Report on Madhya Pradesh State Nutrition Convention for Hunger and Malnutrition Free Inclusive...

Dr. M. Mukhtar Alam, Senior State Advocacy Coordinator

NATIONAL CONFEDERATION OF DALIT ORGANISATIONS m-3,22,model town-iii

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REPORT ON MADHYA PRADESH STATE NUTRITION CONVENTION HELD ON 20

OCTOBER AT GANDHI BHAWAN, BHOPAL

Report on Madhya Pradesh State Nutrition Convention

National Campaign on Nutrition for Dignity- NACDOR 1

Report

Toward Malnutrition and Hunger Free Inclusive Madhya Pradesh State Level Convention on Nutrition organized as part of National Campaign on Nutrition for Dignity (NCND) An initiative of National Confederation of Dalit Organisations (NACDOR) in partnership with Global Alliance for Improved Nutrition (GAIN)) Date: 20 October,2014 Time: 9.00 am to 5.00 pm Venue: Jai Prabha Hall, Gandhi Bhawan, Bhopal

Dalits and their position in Indian Society Dalits represent a community of 166 million in India, constituting 16.2% (Census 2011) of the population. It means one out of every six Indians is Dalit. Though Dalit population constitute a significant number of the total Indian population, their control over resources of the country is marginal—less than 5%. Close to half of the Dalit population lives under the Poverty Line, and even more (62%) are illiterate. Among the Dalits, most of those engaged in agricultural work are landless or nearly landless agricultural labourers. The average household income for Dalits was of Rs. 17,465 in 1998, just 68% of the national average.

Dalits due to their caste identity regularly face discrimination and violence which prevent them from enjoying the basic human rights and dignity guaranteed to all citizens of India. They are daily victims of the worst crimes and atrocities, far outnumbering other sections of society in that respect as well. The vast majority of these crimes remain unreported due to omnipresent fear, and those that are reported are often ignored by police or end up languishing in the backlogged court system. Even after 67 years of Independence, India is still very much afflicted by the cancer of the caste system. Therefore Dalits remain the most vulnerable, marginalized and brutalized community in the country. Nutrition and issues of exclusion and untouchability Despite India’s remarkable economic growth over the last decade, many children still struggle to meet their most basic needs, including access to sufficient food and health care. According to the National Family Health Survey (NFHS-3, 2005-2006), 20 % of Indian children under five years old are wasted and 48 % are stunted. Importantly, with 43 % of children underweight, rates of child underweight in India are twice higher than the average figure in sub-Saharan Africa (22%).The relationship between social exclusion and malnutrition is made explicit by researchers analyzing trends in malnutrition. Children from Adivasi and Dalit and backward castes are estimated to be twice as likely to be underweight than children from other social background. The incidence of malnutrition Scheduled Caste children under the age of five is 50.6 % (Thorat and Sabharwal, 2011) –against the national average of 48 % (NFHS-3). Furthermore, children whose mothers have little or no education are 66 % more likely to be underweight due to cyclical relationship between poverty, exclusion and restricted access to infrastructure and services. The Dalit population is the most vulnerable section, affected by multidimensional poverty and deprivation. On the other hand, Adivasi, who are theoretically located outside the ambit of mainstream caste-based social structure are at the bottom of all development indices. Adivasi population in India is historically neglected, at the same time their problem is also geographical. They inhabit in the most remote areas of the country, where the fruits of development seldom reach to them. There are vast empirical evidences, to suggest that Dalit and Adivasi population are suffering from multiple deprivations and also exposed to various forms of discrimination in the public life. The study by Baraik and Kulkarni (2006)



indicates that the level of infant mortality among the Dalit and Adivasi population was substantially higher than the non-scheduled population. Furthermore, Dalit and Adivasi in India have less access to health care facilities and their overall nutritional status is much lower (Roy, Kulkarni and Vaidehi: 2004). Social inequality of child malnutrition between the SC, ST and the Non-Scheduled component has been studied by Sinha (2005) and Mishra (2006). The undernourishment among SC and ST populations are primarily due to extensive poverty among them. Because of the higher levels of poverty and other underlying factors of undernutrition, like- household food security, care of the children, access to health and sanitation facilities etc. are also tend to effect. The persistent higher levels of poverty and undernutrition among the SC & ST population is also attributed to different policy failures. Therefore the importance of scrutinizing several policy factors also becomes important for understanding of it.

