Inadequate intervention?

There was significant anticipation surrounding the interim Union budget this year with the elections round the corner. The anticipation primarily revolved around bolstering measures for addressing popular concerns and grassroots level issues. This included providing a boost to people’s needs such as essential food and nutrition services, particularly for children and pregnant women, as the lingering effects of the pandemic continue to persist.

However, the interim Union budget placed a much higher emphasis on achieving developed country status, which contrasts with the pressing issues of hunger and malnutrition, and creates a paradox.

If one looks at the data from the National Family Health Survey-5 (NFHS-5), the situation remains concerning. A report recently released by the Food and Agricultural Organization also added to it, which indicated that 74.1 per cent of Indians were unable to afford a healthy diet in 2021.

Furthermore, the Global Hunger Index 2023 analysed four key indicators — undernourishment, child wasting, child stunting and child mortality, to rank countries. India’s position on this has descended to 111th out of 125 countries. These figures highlight the nutrition challenges we face.

Let's now examine the budgets allocated towards nutrition schemes and programs within India's recently announced budget.

Budgetary support to nutrition programmes, schemes

Saksham Anganwadi and Poshan 2.0, the flagship programmes of the government signify a strategic shift towards enhancing nutritional outcomes. Operating in mission mode, these initiatives were launched for the 15th Finance Commission period. The programme adopts a life cycle approach to address the nutrition needs of below 6 children, pregnant women, lactating mothers, and adolescent girls.

Both Saksham Anganwadi and Poshan 2.0 have faced budget cuts compared to last year's revised estimates. The reduction in funding for these initiatives, when adjusted for inflation, amount to a notable 1.77 per cent decline in real terms. The low priority given to nutrition is worrisome, particularly in the light of prevailing challenges.

A significant gap between the allocated budget and the projected demand of the Union Ministry of Women and Child Development was already highlighted by the Parliamentary Standing Committee of the ministry, which noted that the allocation was only 92.5 per cent of the projected demand set by the ministry in 2023-24.

The report asserted that it is the Union budget's responsibility to meet the needs of state governments and stressed the necessity for increased budgets. Despite this, there was a dip of 2.5 per cent against 2023-24 BE for Samarthya, which encompasses the PM Matru Vandana Yojana to provide cash transfers to pregnant women and lactating mothers.

Issues with supplementary nutrition programme

There has been a widespread concern about lack of adequate quality in the freshly cooked meal offered to children aged 3-6 years at Anganwadi Centres (AWC), as meals primarily consist of cereals.

Optimal nutrition outcomes require a relook of Integrated Child Development Services (ICDS) dietary norms. It is suggested incorporating food groups such as eggs, fruits, milk, and locally sourced foods can help meet these needs. To support these dietary enhancements, increasing budgetary allocations is vital.

The Take-Home Ration (THR) component of the supplementary nutrition programme provides food grains in dry ration form or as a powdered mix of selected cereals. However, the quality of the mixture has been a persistent issue.

The issue of irregularities in THR supplies is prevalent across various locations, primarily attributed to delays in payments and clearances. To address this, there is a need to raise the cost of THR to cover transportation expenses.

To combat malnutrition effectively, a comprehensive approach spanning multiple sectors is required. This approach should address various factors such as ensuring food availability, improving feeding practices, enhancing household conditions such as access to clean water and sanitation facilities etc.

The mid-day meal / PM Poshan programme showed a 17.48 per cent increase, and Jal Jeevan Mission (JJM), another key scheme, experienced a negligible increase of 0.23 per cent as compared to the 2023-24 BE.

MGNREGS continues to play a crucial role, providing income and employment security for rural residents. Apart from bolstering livelihoods, it supports essential infrastructure development, including the construction of AWCs.

The allocation of Rs 86,000 crore remains unchanged from the previous year's revised estimate, falling well below the actual needs on ground, which can be seen when comparing to Actuals of Rs 98,467 crore for 2021-22.

Despite legally mandated increases in demand for employment, the ongoing decrease in allocations raises concern about the government's commitment to addressing urgent issues.

The National Social Assistance Programme (NSAP), which offers income security to vulnerable groups like the elderly, widows and persons with disabilities below the poverty line (BPL), has consistently grappled with limited funding. The minimal 0.16 per cent increase in NSAP allocations in the current budget aligns with a longstanding recurring trend.

Anganwadi workers’ unfulfilled demand

The budget announcement has expanded health insurance coverage under Ayushman Bharat Jan Arogya Yojana to include Anganwadi workers (AWW), helpers, and Accredited Social Health Activists (ASHA) workers. The government’s decision to introduce a health insurance cover poses its own challenges, particularly when implemented through a public-private partnership.

AWWs have been the cornerstone of ICDS for nearly five decades since the inception of the programme. They bear the vital responsibility of providing nutrition services, and a wide range of other tasks. These include using smartphones and applications, delivering nutrition and health education, coordinating with auxiliary nurse midwives and other healthcare professionals, besides playing a crucial role in various other community welfare programmes. They are given a fixed amount as honorarium (Rs 4,500) per month under the scheme. The current rate was revised last in October 2018, and is inadequate for the heavily burdened workforce.

The Union Budget falls short particularly considering the periodic protests across various states for an increase in the honorarium. Some states provide significantly higher fund support from their own sources over and above the amount given by the Union government. These economically strong states have the means to provide the support but the disadvantaged states lack the financial capacity to provide adequate support, resulting in lower wages for their workers.

The interim budget missed the opportunity to address the urgent issues such as lack of quality meals at AWCs, higher wages for workers and inadequate infrastructure. Given these pressing demands, it is hoped that the full budget for 2024-25 to be presented in July will take measures to adequately address these concerns. DTE

Views expressed are personal