When 28-year-old Ekta Choda was pregnant last year, local Anganwadi in Pamul village, an hour’s drive from Vadodara, gave her three packages of a fine white mixture each month. Each package was 1.5 kg of batter, consisting of wheat, chickpea flour, soy flour, sugar, oil, rice and corn, rich in protein and nutrients.
Chudha would add ghee to the mixture to cook a sweet dish – chira – or to make theplas, both of which are commonly consumed in Gujarat. “I never liked the taste,” she said, “but I ate it.”
With the Shodha family so involved in farm work, there was little money to spend on food during pregnancy, and the food mixture distributed by Anganwadi filled a vital nutritional gap. The Anganwadi Local Centres, under the state’s Women and Child Development Division, provide care and nutrition for children under the age of six and pregnant and lactating women.
After Shoda was born, Anjanwadi began providing a similar bundle – called Balshakti – for her six-month-old son. But Shoda’s son, now a year old, spits out any food cooked with the mixture. Shoda said she asked the Anganwadi worker to stop giving her the ration packets, but to no avail. “She says take the can and do whatever you want,” Shoda said.
Choda now dumps the contents into a neighbour’s cattle feed bin. “I tried, [but] She said, “My son doesn’t like the taste.”
Several rounds of National Family Health Survey data have shown that nutrition levels in Gujarat are worrying, especially among children. Since 2019, the Government of Gujarat has been distributing these ready-to-cook rations of energy and micronutrient rich foods to children, adolescent girls, pregnant and lactating mothers.
Gujarat has more than 53 beneficiaries under Anganwadis. In 2020 and 21, the government introduced take-home rations of food mixtures to 38.18 lakh beneficiaries. It has also made an annual budget allocation of Rs. 723.4 crore for home rations, hot and cooked meals. It was not clear how much was allocated separately for the food mixture packages.
But, according to ground reports and feedback from Anganwadis, children find the nutrient-rich food packages unappetizing, challenging the state.
Despite the comments, the government is determined to continue with take-home rations, said Sunita Makwan, a health campaigner for the non-profit Kaira Social Services that works on health and women’s issues. “A lot of money is being wasted buying them,” she said. “The government knows women throw quotas.”
At least the cattle are getting better.
Daksha Prajapati, an Anganwadi worker in Pamul village, Anand district, said she told her supervisor about the complaints of mothers in her village. “I can’t do anything more,” she said. As she watched the children in Anganwadi eat a hot meal of rice and dal without fuss, she added, “The children prefer cooked meals over that packet.”
Reshma Chawda tried to use the food mixture to make a shirah for her daughter Diksha, but after a few days she gave up and fed the contents to a cow. “At least the cattle are getting better,” she said.
Madhubin Choda, who owns a cow and a buffalo in the same village, has stopped buying fodder since many villagers have provided food rations for her cattle. Her granddaughter, who is now four years old, also likes the hot meals at Anganwadi Restaurant, like the other children in the village.
Rashida Choda, 37 years old, has two children registered in Anganwadi. When the Anganwadi workers advised her of the benefits of the fortified food mixture, she made chapatti and chira for her son. “He ate it first,” she said. “But he didn’t gain weight,” she said. Later, he started vomiting food. Her eldest daughter, who is five years old, also eats at Anganwadi.
K.K. said Nirala, secretary in the state’s Department of Women and Child Development, said the fortified food packs were meant to supplement a child’s diet.
declining trend
The fifth round of the National Family Health Survey conducted in 2019-21 showed that in Gujarat, 25.1% of the children surveyed are under the age of five He suffered from emaciation, or was too thin for her height. This was much worse than the national average of 19.3%. That’s not all. Gujarat’s performance in this regard has become even worse. the The third round of the National Family Health Survey conducted in 2005-2006 found that 19% of children under the age of five in the state suffered from wasting.
Between 2019-21, the incidence of stunting in Gujarat – when children are too short for their age – was 39% among children under five, compared to the national average of 35%. And nearly 40% of children under the age of five are underweight, compared to 32% nationally.