Crisis of malnutrition in Madhya Pradesh with emphasis on SC and ST

Children are one third of the population in India and they need social support systems that

enable them to grow a healthy person contributing to the family and national wellbeing.

Child survival, development and protection are the critical phases in the lifecycle of a child

that has constitutional and legal framework of protection under the constitution of India

through article 41. Child survival is dependent on the social, economic and cultural factors

that influence the survival possibilities of children where nutrition is an important factor

for child survival in the first 1000 years. Reducing level of malnutrition, eliminating

deficiency of micronutrient, ensuring enrollment in schools and retention and enhancing

rate of education completion are the key issues in development of children while prevention

of exploitation, discrimination and violence on the children are critical issues in the

protection of children.

In Madhya Pradesh, there are successes achieved but the indicators refer to the attainment

of goal shows that the state would not be achieving the millennium development goals and

this is the reason ,the state is under 8 empowered action states. As per the annual health

survey 2010-11, the declining sex ratio is a challenge in the state where death of girl children

results from the selection of the boys and some other discriminatory practices. Despite

running of several schemes and successes, the state has a nutritional challenge that needs

to be meet collectively while the state is bound by the constitutional and legal obligations.

The state of Madhya Pradesh was rated 30.9 on the Indian State Hunger Index. The planning

commission has termed hunger index of the state of Madhya Pradesh as extremely alarming.

The rank of Madhya Pradesh has fallen to 17 in the year 2008 from 11 in the year 1994.

Madhya Pradesh is the biggest contributor of the total neo natal and child mortality death

in the country. The state of Madhya Pradesh recorded for highest infant mortality rate (IMR)

in the NFHS-3 i.e. 72 for all while for SC the rate is 81.5 and for ST it is 95.6 per 1000

chhildren. The state of Madhya Pradesh is second highest in maternal mortality rate (MMR)

i.e. 379 per 1,00,000 live births. Since 1990, the most of the underweight children are in

Madhya Pradesh. Nearly 16% of the population in Madhya Pradesh in below six years ages,

needs health, nutrition and development care.

For the neonatal death rate of children dying before completing 29 days, Madhya Pradesh

has the highest with the figure of 44.9 per 1000 with SC neonatal death rate being 50.2 and

ST neonatal death rate being 56.5. The situation of children below the age of one year’s

dying is also a concern in Madhya Pradesh having the highest figure in the nation with 62



children dying but in the last decade it has improved by 12 point from 52 . Infant mortality

rate as per NFHS-3 was 70 for all while it was 95.6 for ST children.

Madhya Pradesh tops the lists of undernourished state with 60.3% children under 5, % below

2 SD and here the figure for SC children is 62.5 and ST figure is 71.4 as per NFHS-3. With

reference to child death rate in the share of total death rate, the rate for Madhya Pradesh

is the highest being 20.4 %. Below 5 mortality rate at the national level has reduced over

the last decade from 125 to 59 as per the Annual Health survey 2010-2011. Madhya Pradesh

falls below Assam in having the highest number of death in this category with the figure of

82/1000. As per NFHS-3, under 5 child mortality was 94.2 per 1000 while this was more

distressing for ST being 140.4 followed by SC children being 110.1. Breast feeding within

one hour of birth was for all groups was 15.9 per cent while this was 17.4 per cent among

SCs and 11.7 per cent among STs. Aneamia prevalence among children under 5 was 74.1 for

all while this was 75.6 for SCs and 82.5 for STs. Vaccination of children was lowest among

STs being 22.3 while for all it was 40.3, SC fared better than the average on this having the

figure of 40.5 . 39.9 per 1000 children under 3 years were stunted and 33.3 per 1000 were

wasted.

Sex ratio in MP varied across the urban and rural areas.

In the Urban areas sex ratio is between 895 and 935 and

in the rural areas the same is between the ranges of 879

to 917. Sex ratio at the time of birth has improved in the

last decade in India being 892 in 2002 while the same in

2008-10 was 905. In the case of birth registration MP has

not yet received 100 % registration. With reference to

child death rate in the share of total death rate, the rate

for MP is the highest being 20.4 %.

