Key nutrition scheme set to miss targets despite SC orders

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by Pragya Singh and Sangeeta Singh

SC issues notices to chief secretaries of five states that it notes as the worst performers on the Anganwadi front

New Delhi: Despite 50 or so direct orders from the Supreme Court and a commitment by the current government under its National Common Minimum Programme, the only scheme to provide nutrition to children, adolescent girls, pregnant women and lactating mothers in India is set to miss its target.

Though the scheme has run for 32 years and spent more than Rs10,000 crore, the malnutrition rate among children up to six years old in India is nearly twice that of sub-Saharan Africa.
Decline in incidence of malnutrition has tapered, down to 46% in 2006, from 47% in 1999 and 51% in 1993, according to a series of government-conducted national family health surveys.
"There are more malnourished children in India than anywhere else in the world and virtually no progress has been made on this front in over a decade," said Santosh Mehrotra, a consultant on rural development at the Planning Commission.

He closely tracks the Integrated Child Development Scheme (ICDS). The National Common Minimum Programme is a priority list of development schemes that constituents of the current government, now sharply divided over the India-US nuclear deal, have all agreed would be top agenda items for the UPA government.

Without much response from programme implementors, the Supreme Court has decided to up its ante. In its latest hearing of this case on 25 July, it issued contempt of court notices to chief secretaries of five states that it noted were the worst performers on the Anganwadi front.

The chief secretaries of Rajasthan, Kerala, Bihar, Orissa and Himachal Pradesh have been asked to appear and explain before a two-judge bench on 30 August.

The overall poor performance is being attributed to the failure of states to propagate Anganwadis that disburse nutritious food supplements and provide pre-school education, immunization referrals and other services, as part of the scheme. This despite an apex court order in April 2004 that directed the government to set up 1.4 million Anganwadis, or one in every settlement, by December 2008.

Several interim orders and reprimands have ensued since, but only 8,45,000 Anganwadis have been set up through March. To meet the Supreme Court specified target, 5,50,000 Anganwadis will have to be set up in the next 16 months. There were 8.45 lakh Anganwadis in February 2003 and 6,50,000 in March 2004, which means that less than 1,00,000 are being added every year. If centres that have been sanctioned—but don't yet function—were also taken into account, there would be under 1.1 million Anganwadis today. Only about 70 million of the country's 160 million children are currently covered by the scheme.

In Kerala, one of the "best" states on several fronts, including education, 29% children are underweight, 21% are stunted and 16% wasted, according to the third National Family Health Survey in 2004-05. In a previous survey held over 1998-99, 27% of the children in the state were found underweight, 11% wasted and 22% stunted.

"Despite our previous order, the pace at which the sanctioned Anganwadi centres are being made operational is a sad reflection on state governments," the court bench consisting of Justice Arijit Pasayat and Justice \nS.H. Kapadia said while passing the 25 July order.

"There is concern across the government about malnutrition, but some sections are, maybe, not convinced about the scheme. But there is no alternative to ICDS, we just need to run it right," said Biraj Patnaik, principal adviser to the Commissioners of the Supreme Court on the right-to- food case, as the matter has come to be known. The chief secretaries of Rajasthan, Kerala, Bihar, Orissa and Himachal Pradesh have been asked to appear and explain before a two-judge bench on 30 August. The overall poor performance is being attributed to the failure of states to propagate Anganwadis that disburse nutritious food supplements and provide pre-school education, immunization referrals and other services, as part of the scheme.

This despite an apex court order in April 2004 that directed the government to set up 1.4 million Anganwadis, or one in every settlement, by December 2008.

Several interim orders and reprimands have ensued since, but only 8,45,000 Anganwadis have been set up through March.

To meet the Supreme Court specified target, 5,50,000 Anganwadis will have to be set up in the next 16 months. There were 8.45 lakh Anganwadis in February 2003 and 6,50,000 in March 2004, which means that less than 1,00,000 are being added every year.

If centres that have been sanctioned—but don't yet function—were also taken into account, there would be under 1.1 million Anganwadis today. Only about 70 million of the country's 160 million children are currently covered by the scheme.

In Kerala, one of the "best" states on several fronts, including education, 29% children are underweight, 21% are stunted and 16% wasted, according to the third National Family Health Survey in 2004-05.

In a previous survey held over 1998-99, 27% of the children in the state were found underweight, 11% wasted and 22% stunted.

"Despite our previous order, the pace at which the sanctioned Anganwadi centres are being made operational is a sad reflection on state governments," the court bench consisting of Justice Arijit Pasayat and Justice S.H. Kapadia said while passing the 25 July order.

"There is concern across the government about malnutrition, but some sections are, maybe, not convinced about the scheme. But there is no alternative to ICDS, we just need to run it right," said Biraj Patnaik, principal adviser to the Commissioners of the Supreme Court on the right-to- food case, as the matter has come to be known.

In Madhya Pradesh, 60% of children are underweight, according to the 2004-05 survey, while 40% are stunted and 33% are wasted. In Rajasthan and Orissa, 44% are underweight, and in 22 states that include West Bengal, Karnataka, Maharashtra, Punjab, Chhattisgarh and Manipur, 21-45% are stunted. The sooner action is taken to improve health and nutrition, the better it always is, points out Ishi Khosla, a nutritionist based in New Delhi.

"As the effects of not having the right kind of food can be devastating on a child's health and future, and the sooner he or she gets the right nutrients, the easier it is to reverse the effects of malnutrition," she says. "A lot depends on the state governments and how they go about addressing the scheme," says Patnaik. "We do see an urgency, specially with chief secretary after chief secretary being summoned to the courts. You see, the pressure from the court is so unrelenting that the states may stall for a month, or a while, but not for too long."
In Madhya Pradesh, 60% of children are underweight, according to the 2004-05 survey, while 40% are stunted and 33% are wasted. In Rajasthan and Orissa, 44% are underweight, and in 22 states that include West Bengal, Karnataka, Maharashtra, Punjab, Chhattisgarh and Manipur, 21-45% are stunted. The sooner action is taken to improve health and nutrition, the better it always is, points out Ishi Khosla, a nutritionist based in New Delhi.

"As the effects of not having the right kind of food can be devastating on a child's health and future, and the sooner he or she gets the right nutrients, the easier it is to reverse the effects of malnutrition," she says.

"A lot depends on the state governments and how they go about addressing the scheme," says Patnaik. "We do see an urgency, specially with chief secretary after chief secretary being summoned to the courts. You see, the pressure from the court is so unrelenting that the states may stall for a month, or a while, but not for too long."