By introducing eggs in mid-day meals, Maharashtra government could end malnutrition in the state. Will it?
In 2005, Maharashtra’s Palghar district became the face of chronic child malnutrition in India as reports emerged of the death of 718 children due to malnutrition. Palghar, a predominantly tribal region, with a 37 percent Adivasi population, is only 114 kilometres away from Mumbai, the capital of Maharashtra and one of the richest cities in Asia. The next decade saw India’s gross domestic product grow in double digits, enthralling both the foreign and national press. Mumbai, the country’s business capital drew much adulation.
The same decade later, in 2016, 600 children died due to undernutrition in Palghar district. Though scarcely reported during the time, India had more malnourished children than all of sub-Saharan Africa combined. Palghar’s epidemic levels of malnutrition were further worsened during the government-imposed lockdown to slow the spread of COVID-19 which created a state of food shock in the district. In June 2020, the district reported 2,459 cases of severe and moderate acute malnutrition, a sharp increase of two percent in just two months.
The story of severe child nutrition is, sadly, not limited to Palghar district alone. Districts across Maharashtra report alarming rates of childhood malnutrition that continues unabated regardless of the country’s purported economic successes. The National Family Health Survey 5, a nationwide survey of a wide range of health and social indicators conducted by the ministry of health and family welfare in 2019 and 2020, paints a grim picture of child nutritional status across India. The trends in Maharashtra are particularly alarming considering that the state cannot be called resource starved. In fact, the state of Maharashtra continues to be the richest state in terms of GDP, seventh richest in terms of per capita income, and highest in tax collections.
Despite having a high number of billionaires living in the state and the presence of businesses creating unparalleled wealth, the state’s social welfare programmes continue to be chronically underfunded. The child nutrition program is no exception. In 2017, the child development budget was cut by 31 percent. The state budgets since are more of the same. In the last state budget, presented on 6 March 2020, the nutrition allocations were cut by staggering 32 percent. These cuts, though often debated, presented and passed by primarily upper-caste bureaucrats, legislators and ministers, disproportionately affect Dalit and Adivasi children.
The findings of NFHS 5 further underline the progression of this nutritional apartheid, in comparison to NFHS 4 which was conducted in 2015 and 2016. NFHS 5 found that 25.6 percent of children in Maharashtra under the age of five were wasted. Of those surveyed, 36.1 percent were underweight. Both these numbers have stayed largely stagnant since NHFS 4. However, the percentage of children under five who were stunted and severely wasted rose significantly, to 35.2 percent and 10.9 percent. The percentage of children who are overweight has also seen a sharp increase from 1.9 percent to 4.1 percent. A child who is underweight or stunted, has a lower weight or height than they are supposed to for their age. Wasting refers to having a lower weight than the average child would for their height. In nearly all these indicators, Maharashtra is worse than the national average, despite the state’s relative wealth.
In 2011, recognising that the state had deep regional and societal inequalities in funding, the Maharashtra government set up the high-level committee on balanced regional development issues in Maharashtra, headed by the economist Vijay Kelkar. The committee’s report, published in 2013, found that the infant mortality rate of tribal areas in Maharashtra is 60-70 per cent higher than the state average. Despite the state government denying that these deaths have anything to do with malnutrition, activists and public health experts have consistently argued the two indices cannot be seen as independent from one another.
Meanwhile, a decade after the Kelkar committee report underlined the failures of government programmes and recommended policy corrections, very little has changed in Adivasi regions or the state as a whole. A report published by the ministry of statistics and programme implementation in partnership with the World Food Programme, titled the Food and Nutritional Security Analysis 2019, underlines this. The report found that Maharashtra is among the top six states with the highest prevalence of stunted and underweight children. It also found that wasting among the children in the state had been consistently rising. It also added that Maharashtra’s high prevalence of stunting among children from Adivasi and Dalit communities had barely changed.
The Mahavikas Aghadi, an alliance of the Shiv Sena, Congress and Nationalist Congress Party came to power in the state in 2019 on the back of a promise to ensure that development in the state would not discriminate by region or community. If the government is serious about the future of the forty million children of Maharashtra, it needs to immediately increase the budgetary allocations for child nutrition. The Maharashtra budget, which is likely to be presented on the 8 March, is a valuable opportunity to correct the course towards nutritional discrimination that the state was hurtling headlong along. The need to do this has only been strengthened by the severe cuts to the Integrated Child Development Scheme, by over Rs 5,000 crore, that was announced in this year’s central budget. ICDS is a central government programme aimed at providing educational, nutritional and health care to children.