For the neonatal death rate of children dying before

completing 29 days, MP has the highest with the figure

of 44 per 1000. At the national level, the rate has

reduced in the decade from 66 to 47 .There is an urban

rural divide here with 20 point difference. The situation

of children below the age of one year’s dying is also a

concern in Madhya Pradesh having the highest figure in

the nation with 62 children dying but in the last decade

it has improved by 12 point . District Panna has the highest rate of death being 93/1000.

Here the millennium development goals was to reduce the rate by2/3 r d .In MP, 20 points

improvement is needed for attaining the millennium development goals for the state as per

the annual health Survey 2010-11. As per NFHS-3, malnutrition is particularly prevalent

among the SCs, STs, OBCs and Muslims. SC Muslims have the highest proportion of

underweight children followed by ST-Hindus and SC-Hindus. Women from SC-Hindu and SC-

Muslims have the highest incidence of malnutrition (Thorat and Sabharwal, 2011) cited in

The Crisis of Malnutrition in India, A Dalit View Point.

Below 5 mortality rate at the national level has reduced over the last decade from 125 to

59. MP falls below Assam in having the highest number of death in this category with the

figure of 82/1000. Considering the gender disparity, MP falls below UP having the highest

disparity of 9 while MP has 7 point gender gap. Panna has the highest under 5 mortality rate

of 140/1000 while Indore has the lowest figure of 51/1000.

Figure 1 Deepak in village Ansra, Chataini Panchayat, Rewa remains malnourished due to extremely poor delivery of ICDS services



As national level, India has to have the rate of 42 while, India is reaching the target of 52

missing the millennium development goals targets target by 10 points. MP is falling behind

as well. As per a study measuring the performance of states through developing a Child

Under nutrition Index (CUI) Child Nutrition Score (CNS), Madhya Pradesh ranks second after

Bihar which shows the urgency that state of Madhya Pradesh must have for addressing the

deficits in the scores and thereby eliminating child under-nutrition on a war footing.

The Convention The convention as part of National Campaign on Nutrition for Dignity (NCND) designed to advance our knowledge and scholarship; offer recommendations for suitable change in policy and programs; engage with multiple stakeholders to further the agenda of Nutrition from the perspective of Dalits and Adivasis was organized . It would provide a platform to social activists, CSO leaders, INGO representatives, Government officials, political leaders,

experts and community leaders to share their ideas and views on issues related to malnutrition and try to find a way out for addressing this serious issue in an inclusive manner. These conventions are being planned to highlight the voices and concerns of a variety of stakeholders whose lives and life-styles have been affected due to the absence of inadequate nutrition. This convention was organized to bring Dalit and Adivasi voices from the ground to highlight the challenges faced by them in accessing services related to nutrition and Food Security. Through the Conventions, NACDOR sought suggestions and opinions of Dalit leaders, intellectuals, media representatives, CSO leaders, experts and subject specialists on nutrition and Food Security issues. The convention geared for increasing accountability, transparency and effectiveness in the implementation process of ICDS, PDS and MDM had the following objectives. Purpose of the State Level Convention

1. To share experiences on the situation of malnutrition in the state ground realities

from the social audits and sharing of experience on the implementation of the

schemes for nutrition and food security

2. To bring all the stakeholders and duty bearers together for discussing the state of

nutrition in the state with special focus on Dalits, Adivasis, minorities and vulnerable

communities

3. To assess the convergence that has been achieved in the application of the multi-

sectoral approach undertaken for nutrition and food security

4. To create an interface with the state level nutrition ,health and education

authorities in order to seek advice on the way forward for civil society engagement

geared for realizing the nutrition and health related goals in the state

5. To strengthen the state wide attention on malnutrition and under nutrition among

the SC and ST and highlight the violation of entitlements and rights in nutrition and

food security program.

6. To discuss the critical issues of advocacy in order to realize malnutrition and hunger

Free State by increasing accountability, transparency and effectiveness in the

implementation process of ICDS, MDM and PDS and other schemes enlisted for

convergence.

