Manoj Kumar, District Programme Officer, Chitrakoot, Uttar Pradesh, cites reasons behind the near-complete failure of the government to bring down the child malnutrition
Uttar Pradesh is the most populous state in India and has the highest rates of malnutrition in the country, with half of all children under five years having stunted linear growth and 10 per cent are wasted. The state and Central governments have made several interventions to address the problem of poor nutrition, including the State Nutrition Mission (SNM-UP), Integrated Child Development Services (ICDS) and the National Nutrition Mission (NNM). However, the percentage of UP children receiving ICDS services remains relatively.
Uttar Pradesh’s Chitrakoot district is one such example of the near-complete failure of the government to bring down the child malnutrition. Since 2006, the district has featured among India’s most backward districts and had reported some of the worst health indicators in Uttar Pradesh in the fourth National Family Health Survey (2015-16). Around half the children under five are stunted (50.9 per cent) and underweight (52.5 per cent), one-third are wasted (33.3 per cent) and nearly one-sixth are severely wasted (14.7 per cent), much worse than the rate in Uttar Pradesh and India overall.
The story of anganwadi workers is an illustration of poor monitoring and support from the government, particularly the senior officials to tackle the appalling condition of malnourished children in Chitrakoot. There have been reports of Anganwadi centres have not been provided with height measuring devices or even measuring tapes by the ICDS authorities. The majority of the weighing machines provided are faulty, causing a significant impact on the ability of the anganwadi workers to prepare the weight and growth chart.
All through Chitrakoot, the maintenance of buildings that house anganwadi and health centres are dismal, without electricity, proper toilets, lack of drinking water, furniture etc. The anganwadi centres are not equipped with a range of facilities including educational kits, medicine kits, toys, utensils etc., and often anganwadi workers have to provide these with money from their own pockets.
Due to the lack of prescribed number of Anganwadi workers in the district (one anganwadi worker is handling three to four centres), AWCs may not be reaching some of the more remote parts of their survey in the district. As a result, in many cases, mothers don’t turn up or send their small children by themselves to the centre. Parents are often busy working in the fields or as daily wage labourers several miles away from their home and leave their babies to be cared for by older siblings who are often young children themselves.
Rampant misinformation, taboos, and superstitions are another reason leading to unhealthy children. Anganwadi worker narrates stories of young SAM children regularly taken to local tantriks and ojhas for treatment (jharphook). Community-based events like Annaprashan and Godbharai started by ICDS department under State Nutrition Mission are generating awareness regarding the value of nutrition in the district.
Despite all this, the AWWs are hopeful about the efforts of the ICDS programme. They do believe that parents have started listening and taking their advice, and if minor changes are made and they keep up their hard work, it is possible to solve the problem of malnutrition, maybe even fully. The Community Health Centres (CHCs) have been helpful in providing support. Chitrakoot would not just need better funds and efficient government services but must also ensure that women get an education, access to finances, better sanitation and more decision-making power to eradicate the problem entirely.