While India’s national rates of stunting, wasting and underweight children have improved compared to previous surveys, Gujarat’s figures showed little change or worsened.
The decrease is particularly noticeable in the rural areas of the state as shown in the table:
A state government screening process found that as of November 2021, 1.64 lakh Among the 21.1 children screened had severe acute malnutrition.
“Poor nutrition makes it difficult for a child to fight infection,” says epidemiologist Dr. Pradeep Awate. Emaciation leads to a decrease in the storage of fat in the body, which in turn suppresses the immune system, Increased infant mortality risk. These effects last well into adulthood, too.
Fortified but packed
Before the introduction of blended rations, the Gujarat government ran a scheme called Bal Bhog, under which nutritional supplements were distributed in various forms – as canned food, then as chocolate. The state government has also distributed packets of sukhadi (Gujarati sweet dish), chira and upma along with these homemade nutritional supplements. For children between the ages of three and six, cooked meals are served hot at Anganwadis.
In 2019, with the aim of improving nutrition among children under three years of age, the state government entered into an agreement with the Gujarat Milk Marketing Co-operative Federation, which runs Amul, to manufacture and distribute fortified food rations. Under the Gujarat Cooperative Milk Marketing Federation, district unions in Kaira, Banas and Surat individually set up factories to produce 200 metric tons of fortified food mixture per day.
Now, healthy children receive 3.5 kg packages of Balshakti and milk every month, while malnourished children receive 5 kg packages. Children suffering from severe malnutrition should consume 185 grams of this packaged food per day. Teenage girls are given 4 kg per month of a type called ‘Purnashakti’, while pregnant and lactating mothers are given 4 kg per month of ‘Matrushakti’.
Chirag Khadol, a health activist in Kasur village in Anand district, where Amol is headquartered, said locals have different food habits: they prefer chapatti, dal, rice and vegetables to processed foods.
“The Anganwadi workers tried to advise the women about the benefits of the ration and even told them about various recipes,” Khadol said. “But the people refused to change.” However, Nirala, a secretary in the state’s Department of Women’s and Child Development, argued that the idea was not to change anyone’s diet, but to provide an additional supplement.
Activists push for change
Activists in Dahod, Anand, Vadodara and Ahmedabad said they had urged the government to adjust the taste of mix food to improve consumption or to switch to hot, cooked meals. “But there is no attempt to make the class more child-friendly,” said Renu Khanna, of the non-profit organization Sahag.
a Survey of 750 beneficiaries of the home ration system conducted from December 2020 to February 2021 found that children dislike the taste of food rations. The survey was conducted by Kronal C. Kamani, assistant professor at Anand Agricultural University, across 24 districts in Gujarat. 25% of the respondents said that children do not like the flavor of the food rations, while 35% complained about the poor distribution of food. Only 9.6% of the respondents said they were happy with the portions of the nutritional mix.
Of the total beneficiaries surveyed, 743 earn less than Rs 2 lakh per annum and depend on free rations to support their families. The paper recommended that the state improve the taste of food rations while making anganwadi more suitable for children and improving access to rations in rural areas.
Minister Nirala said the government was working on feedback and would add millet to the take-home ration packet. “Within Gujarat, people in Saurashtra prefer salty food, and in central Gujarat they prefer sweeter dishes,” said Nirala. “We try to create a neutral flavor,” he said, “so people can add salt or sugar to make a proper meal.”
Better is traditional and familiar food that matches the dietary patterns of the beneficiaries, said Savita Gorsingh Pariya, a health activist working in Dahod and Mahisagar district. “Hot and cooked meals are best suited,” she said, adding that the anganwadi can monitor the food consumption of the beneficiaries. Experts say cooked meals made using traditional recipes may not provide the required nutrition. Take-home rations are convenient for the beneficiaries and also reduce the burden on the anganwadis to provide cooked meals.
Paria said the government is continuing mix rations, claiming they are healthy. “But if children don’t consume it, what’s the point?” She said. According to Baria, many teenage girls who eat food made from ration mixes still experience low hemoglobin. “We need a better solution to improve their health.”