Expected Outcome

A platform created for sharing ideas and models addressing malnutrition and hunger among Dalits, Adivasis and minorities and generating recommendations for improving



effectiveness of the delivery mechanisms which have been put in place for addressing malnutrition and hunger.

The conclave of Dalit leaders, intellectuals, CSOs working on Nutrition, Education and Governance organized ensuring discussion and deliberation on making Madhya Pradesh malnutrition and hunger free and inclusive and through sharing of various initiatives undertaken by the Government Ministries as well as National and International Civil Society Organisations and leading Dalit Rights Networks to address

malnutrition and hunger

Awareness raised on key strategies, approaches and tools developed by National and State Governments, International and National Civil society organisations and networks working in India in finding effective and sustainable ways for eradicating under nutrition and malnutrition among Dalits, Adivasis and vulnerable communities.

Recommendations generated for the programmes and strategies of Ministries that are listed for convergence in action for realizing the goals of National Nutrition Policy such as Ministry of Women and Child Development, Ministry of Panchayati Raj and Ministry of Social Justice and Empowerment an so on for realizing the vision of malnutrition and hunger free Inclusive Madhya Pradesh with focus on Dalits, Adivasis, minorities and vulnerable groups.

Deliberations:

Dr. M.Mukhtar Alam welcomed all the guests and explained the context of the conventions

sharing the purposes, critical learnings of the social audit, advocacy framework in the GAIN

supported and NACDOR led National Convention on Nutrition for Dignity. He highlighted the

seamless activities that are taking place in the campaign through addressing the

administrative and policy gaps that were being identified through social audits at the ground

level. He informed that officials who had confirmed earlier did not come and therefore the

session with the government officials had to be given . With the brief welcome and

description of the context, he called for introduction of all the participants.

After introduction , session with the elected representatives and governance specialists was

brought in order with the sharing of Ms. Shashi Rani of Women’s Resource Centre, Ms.

Shibani Sharma, Hunger Project ,Mr.Mastram Ghosh, Secretary Social Change Foundation

and District Nutrition Leader and Mr. Ram Charan Kol, former Sarpanch ,Chataini panchayat

of Rewa district. Ms. Rashmi shared about her work in the panchayats with women who were

empowered to deliver best through participating in the Panchayat planning processes. Ms.

Shibani Sharma of Hunger Project shared about her work in the improving local governance.

She informed that Hunger Project is part of the Standing Committee of SPHERE.

Informing on her work for nutrition, she informed about the need to activate Village Health,

Sanitation and Nutrition committees in order to ensure better nutrition governance. She

focussed on the shifting cropping pattern that is creating scarcity of produce that were

meant for the making a fulsome nutritional package with regular animal husbandry and

backyard vegetable cultivations. She highlighted the depletion of traditional foods. For the

nutritional package that is currently following through ICDS, MDM and PDS, she highlighted

as to the different preferences of the communities . She suggested the community

preferences could be factored in the choice of nutritional package. She highlighted the

convergence gaps in the monitoring of nutrition and food security related programmes. On

the impact of NRC centres for children, she called for regular feeding of children as per the

stipulated Menu in order to maintain the nutritional status received at the Nutrition



Rehabilitation centres. Reflecting on the food security, she called for addressing all the

policy gaps.

Mr. Mastram Ghosh shared on the

impact of social audits

highlighting the actions that has

been possible. He shared on the

notices that were served to

Anganwadi karyakartas who were

not attending the duties at the

Anganwadi centre. He shared on

the report of the case of Lalla

Saur whose family despite being

large were not receiving ration

for many years for all members in

the households. Considering the

despicable condition of 91 year

old Lalla Saur and his wife Ratani Saur, he informed on its reporting to Mr. Sachin Jain who

wrote a letter to the collector of district and then tehseeldar for Niwari block gave coupons

for all in the family before card could be made. Further he informed on the following:

Many Ananganwadi Karyakartas are running self help group which creates a vested

interest. In Kaina, there are 35 Anganwadi Karyakartas who are running the self help

group for giving food for Anganwadi and school.

Weighing is not proper for the grains given to people. There are cases when people

are being abused. He sighted the example of Bhagwat Prasad Ahirwar who had

testified on this and then action was taken after the social audit.

PDS dealers have fixed 27,28 and 29 for distribution and if people are not taking the

ration on these days, their share is sold out.

