Fortified snacks over hot meals? It doesn't go down well.

Let's eat: A VIP visit means the full course for children in a Haryana village

Ministry's prescription

* Packaged single-source micronutrient snacks instead of fresh cooked meals. Distribution is easy to monitor. Solves the problem of cooking.
* Central procurement of the fortified snacks through chain of contractors

Nutrition Experts Object To...

* Studies say there is no substitute for freshly cooked, balanced meals
* Single-source packaged food fortified with micronutrients is not easily digested or absorbed by a malnourished child

A fresh, wholesome cooked meal—can there ever be a substitute for it? The world over, it's a staple idea for nutritionists: by no stretch can packaged snacks be called a healthy alternative.

"It's unfortunate, the ministry is siding with profits and against the children." Jean Dreze, Development Economist       
   
Tell that to the Union ministry of women and child development headed by Renuka Choudhury. Despite proven wisdom and strong opposition from experts, it wants to do away with cooked meals for children in the 3-6 age group under the supplementary nutrition programme (SNP) of the Integrated Child Development Scheme (ICDS). Instead, the ministry is pushing ahead with its plans to 'feed' children in anganwadis (government-run creches) with pre-packed food—though labelled nutrient-rich and fortified. The matter comes to a head since there are allegations that commercial forces may be at work here vis-a-vis the procurement of pre-packaged food.

The proposed move has come in for severe criticism from several quarters. The UPA's National Advisory Council (NAC), members of the steering committee on nutrition and food security (set up by the Planning Commission) and other experts have all described the programme as seriously flawed. Points out Veena Shatrugna, deputy director of the Hyderabad-based National Institute of Nutrition: "The undernourished should get nutrition from food.

Children cannot get calories from one source. But the approach of the women and child welfare department seems to be to supply micronutrients by fortifying biscuits. Now, biscuits cannot be a substitute for food. People in the pharmaceutical business will say give the children tablets. But we as nutritionists would say give the children food."  
   
Malnutrition is a serious problem, 46% of our children in the 3-6 age group are underweight.   
       
According to her, the way to tackle malnutrition is through a wholesome food-based approach—studies have shown that a single source concentrated with micronutrients will not be easily digested and absorbed by undernourished bodies. "Providing a hot, cooked nutritious meal consisting of cereal, pulses, eggs and vegetables is essential for a supplementary nutrition programme to have an impact. Is this too much to ask of the ICDS?" Veena asks.

On November 8, the members of the steering committee on nutrition and food security, Jean Dreze, Biraj Patnaik, Vandana Prasad and Veena Shatrugna, wrote to Planning Commission deputy chairman Monktek Singh Ahluwalia to underscore their opposition. The members also wanted locally procured food cooked in accordance with local taste/preferences to be provided to the children. Says Dreze: "We would like cooked, nutritious meals to be provided to children. This is already being done in some states and there is a trend towards provision of cooked meals under the supplementary nutrition programme in many others."

However, he adds that this transition has to contend with a strong lobby in favour of pre-packed food supplements. "It's really unfortunate that the ministry for women and child development is being swayed by commercial interests that favour centralised procurement of pre-packaged food instead of locally cooked meals. It is sad to see the ministry siding with profits and against children."

National Advisory Council member N.C

Saxena is clearly miffed with the situation. "Food habits are local and we have to be sensitive to what children eat. They will not readily consume factory-produced packaged micronutrients as proposed by the ministry," he says. Saxena has written to Prime Minister Manmohan Singh expressing his concerns with the ministry's plan.

But despite the concerns, it seems the packaged nutrients programme is ready to go onstream. A senior official at the women and child development ministry justified the decision, telling Outlook that the circumstances as they exist on the ground are fraught with problems. "Most of the centres which run ICDS schemes don't have the infrastructure to either cook or monitor the quality of meals and water used for cooking," he says.

But this argument discounts the fact that the hot meal scheme is already in place in more than 18 states. It's just that delivery and checks on quality have to be improved. What is baffling is why the ministry would want to tamper with a system, which, if not perfect, has been effective? And that too in a country where malnutrition is an extremely serious problem: 46 per cent children in the 3-6 age bracket are underweight.

Meanwhile, the steering committee has come out with a list of interventions to improve the present SNP programme. This includes frequent meals in adequate quantity and with adequate nutrients in the form of animal proteins (milk, eggs, meat, fish), fruits and vegetables. Some thought has also gone into the THR (take-home rations) issue. The panel wants carefully designed rations based on locally procured food to be delivered every week. (Currently, THR is in only one form, grain.) It has also been suggested that THRs be combined with nutrition counselling for parents, to ensure the food is kept for the child rather than distributed amongst the family.

With so much at stake, and a belligerent ministry bent on its health snack plan, support for the cooked food programme has come from an unlikely quarter. The PMO is said to be in favour of the nutrition experts' recommendations. Sources there told Outlook that it is hopeful that the Planning Commission and the ministry will come to an agreement on decentralising the ICDS programme to provide freshly cooked food locally. As an official pointed out: "The panchayats have more resources in their control, they should own the content. What is required is a well-implemented scheme to tackle malnutrition locally through local interaction. There's no doubt the programme has to be recast to address the issue of malnutrition."

Next week, the National Development Council is expected to suggest a roadmap for the ICDS. One crucial decision it will take will be on the nutrition programme for children. Should it be freshly cooked food or packaged formula? There are many who hope that conventional nutrition sense will prevail..



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