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Why We Need Much More Than A Scheme To Protect India’s Starving Children

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By Komal Ganotra: 

A mother feeds her malnourished child in the Nutritional Rehabilitation Centre of Sheopur district in the central Indian state of Madhya Pradesh April 6, 2010. India ranked 65th out of 84 countries in the Global Hunger Index of 2009, below countries including North Korea and Zimbabwe -- hindering India's ambitions to channel its demographic dividend to fuel its global economic ambitions. Picture taken April 6, 2010. REUTERS/Reinhard Krause (INDIA - Tags: HEALTH SOCIETY) - RTR2D0JX
Source: REUTERS/Reinhard Krause

India represents one of the largest number of malnourished children in the world and performs dismally on all child nutrition indicators. Under-nutrition in infants and young children leads to growth failure, lowered resistance to infections, increased rates of morbidity, increased risks to survival, impaired growth and poor school performance. Thus, a lack of proper nutrition during childhood has tangible long-term impacts on the mental and physical development of individuals.

The ages 0-6 lay the foundation for the growth of children into healthy and productive adults. It marks a crucial phase for a child, as 80% of the brain development takes place during this time. An emphasis on proper and effective nutrition in this age is not only important but necessary. This involves a commitment both to the children and the mothers. The inter-generational cycle of under nutrition ensures that an undernourished mother gives birth to an undernourished child, experiencing cumulative growth and development deficits largely irreversible in nature. Ensuring a healthy start for children in this age group requires a multi-dimensional approach centered around nutrition, comprehensive immunisation and medical care, pre and post natal healthcare for mothers while focusing on social development and capacity building.

Recognising the crucial importance of a holistic emphasis on the age group 0-6, the Integrated Child Development Services (ICDS) Scheme, a centrally sponsored national flagship scheme of the Government of India, aims at addressing health, nutrition and the development needs of young children (0-6 years), pregnant women and nursing mothers.

However, despite government efforts and schemes, the nutrition figures in the country pose a grave concern.  Under the ICDS Scheme, the Anganwadi Centres aims to provide the requisite nutrition, health services and care to children and mothers. According to the Ministry of Women and Child Development, in 2012-13 while 13,73,349 Anganwadis were sanctioned, 34,617 were still not operational and 33 % of the children in the country were not covered under the Anganwadis.

This comes to prominence all the more in remote areas. To highlight the gravity of the scenario, we consider the story of Pancho, a 6-year-old girl who belongs to the Saharia tribe, living in a village in district Baran, Rajasthan. Pancho was diagnosed to be severely malnourished. The village is 40 km away from the block headquarter in Shahabad and about 120 km away from district headquarter in Baran. The primitive tribe has been residing in Baran district for years now after being forced to move out of their original habitat, the forests. The abject poverty that the tribe lives in is striking.

Children bear the brunt of the deprivation, and as families struggle for sustenance, providing nutritious food to children is a distant reality.

The village has an Anganwadi which is accessible as well as operational yet there is no visible impact of its services in changing the nutritional status of children like Pancho. The problem lies not only in the irregularity of services and a lack of access but also the ignorance of the parents, who often fail to understand the severity of the condition of the child. It was only when a local NGO, Prayatna Sanstha, which works in partnership with CRY, noticed Pancho in one of their community visits early last year, did her condition come to light. After being counseled by the NGO, the community collective and Child Protection Committee the parents took to the child to the Malnutrition Treatment Centre (MTC).

While the treatment and special care at the centre lead to improved nutrition status of the child, she fell back into the malnutrition trap after 2-3 months, owing to inadequate nutrition and care at home. It was only after convincing her parents and prolonged treatment at the District Hospital in Baran, that Pancho is on the road to recovery.

The cases of malnutrition in Baran have been reported multiple times in the past yet children like Pancho suffer from nutritional deficits and there is little state intervention. This does raise questions on the nature and outcomes of growth monitoring and the required intervention thereafter.

To reach out to such children effectively, what we need is a well-defined system for management of malnutrition, which would involve the convergence of all stakeholders; not just Anganwadis but the health care centers, hospitals and MTCs as well. While ICDS is a well-designed programme and we have functional Anganwadis running in most places, bottlenecks in service delivery and community outreach pose a challenge in its proper implementation. The quality of services needs to be improved, with strict emphasis on growth monitoring of children and flagging off possible cases of malnutrition.

With improved service delivery of ICDS, preventive rather than reactive approach to tackle malnutrition, better community outreach, the nutrition status of children in the country will surely witness a significant change. Investing in our children in the age group of 0-6 will translate itself into long-term positive returns, and pave the way for a healthier and happier nation.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

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Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

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A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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