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Building Momentum For Impact: Odisha’s Nutrition Mission To Overcome Undernutrition

By Sameet Panda and Jitendra Rath

Odisha is one amongst the states which has been doing commendable work for improving the status of nutrition among its women and children. A comparison of various indicators of the last two National Family Health Surveys (NFHS) reflects the same. The key indicators of undernutrition include stunting, wasting, underweight, anaemia and the mortality rate, on the basis of which overall progress of health and nutrition can be mapped.

The NFHS IV that was carried out in 2015-16 reflects that in the state there was a 24.22 percentage decrease in stunting compared to NFHS-III in 2005-06. This means in 2005-06, 45 out of 100 under-five children were having a lower height for their age, and this number has come down to approximately 35 in 2015-16; within ten years. Similarly, there is also a positive change in the status of underweight children below the age of five, which has come down from 40.7% to 34.4% during the two consecutive surveys. Though anaemia is still prevalent among women and children, there is a substantial decrease in it, especially among the children below the age of five. While anaemia was prevalent among 65% of the children in the previous survey, it came down to 44.6% in 2015-16. Anaemia among women within the age group of 15 to 49 years remains high with every second woman in the state being anaemic. There’s also been a decrease in infant mortality rate which has come down to 44% from 75%. There were 1000 live births between 2005 to 2016.

The improvement in nutritional indicators is the result of various steps that were taken by the State such as introducing nutrition-specific and nutrition-sensitive programmes. Further, it could have been possible with the State’s effort for building an enabling environment for ensuring food and nutrition security. The enabling environment or momentum includes: framing appropriate policies, strengthening governance, and infusing necessary resources and building capacities of various stakeholders who drive nutrition specific and sensitive interventions.

A Decade Of Enabling Environment

In the last decade the state government not only came out with a slew of social protection programmes, but it has also worked towards strengthening governance, as well as infused necessary resources from the state exchequer, not depending solely on support from central government.  A discussion on three significant schemes implemented by the state during the last ten years would help to bring clarity on how better enabling environment helped in this case.

Let’s take the two rupees rice scheme under the Targeted Public Distribution System (TPDS), which was launched by the state government in 2008 by modifying the existing TPDS. To make the programme function well, the TPDS was simplified with increased coverage, reducing the price of rice with state government putting its resources, standardising dates of delivery and logistics as well as forming accountability and setting up a better grievance redressal mechanism. These steps have helped in improving the functioning of the scheme in the state with the present political dispensation still reaping rich political dividend out of it.

This is true for maternity benefit programme known as “Mamata” which was launched by the state in 2011 by using its own resources. Under the Mamata scheme, the state government is providing ₹ 5000 as conditional cash support to pregnant women and lactating mothers. As per the available data till December 2016, more than 25.80 lakh women were provided with this support, perhaps the largest conditional cash transfer related to nutrition and women’s health in the state of Odisha. Apart from this, the state has launched various campaigns to promote immunisation, framed and rolled out health and nutrition strategies, spelling out clearly the areas of intervention and target. Further, in 2014, Odisha took a drastic step and decentralised the procurement in ICDS, giving a free hand for purchase and distribution of locally available foods and strengthening community monitoring.

All the above-discussed policies have played an important role in creating an enabling environment for improving food and nutrition status in the state. However, it was expected that the state government would use the learning to further the cause of food and nutrition security post implementation of National Food Security Act 2013 (NFSA) in the state. NFSA covers a gamut of food and nutrition-related schemes to provide food and nutritional security in a life cycle approach. However, it is found to be faltering in many counts when it comes to implementation of the Act.

The State Of NFSA In Odisha

The National Food Security Act 2013, brought together the existing Targeted Public Distribution System (TPDS), Integrated Child Development Services (ICDS), Mid Day Meal Scheme (MDM) and Maternity Benefit Schemes under one umbrella and made it a matter of fundamental right. The act emphasises on transparency, people’s participation and accountability and has mandated social audits at the Gram Panchayat level. It has provision for the formation of various institutions, the formation of state rules and the creation of a robust grievance redressal mechanism.

In another way, it can be said that the National Food Security Act bestowed a framework for building momentum for further improving food and nutrition across the nation.

The government of Odisha took more than two years to roll out TPDS across the state. It has also formed the State Food Commission with a Chairperson and two other members. It has also designated the Project Director District Rural Development Agency (PD-DRDA) as the District Grievance Redressal Officer (DGRO) to address grievances at the district level. The state has also notified the rules for MDM and PDS Control Order 2016 in line with central guidelines.

However, there are multiple issues the government is mandated to undertake but has not done yet, thereby missing the chance of building momentum, and fastening the impact on food and nutrition in the state.

