Rajani* starts her day at five in the morning. She cleans her house situated in an urban slum between Delhi and Ghaziabad. She wakes up her four daughters to get them ready for their school. They go to a school nearby, run by a local NGO. But her eldest daughter, Khushbu*, stays back most of the days. She is only 12 years old and has to cook for the family.
Rajani’s husband takes up odd jobs. Sometimes, he is away in Punjab, working as a farm labourer. At other times, he is in Delhi, loading and unloading vegetables in the local mandi. Rajani leaves her house in the hands of Khushbu and goes to work in the upscale locality nearby. She washes vessels, sweeps and mops floors and cooks for a family of four that employs her for a meagre salary. Amidst all the chores, she has no time to rest or care for herself. She is six months pregnant, in the hope of having a son. As she leaves after her work, she stops at a stall to have a cup of tea – her first drink of the day. She returns home to have rice and potato for lunch. That’s all they can afford.
Ask Rajani about how she takes care of herself, and she will say it is better than the situation back home in Gumla, Jharkhand. She narrates how her cousin died while delivering her baby and other women in her village who deliver stillborn babies or die during childbirth. Jharkhand has one of the country’s worst maternal mortality rates.
According to Jharkhand’s Economic Survey 2015-16, over 90% of expectant mothers are unaware of their nutritional requirements. Only 8.6% of the mothers knew about nourishment during pregnancy, breastfeeding practices and nutrition in general for children.
The recent Jharkhand Economic Survey (2017-18) paints a different picture – village organisations (VO) in 24 districts have been trained to deliver government services. The survey mentions, “As a result, the coordination of the VO members with the serviced delivery functionaries like Sahiya (ASHA worker), ANM and AWW (Anganwadi Workers) have improved.”
In Jharkhand, only 57.3% of the rural women have access to institutional births, as per the Government of India’s National Family Health Survey 2015-16. And around 63% of the rural pregnant women are anaemic. The statistics for children are equally disturbing. More than 48% of the children (under the age of 5) in the state’s rural region are stunted, and 29.5% of the children (under the age of 5) are wasted.
A glance through various statistics over the years shows the situation in the state’s rural and tribal areas has always been grim. Very little has changed, despite the tall claims of various governments that ruled the state. NGOs working on the ground are doing their part. But the problem is massive for a few organisations to handle.
The malnutrition crisis in Jharkhand requires political will and a systematic approach, not just a vote bank promise that appears every election. A convergence of various state departments and good-willed NGOs can catalyse a revolution, ensuring the benefits trickle down till the last person. The crisis is so deep that the system can use detailed plans, checks and balances, and monitor the progress at periodic intervals.
The Government of India’s Poshan Abhiyaan can be a good start to addressing the issue of malnutrition amongst tribal communities across the country, provided they are also included in the development process. Then, Rajani may start talking highly of her village. Then, Rajani’s relatives back home may begin to live productive lives, fulfilling their dreams of happy families.
*Names changed to protect the identity.