The Covid-19 pandemic is likely to have “aggravated the silent crisis” of undernutrition in India, an inter-ministerial committee has observed, recommending that protein-rich food items like eggs, nuts and legumes, as well as micronutrients like calcium, iron, zinc, folate and vitamin A be legally mandated in meals given through food safety programmes in schools and anganwadis by revising Schedule II of the National Food Security Act (NFSA), 2013.
The inter-ministerial committee includes officials from the Ministry of Food, the Ministry of Health, the Ministry of Women and Child Development, and the Ministry of Education, as well as scientists from the Indian Council of Medical Research (ICMR) and the Food Safety and Standards Authority of India (FSSAI).
Currently, eggs are served in mid-day meals in 13 states and three UTs as part of “additional food items”. It is served with a frequency varying from five days a week to once a month. The states and UTs bear the cost of the supplementary provision. The inclusion of eggs in food safety nets have been opposed by many religious groups as well as chief ministers like Madhya Pradesh’s Shivraj Singh Chauhan.
The committee has suggested that “urgent action” is needed to address the crisis, citing the National Family Health Survey-5 (NFHS-5), which has documented a rise in the “rates of child undernutrition, stunting and wasting in most of the states”, along with an increase in prevalence of anaemia among pregnant women and those of reproductive age. The draft report, submitted in October 2021, is currently under the Centre’s consideration.
“Though the NFSA has been in place since 2013, the desired outcomes have not yet been achieved. The NFHS-5 survey results show a worrying trend in increase in malnutrition and anaemia in many states…persistent levels of undernutrition despite rapid economic growth remains the single biggest public health problem in India,” the report stated, adding, “The pandemic is only likely to aggravate the silent crisis and there is a need for urgent action.”
It recommended new standards of kilocalories and protein per meal, along with fixing proposed intake of micronutrients for all categories of beneficiaries, and the food items required to achieve those standards. While the Integrated Child Development Services scheme (ICDS) covers children aged six months to six years and pregnant/lactating mothers, students in lower primary classes, upper primary classes in government and government-aided schools are beneficiaries of the PM Poshan scheme.
According to the cost implications of the recommendations worked out by the committee, the cost per meal (excluding milk and fruits) in lower primary classes will be Rs 9.6 and Rs 12.1 in upper primary. Currently, the cooking costs are Rs 4.97 and Rs 7.45 respectively. The report states that those who do not consume eggs may be provided “double the proposed quantity of nuts and seeds”.
Call for change in NFSA
Schedule II of the National Food Security Act lays down nutritional standards for government food safety programmes like mid-day meal, PM Poshan and Integrated Child Development Services scheme. Currently, it quantifies nutrition per meal in terms of calories and protein only, but the inter-ministerial panel has called for micronutrients to also be taken into account.
Here are some of the existing and proposed standards:
Lower primary classes: Current norms mandate 100 gm foodgrains, 20 gm pulses, 50 gm vegetables (including leafy variety), 5 gm oil/fat, and salt and condiments (as per need) per meal per child, which account for 450 kilocalories and 12 gm protein.
The proposal mandates 70 gm cereals and millets, 25 gm pulses and legumes, 75 gm vegetables (including 50 gm of leafy variety), 10 gm nuts and seeds, 10 gm oil and 50 gm eggs, which will provide 450 kilocalories, 15-20 gm of protein, 170 mg calcium, 2 mg zinc, 3.5 mg iron, 50 micrograms folate and 100 micrograms vitamin A. As additional items, 150 gm milk and 100 gm fruits have been suggested.
Upper primary classes: Under existing norms, 150 gm foodgrains, 30 gm pulses, 75 gm vegetables (including leafy variety), 7.5 gm oil/fat, and salt and condiments (as per need) are served per meal, which account for 700 kilocalories and 20 gm protein.
The proposal mandates 100 gm cereals and millets, 35 gm pulses and legumes, 100 gm vegetables (including 50 gm of leafy variety), 15 gm nuts and seeds, 10 gm oil and 50 gm egg, which will provide 700 kilocalories, 22-25 gm protein, 270 mg calcium, 4 mg zinc, 5.5 mg iron, 75 micrograms folate and 145 micrograms vitamin A. As additional items, 200 gm milk and 100 gm fruits have been suggested.
Pregnant and lactating women: Under existing standards, beneficiaries are entitled to 600 kilocalories and 18-20 gm protein per meal given in the form of take home ration or THR. The draft report proposes that the nutritional values be revised to 600 kcal, 22-25 gm protein, minimum 335 mg calcium, 4 mg zinc, 7 mg iron, 160 micrograms folate and 240 micrograms vitamin A.
Anganwadi children (6 months-3 years): Currently, they are entitled to 500 kilocalories and 12-15 gm protein per THR meal. Proposed values are 400 kcal, 15-20 gm protein, minimum 135 mg Calcium, 1 mg Zinc, 2 mg Iron, 35 micrograms folate and 60 micrograms vitamin A.
Anganwadi children (3-6 years): Presently entitled to 500 kilocalories and 12-15 gm protein per THR meal. Proposed values are 400 kcal, 15-20 gm protein, minimum 150 mg calcium, 1.5 mg zinc, 3 mg iron, 40 micrograms folate and 80 micrograms vitamin A.