Issues At Policy Level

The state government is yet to notify comprehensive rules for grievance redressal. The PD-DRDAs have been designated as the DGRO however; no modalities have been formulated on their functioning. As a result of this, there is no robust grievance redressal mechanism functioning in the state as far as food and nutrition are concerned.

NFSA mandates issuance of food security allowance in case of non-delivery of entitled food grain and except for MDM, there is no clarity for other schemes. Therefore, even though there are cases of delay in distribution of ration, discontinuation in ICDS feeding programmes, no one gets the food security allowance which is a right mentioned under the act.

The government was mandated to notify various modes through which the public can lodge their grievances, but they have not been set up or functioning. The state government was also mandated to put information relating to a scheme in public domain where the government has provided information relating to TPDS and MDM in public domain, whereas for ICDS and Mamata no information is made public.

The government is required to formulate policy on undertaking social audit of NFSA however; the state is yet to come out with any rules or guideline on the social audit. On the other hand, Collective Action for Nutrition (CAN), an initiative that is working on Governance of Nutrition in Odisha has set an example of carrying out social audits and how it could play a role in bringing people’s participation, transparency and accountability which are crucial for effective implementation of any nutrition specific and sensitive programmes.

The other important aspect is strengthening community-level committees such as vigilance committee, Jaanch committee, mothers committee etc. A vigilance committee has mostly not been formed in the state at Panchayat or state levels.

Issues At The Implementation level

Recently, the state has come up with its own food security scheme to include all the eligible but excluded households who are left out from the TPDS as part of NFSA by population growth. A rough estimation indicates that this exclusion rate could be around 10%. While this is a positive step, the issue of intra-household exclusion will continue. Around 17% of the individuals within the household are excluded (household having PHH card with some of the members’ names missing), and the state has to consider their inclusion.

Irregular and proper quality supply of Take Home Ration, mainly Chhatua (dry ration) and eggs for the Pregnant and Lactating (P&L) mothers and children below three years of age, remains a concern. It is to be noted here that from July 2018, the State Government has revised the menu under the supplementary nutrition programme of ICDS. However, the Anganwadi workers’ associations have denied implementing the decision giving the reason that the cost norm is not sufficient to provide five eggs in a week.

A long delay in transfer of Mamata instalment is another concern across the state.

The Need Is To Put Learning Into Action

It has been argued in the beginning that successful implementation of any scheme is possible not only with appropriate policy but strengthening governance, building capacities of functionaries; putting forth accountability mechanism is equally important.

If the state government is serious about improving food and nutrition security of the population in the state, it is essential to put its past learnings into action.

First, the state needs to come out with a comprehensive rule for NFSA which details with the grievance redressal mechanism, fixing accountability at different levels, food security allowance and a robust social audit process. It is essential to develop modalities of functioning DGROs and making people aware of the mechanism.

Second, the information relating to schemes of NFSA need to be put in public domain in the line of TPDS, it is well established that improved transparency leads to the effective implementation of programmes. Therefore, information should be displayed at the institution level, i.e., FPS, AWC, schools as well as on internet for larger public monitoring.

Third, to ensure the schemes are implemented effectively on the ground, it is essential to form and strengthen community monitoring bodies like vigilance committees, Jaanch committee, and Mothers committee and building their capacities so that they can monitor the schemes effectively on the ground. The state should take immediate steps to form vigilance committee at the Panchayat and the institutional level to enhance their capacities.

Fourth, to ensure that the schemes are functioning well on the ground. Not only regular monitoring at the state level, but it is also essential to take immediate corrective action in case any scheme is found to be faltering like in the case of Mamata Scheme. It took more than a year to rectify the faulty software responsibly for delaying the timely release of the instalments. It should not be allowed to happen.

Fifth, to improve food and nutrition security it is essential for the state to look beyond these four schemes and work towards implementing scheduled 3 of NFSA, which suggests the state to increase investment in agriculture, improve procurement and storage of food grain and improve health care, sanitation, drinking water and pension for elderly and other destitute persons.

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About the authors:

Sameet has experience at working in the development sector for more than a decade. He started his journey in this sector by working as a researcher with Supreme Court Commissioners on the Right to Food and went on to work with the national and international organisation like Child Rights and You, and Action Aid. He has a masters degree in social work. His areas of interest are food, nutrition, education, governance and programme management.

Jitendra has been in the social development sector since 2004. He has worked with various organisations including CRY-Child Rights and You and Oxfam India. Based out of Odisha, Jitendra writes extensively in the regional newspapers and magazines on various developmental issues. Currently, he is associated with Collective Action for Nutrition initiative. His areas of interest are child rights and governance.

 

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