Those who do not are taking the ration and selling the same in the market. Action

has been taken by the Supply officer.

Gram sabha under the social audit is proving most effective as these are not

happening and this is the reason , there is need to support NGOs in organizing social

audit processes in the support of Gram Sabha.

Panchayat leaders are not organizing Gram Sabhas. Social audit process organized

Gram Sabhas were the first with the participation of so many Dalit, Adivasis and

vulnerable communities.

Recommended for more support to the social audit processes at the panchayat level.

Mr.Ram Charan Kol , Former Sarpanch spoke on the social audits conducted in Jatri,

Chataini, Sohawal Plot, Madri, Geduraha panchayats. He enthusiastically informed that

social audit processes has generated results. On the follow up action, he informed a Thakur

who had sold out grains for three months. He collected the ration cards and then met the

dealer who had to give all the ration through buying from the market. This was a good

impact of the social audit process. He noted several other results of the social audit

processes. Women self help groups who have not received payment received ten thousand

each. On the strategy for taking action, he says that taking a group of people is helpful

rather than having only few representing the issues of deficit in delivery. Further sharing on

the impact of social audit he reported that teachers are coming regulary now. Food for

children at Anganwadi is not yet coming and for this action has to be taken in the Lafda

village. PDS salesman is distributing grains regularly.



Dr.M.Mukhtar Alam shared more on his personal experience of being part of the social audit

processes in the districts of Morena, Damoh, Teekamgarh and Rewa and acknowledge the

testimonies on the impact of the social audit shared by Mr. Mastram Ghosh and Mr. Ram

Charan Kol. He highlighted the fact that social audit is provisioned but it is not being taken

up. However, with the NACDOR initiated community led social audit processes in the support

of Gram Sabha is proving an effective tool which must be taking place every six month. He

highlighted how social audit ensured delivery of entitlements and how these have been

demonstrated to happen as a result of social audit processes conducted in four districts for

having large impact. He cited the example of Morena district social audit where the social

audit processes and its sharing in the news has created multiplier impact with increasing

monitoring visits for MDM, ICDS and where there has been a slew of action reported in the

newspapers. Comments were sought from the participants:

Narendra Sharma ji of Action Aid called for adoption of rights based approach for

delivery of services and those responsible should deliver.

Prof. Sarah Husain wondered where NGOs has nutritionists as part of their team for

advising on the nutrition and diet in urban and rural areas. A debate ensued on this

with the sharing that nutrition is not a matter of specialists only considering the fact

that knowledge on nutrition has been part of community knowledge systems.

Mr. Narendra Sharma, Action Aid felt that exisitiing knowledge on nutrition in the

community needs to be used rather than induction of packaged nutrition formulas

for all children across the region and communities.

Village Health, Sanitation and Nutrition Committees need to be activated and

trained.

Use of local knowledge on nutrition needs to be encouraged and support for this

needs to be provided along with induction of nutritious products for under nourished

and malnourished children. A holistic approach needs to be taken.

Shibani Sharma noting the Community nutrition processes that are on found that

food security issues are critical along with nutrition security.

Mr. Narendra Sharma expressed caution for the packaged induction of nutrition

through the involvement of corporations.

Dr. Syed Maharul Hasan called for having a balanced approach for eradication

malnutrition and under nutrition where community education is important with the

involvement of nutritionists, nutrition messaging, building native knowledge,

supporting malnutrition prone households.

Shibani Sharma of Hunger Project called for long term strategy for addressing under-

nutrition and malnutrition addressing all the factors.

Mr. Narendra Sharma observed on the reason as to why 70 per cent of Adivasi children

have been malnourished though the incidence was not high earlier. He wondered

whether this figure is part of a corporate strategy.

Mr. Sukant Chandra Behera pointed out that malnutrition has been part of Dalit and

Adivasi lives which is getting exacerbated in the current condition f their

dispossession, landlessness and powerlessness.

Mr.Jayant Lakra from Action Aid called for customizing the nutrition inputs given

through ICDS and ensure sustainability of the nutritional intake by all .

Dr. Sarah Hasan called for sharing on how low cost nutritional intake such as palak

juice, liver soup eliminates Anemia faster and this needs to be adopted as per the

dietary preferences.



