MDMS: Malnutrition and Solutions

What’s On Your Plate?

In Milan, where I live, lunch consists in a first course (usually pasta or rice, sometimes the much-hated soup), a second plate of meat or fish, a side dish of vegetables and finlly fruit or dessert.
In a dish in Paris we could easily find fish, spinach, potatoes, cheese and bread.
If we were children in Bangkok we could see ourselves served with pork in sweet and sour sauce, rice and a pudding wrapped in banana leaves.

What about India? On 15 August 1995 the NP – NSPE (National Programme of Nutritional Support to Primary Education) was launched. The programthen led, in 2001, to the creation of the MDMS (Mid Day Meal Scheme).Over the years the scheme has undergone some changes and modifications, which led to the current shape of the program, renamed the National Program of Mid Day Meal Scheme: extended to all areas of the territory, with a summer extension in those severley affected by drought, provides for a quantity of food equal to 450 calories and 12 grams of protein per day for at least 200 days a year; all students up to 8th class in the primary school benefit from the program, in every Government school or subsidized school(asreported on the Department of School Education&Literacy web page).

So, what does any Indian student eat? Rice, lentils, roti, fruit and milk once a week. What about proteins? What about eggs?

What’sbad?

Although some improvements have been ascertained with the introduction of the program, as reported on the official page of the Mid Day Meal Scheme in the Findings of Research studies, cases of poor quality in the food served in the schools and malnutrition among children are constantly reported.

This August, a video in which about 100 students were recorded eating roti and salt at lunch, still inside the MDMS, became viral. The scandal lead to the immediate suspension of the teachers and the principal of the school under investigation, and to an official appeal from the National Commission for Human Rights to the Government of Uttar Pradesh: the selected commission then r equested a full report on the matter. However, as reported by the weekly journal The Week,the Government ofUttar Pradesh was already aware of serious cuts within the program. A study conducted on 40 schools in 2016 by GIDS (Giri Institute of Development Studies in Lucknow) has highlighted how“not all school had kitchen sheds due to lack of space and funds; […]. Regarding the availability of food supplies […] of the 40 schools in the study, only 26 had supplies worth a month. On the quality parameter, three in 10 schools described the food as of “average” quality”. The quantity of the meal was also reported to be insufficient […]. […] lack of plates at schools because of which children had to get utensils from home […].”
Another more recent report by the MHRD (Union Ministry of Human Resource Development), dating back to March 2017, found that around 63% of schools still use firewood to cook meals instead of the healthier and greener LPG.

If from the health point of view the risks are clear and obvious, from a social point of view the situation cannot be considered any better: the program has failed to achieve one of its main goals, to improve the number of enrollments to primary school. Indeed, the latest report drafted by CAG (Controller and General Auditor of India) shows how the schools in which the scheme is being put in place record a decline in the registrations in the last five years (from 146.9 million in 2009/2010 to 138.7 million in 2013/2014, as reported by the DownToEarth website).

What’snext?

Given what has been said so far, the need to make changes in the program, or at least to follow it as it was actually designed became increasingly obvious. In particular, deficiencies have been highlights in the amount of food available for meals in schools, as well as its poor quality (some times even worms have been found in children’s dishes).

What would then be necessary to do? First of all, it is clear and evident the importance of increasing the quantity of food served (a 7-8 year old child needs about 1500-1700 kcal per day). An improvement in the quality of food would be of fundamental importance, establishing a chain of controls that can guarantee at least the minimum requirements.

These are us two of the changes that must necessarily be implemented, in the hope that one step at a time India will achieve what the program was created for.

Martina Pignatelli

International Cooperation &Development Student

Italy

Sources:

o   Department of School Education&Literacy, “Mid-Day MealScheme”

o   The Week, “UP govtwasaware of severe shortcomings of mid-day mealscheme”

o   The Indian Express, “Report on Mid-day MealScheme: 63 per centschoolsstill use firewood for cooking”

Down To Earth, “Mid-day mealhasfailed to attractchildren to government schools, says CAG audit

Malnutrition vs Religion

It will surprise few that India’s children are amongst the most likely to suffer malnourishment however the reasons behind this are certainly not as simple as one would expect (i.e. lack of food).

Fundamentally malnutrition is defined as not enough or too much of a single food group. This in turn leads to complications in utilising consumed sustenance and therefore hampering the body’s ability to fight off and recover from infection. The problem faced by Indian society is primarily related to a lack of protein in the diet of young children which is then exacerbated by the sanitary and religious conditions that they find themselves living in.

While there other forms of serious child malnutrition (such as iodine, vitamin A, or iron, deficiencies) lack of protein is by far the most lethal and, according to the World Health Organisation (WHO), plays a major role 50% of all deaths under 5 years of age. The situation in India is particularly severe where 30% of the entire world’s under-nourished population can be found. In a country of the size, both geographically and economically, of India it is clearly not just a lack of food that is accountable.

One unique factor behind India’s child malnourishment is the influence that is held by India’s various religious sects and the dietary recommendations that are advocated. Contrary to popular belief India is by no means a vegetarian society, however the rise of fundamentally religious political parties who espouse the benefits of a vegetarian lifestyle has restricted what food may be served at school’s midday meals (MDM). Most controversial is restriction on the serving of eggs which can provide a significant protein boost (one egg contains half of the recommended daily intake) and are easily digestible to those suffering with malnutrition.

Originally brought into practice in the 1990s India’s MDM programme has become a vital source of nourishment for the poorest children in society. However, respecting regional religions place strict vegetarian restrictions on the lunchtime menus. A current example is the region of Karnataka where 9 out of 10 children are suffering with malnutrition but as it is administered by the Hindu fundamentalist Bharatiya Janata Party are forbidden from the MDM on religious grounds. Perhaps the fact that milk is served in schools nationwide leads to a logical conclusion drawn by the nation’s Bapu (Mahatma Gandhi) who advised “he who can take milk should have no objection to taking sterile egg”.

Crudely nicknamed “the open defecation capital of the world” the state of India’s public sanitation is the other unique contributing factor to this problem.Particularly affected are rural areas where, according to the WHO, it was estimated that last year 61% of Indians defecated in the open. A staggering statistic, far higher than any other (reportable) country, that results in the deaths of 1000 children each day to diarrhoea related diseases and has a wide reaching impact on their ability to retain nutrition and maintain a healthy, growing body.

To combat this precise issue Prime Minister Nehendra Modi embarked on the Swachh Bharat (Clean India) Mission in October 2014 to be concluded by October 2019 to mark Gandhi’s 150^th birthday. Construction has been undertaken at a furious pace and there are signs that the tide is turning; between Oct ’14 and Jan ‘16 the number of rural families with access to a working toilet went from 42% to 49%, however, physical construction is only half the battle. The other side to tackle is convincing the (mostly) rural population of the need to cease open defecation. In a country proudly steeped in tradition this is no small challenge but one that must be overcome if India is to take its rightful place at table with the world’s other super-powers.

-William Lewis 

-Picture Credit Heeals