Examples of states pulling themselves out of severe malnutrition already exist in India. To rapidly curb malnutrition and stunting in children, providing eggs through ICDS and mid-day meals needs to be urgently implemented. A report by the planning and coordination department of Odisha showed that following the addition of an egg a week to the mid-day meal menu, not only did nutrition improve drastically, so did the attendance of students. Apart from supporting scientific evidence, providing eggs has proved to be the single biggest tool in fighting malnutrition in states like Tamil Nadu. It was the first state to start mid-day meals itself in erstwhile Madras, as early as 1920, under the aegis of the non-brahmin Justice party. While Tamil Nadu currently serves five eggs per week to children, and Odisha one a week, Maharashtra, the richest state of India currently does not serve any.
The mid-day meal scheme was introduced in Maharashtra in 1995 and has undergone multiple changes since then in terms of implementation, age groups and geographies covered. It was only as late as September 2008, that the scheme became active in all the districts of Maharashtra. The primary demand made by activists to further strengthen the nutritional reach of the scheme is the addition of eggs to school menus.
This call has also been supported by members of the state and central administration. In 2015, VJ Bhosale, the state animal husbandry commissioner wrote a letter to Sanjeev Kumar, the principal secretary of women and child development and P Bhapkar, the education commissioner requesting them to include eggs in the mid-day meal and other nutritional schemes. However, no initiatives were taken in that regard. In 2016, while addressing the questions on malnutrition deaths in the state assembly, Pankaja Munde, the minister for women and child welfare at the time, assured that eggs will be soon introduced in the mid-day meals. But her tenure, marked with allegations of corruption in nutritional schemes like ICDS, did not follow through and serve eggs. The Annual Work Plan & Budget 2018-19 for mid-day meals in schools for Maharashtra lists eight dishes on the menu of the mid-day meal scheme—all of them vegetarian. Eggs along with fruits and milk have been listed as “Additional Food items” or items meant for “drought affected districts.”
In 2019, the ministry of human resources and development clarified that it has given the states complete freedom to innovate on mid-day meal menus. The onus, thus, directly falls on the state government. The issue of serving eggs in school mid-day meals has often become a matter of political football between the political parties across India. Eggs in mid-day meals has become a particularly contentious issue for the Bharatiya Janata Party, many of whose leaders oppose it due to Brahminical cultural notions rather than sound arguments relating to nutritional requirements. This explains why Maharashtra made little progress in this regard between 2014 and 2019.
However, the 8 March budget offers a chance at course correction. As BJP ruled states continue to deny the cheapest source of protein to children, it is imperative that Uddhav Thackery, the chief minister of Maharashtra, put the state on the right track in terms of child nutrition. Currently many states provide eggs in school lunches at a cost of between Rs 4 and 7 per egg per child per day. For the 1.06 crore children in Maharashtra who receive mid-day meals, this would cost around Rs 1,272 crore to provide eggs five days a week for a whole year. To put this number into perspective, it is just six percent of what the state spent on police and merely a fraction of the Rs 1,91,451 crore committed to state expenditure in the closing financial year. Since 2013, the government of Maharashtra has been constructing a statue of Shivaji, a 17-century Maratha king, in the Arabian sea off the coast of Mumbai. This was backed by both the BJP and the incumbent Shiv Sena. The statue alone costs the state exchequer almost three times what it would cost to serve eggs five days of the week to all beneficiaries of mid-day meals for a year in the state.
Members of the ruling state government have frequently spoken about how progressive the state is in terms of fiscal and social policies when compared to the BJP-ruled centre. Surpriya Sule, a member of parliament from the NCP, even asked Nirmala Sitharaman, the union finance minister, to learn from Ajit Pawar, Maharashtra’s finance minister, about fiscal management during the pandemic. Introducing eggs in mid-day meals will go a long way to demonstrate what the priorities of the government in Maharashtra are. During the pandemic, Uddhav Thackeray was praised by some for directly speaking to Maharashtrians and addressing their concerns quickly. Will he now listen to the voices of the Dalit and Adivasi children of the state?