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Blog 15: How India’s frontline nutrition programmes are reinventing themselves during the lockdown

In blog 15 in our series on opportunities for building back better food systems and nutrition, Arti Ahuja, an officer in the Indian Administrative Service, gives us a unique insight from India on how government frontline food and nutrition programmes have adapted and reinvented themselves due to the sudden and widespread lockdown. She outlines some of these innovations and concludes that the COVID-19 response has taught us many things: “that the poorest need enhanced state support, that departments can work cohesively outside their silos, that robust systems are the key to an effective response, that the words ‘community’ and ‘worker’ have bigger meanings than we thought, and that there is a hero inside everyone”. The challenge now -- for all of us -- is to utilise forced innovations to build food and nutrition programmes back better after the COVID-19 lockdowns ease.

-- Lawrence Haddad

The Covid19 pandemic has been a time of great upheavals— literally and figuratively. The world as we know and the “normal” way of life are suspended with no guarantee that our future will follow the trajectory of a few months ago. The virus has been both a great disruptor and a greater leveler. Though it may affect kings and prime ministers and movie stars along with the people at the bottom of the pyramid, it is the poor who stand to lose the most.

The situation is no different in India. It already has high levels of stunting, wasting and anemia. The burden falls much more on the poor and socially disadvantaged groups who start from a position of vulnerability when facing an epidemic of this unprecedented magnitude. During lockdowns, the underlying physical vulnerabilities get exacerbated with the lost livelihoods, low resources on hand, and specially for women—unequal intra household distribution of already depleted meals. Food itself may be hard to come by. Fortunately, there is an existing framework. The local Anganwadi centers feed hot cooked meals and take-home rations to children under 5 and pregnant and lactating mothers as supplementary nutrition. Schools do likewise in case of Mid-Day Meals. The public distribution system supplies food grains and pulses at highly subsidized rates to indigent families.

In the time of social distancing and lockdowns, people cannot come to these centers and this has the potential of causing severe hunger in many, especially those on the margins and with no savings. When the distress is sudden, huge and has no defined termination date, state capacity gets stretched. Systems that respond expeditiously, effectively and in a decentralized manner are a key factor in ameliorating some, if not all of the distress. The system has reinvented itself, given the fluid and dynamic situation.

First, multi-sectoral,  action based thematic groups cutting across departments and hierarchies have been formed, leading to convergence beyond the earlier silos. Second, emergency provisions of different laws have been invoked and powers given at the district level to take immediate action, leading to greater flexibility at the cutting edge. Third, the existing base of other social safety nets has been ramped up. New schemes for the poor have been instituted. For example, giving three months advance pensions and rations, income support to farmers, old and indigent, free treatment for Covid19, insurance cover for frontline workers etc. However, India being a vast country, differences in coverage and delivery remain. Informal, migrant urban workers are often part of the digital databases in their villages and not the cities they work in. Some of them, thus may face acute distress unlike their rural counterparts. They are being supported through government institutions, citizen groups, civil society organizations via rations, shelters and open kitchens in urban areas. This is the fourth element, citizen involvement being actively sought and encouraged, especially for the migrant workers.

Fifth, and important in the nutrition context, the rations and supplementary nutrition are being delivered by the Anganwadi Workers to the households so as to minimize large gatherings and also to follow up on the health conditions of the households. The Anganwadi workers and other village level functionaries like the ASHAs and ANMs reaching all doorsteps during Covid19 mostly belong to the same communities that they work with. That makes it easier to identify families needing nutritional support, and household level delivery of health-related services. However, all such situations demand a high level of commitment, time and effort from each person on the ground, dealing with anxious people. This is no doubt a trying and intense time for them, most of whom are women with families of their own to take care of, working round the clock on the battle frontlines as it were.

 

 

These are unprecedented times, calling for out of the box solutions. Governments at all levels, and especially grassroots workers, are doing the best with the given information and resources. They have been working in teams, finding local, creative solutions to newly arising issues, and have become invaluable resources themselves. The Covid19 response has taught us many things - that the poorest need enhanced state support, that departments can work cohesively outside their silos, that robust systems are the key to an effective response, that the words ‘community’ and ‘worker’ have bigger meanings than we thought, and that there is a hero inside everyone. We will need to carry these insights with us even after this pandemic war is won—so that we can counter the next one head on.

 

About the author

Arti Ahuja is an officer of the Indian Administrative Service and has served in different capacities at various levels of government, mostly in the social sector. She holds Masters degrees in public policy and public health from Princeton and Harvard. She has a number of publications in national and international journals, including as a member of the Global Nutrition Report expert group.

 

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