha, Andhra Pradesh, Gujarat, Bihar, Chhattisgarh, Jharkhand, Haryana, Karnataka, Madhya Pradesh, Maharashtra, Meghalaya, Punjab, Telangana, Uttarakhand, Tripura, Andaman & Nicobar Islands and Lakshadweep. The case of Odisha State Food Commission deserves special mention. It is one of the front-runners among its peers and has created a name for itself with its unique initiatives and has been attempting to carry forward the mandate both in letter and spirit.

Odisha State Food Commission – A Perfect Case Study

On March 15, 2016, the Odisha government decided to constitute an exclusive State Food Commission for monitoring and reviewing implementation of the NFS Act. Apart from the schemes specified in the Act, the Odisha State Food Commission has also been reviewing proper implementation of schemes that address hidden hunger in mothers and children -- like supplements of Iron Folic Acid (IFA), Calcium, Vitamin A, de-worming, essential drugs provisioned under Niramaya scheme (for generic medicines), Vitamin K supplements at birth -- to name a few.

Other crucial areas directly linked to the nutritional well-being of the population -- like promotion of early and exclusive breastfeeding, institutional deliveries, treatment and management of malnutrition at facility (NRC) level, adolescent health and maternal nutrition -- are also reviewed for each block and district separately. 

Apart from state and district level reviews, specific advisories have also been issued to concerned departments/districts and regular follow-up is done on the action taken. Nutrition specific/sensitive services at schools and Anganwadi Centres like provision of double fortified salt, safe drinking water and prevention of open defecation are also accorded high priority.

In many community feeding programmes, hygiene, safety and nutrition are often ignored, and other hazards pose a health risk. Schemes like Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) and Forest Rights Act, 2006 are also given due attention as they affect the household income/food basket. The State Food Commission has been promoting the integration of food safety with nutrition security programmes and has been regularly coordinating with the State Food Safety Commission to ensure regular and timely adoption of a standardised procedure for quality testing of food supplied under the Mid-Day Meal Programme, Take Home Ration and Supplementary Nutrition Programme.

Laudatory Achievements of OSFC

The Odisha State Food Commission has set a benchmark with its proactive approach. Some of its achievements include disposal of all 16,750 grievance applications for ration card received directly at its office, Antyodaya Anna Yojana (AAY) Ration Cards ensured to all the PVTG (Particularly Vulnerable Tribal Groups) households living inside micro-projects, removal of nearly four lakh death cases from the beneficiaries list while those in the waiting list have been included in the final priority list. The coverage under AAY and Targeted Public Distribution System has reached close to 100% of the ceiling, SMS-based reporting on Mid-Day Meal Scheme/Iron Folic Acid tablet consumption has been started for real- time monitoring, modification in job chart of officials/functionaries to include payment of Food Security Allowance in case of non-provision of MDM and a budgetary provision for payment of the same has been borne by the Food Supplies & Consumer Welfare Department.

The Commission also facilitated the launch of a project focusing on improving the nutritional status of all the PVTG communities by UNICEF on the platform of Odisha Tribal Empowerment & Livelihoods Programme (OTELP). Review meeting on various nutrition sensitive and nutrition specific interventions/programmes have been conducted in most of the districts, and state-level nodal officers’ meetings are held regularly to monitor the implementation of provisions mandated under the NFSA, 2013.

It conducts bi-annual review-cum-sharing meetings with NGOs from different districts and also with corporate houses engaged in CSR activities related to food and nutrition security and health issues. These initiatives have helped to identify many excluded households to ensure their coverage, apart from highlighting issues pertaining to the hunger hotspots of the state. Extensive visits have been conducted to the micro projects to examine the quality and extent of various food and nutrition services provided to the PVTGs. Recently, the Odisha government launched its own State Food Security Scheme to cover around two million people who could not be covered under the NFSA, 2013.

State Food Commissions Can Play Crucial Role

Focus on several nutrition-specific and nutrition-sensitive interventions are required for drastic and time-bound reduction of undernutrition in the country. This requires convergence and high level of coordination at the Gram Sabha, Gram Panchayat, sector, block, district and state level and among all concerned departments like Women and Child Development, Health, Agriculture, Panchayati Raj & Drinking Water, Disaster and Emergencies, Food Supplies, Social Security, ST/SC Development, Rural Development and Fisheries & Animal Resources Development etc. 

At this moment, the State Food Commissions can play a crucial role to fill this gap of a coordinating and converging body. The government needs to designate the State Food Commissions as the State Food and Nutrition Commission, armed with powers to coordinate, regulate, enforce and monitor the programmes. The nutrition movement has to be led in a mission mode which should be legally binding and supported on various themes by senior professionals on various thematic areas with full support of the political executives.

Nutrition, an orphan, should receive the attention it deserves.

(Ranglal Jamuda is a retired IAS officer and presently functioning as the Chairperson, Odisha State Food Commission.)