Mr. Krishna Singh Bamania shared on the traditional way of keeping Gur and Chana

for people in the households where people used to partake of that. There was

abundance of Mahua and local nutritional produces that were available for all but

these are not being focused now considering the focus on packaged nutrition.

Livestock rearing with agricutlrue, vegetable cultivations was part of sustainable

nutrition rich consumption patterns but the same is being abandoned. Mr. Mastram

Ghosh cited how his household had more than 25 cows and buffaloes giving enough

milk for the household and generating surplus as well.

Concluding the session on nutrition governance, lunch was announced.

In the post lunch session with the International Organisations and development support

organisation, Mr Narendra Sharma highlighted the fact that poverty and malnutrition is

structured. Citing the example of some tribes like Saharia , Baiga and Bharia where

malnutrition has been reported very low to the extent of 94 per cent and at this rate it is

likely that children who would be able to survive would not be more than 45%. Citing these

rates on the reported severe malnutrition, he called for adoption of community based

nutrtion rehabilitation in order to ensure sustained support for the malnourished children

households adopting the social justice framework realising rights for the rights holders and

ensuring delivery by the service

providers.

For the approach for organisations in

order to ensure realisation of the

vision of malnutrition and hunger free

Inclusive Madhya Pradesh, he called

for capacity building of organisations;

research and development from

generating knowledge enabling

corrective action ;local panchayat

level training and workshops engaging

Sarpanches ,Panchayat secretaries ,

village health, sanitation and nutrition

committees, social audit groups , pregnant and lactating mothers, community leaders and

youths from among Dalits, Adivasis and vulnerable communities and Advocacy on the issues

that contribute in the realisation of the vision of malnutrition and hunger free Madhya

Pradesh.

Suggesting the measure, he called for strengthening networking of NGOs including

community based organisations. He called for organising advocacy event in order to highlight

the issues. He called for letter writing campaign emanating from the districts.

Mr. Krishna Singh Bamania called for adopting a comprehensive approach building justice

and reviving traditional nutrition package in the village that had been existing while ensuring

support for all families, children in distress.



Mr. Ashok Bharti highlighted the importance of connecting the conventional wisdom and

knowledge system with the modern instruments and processes for achieving parity in

nutrition eliminating

malnutrition and under nutrition

across the communities with a

focus on Dalits and Adivasis and

vulnerable communities who

indeed have malnutrition and

under nutrition. He citing how

male and female are both

malnourished and there are

knowledge deficits on nutrition

that make many malnourished

despite having money . He cited

the example of women having

goitre due to iodine deficiency,

infants not receiving the

mothers milk. He called for producing a viable business model for nutritious intake using

the conventional knowledge on the nutritious elements and foods. He shared that Mongoloid

syndrome is also a result of poor nutrition. Calling for combination of approaches engaging

all the stakeholders, he called for developing a mega project that would be able to use the

best practice for delivery of nutrition through grassroot action, state level and national level

advocacy.

Dr.Syed Maharul Hasan Founder of United Reformers Organisation with years of experience

in campaign on good governance called Sushashan Abhiyan recalled an instance of how a

minister visited a hospital and finding poor conditions there wished to get the intervention

of collector but collector could not reach there and when he spoke to Principal Secretary,

then he received the response for sharing all the observations in writing for suitable action.

He cited this story for highlighting the importance of written representations on the issues

of nutrition governance. Sharing on the challenges for nutrition, he called for understanding

the reasons for not realising the millennium development goals by 2015.

In the post tea session for sharing the district level experience ,learning of the nutrition

experts, Dr.M.Mukhtar Alam shared on the learning from social audit and informed that 24

social audits have been completed , State Coordination Committee has been formed and its

first meeting has been held. Informing on the seamless action envisaged under the project

for advocating on the issues. He informing the advocacy presentation has been made for the

learning on the social audit. Secretary, Finance, Government of Madhya Pradesh has been

requested for enhancing financial allocation for ICDS in order to ensure that all

infrastructure and salary related demands are met. Minister of Women and Child

Development at the central level has been petitioned for considering increase in the salary

of the ICDS worker, Assistants and Supervisors considering the learning on the low

compensation for them. Supervisors need to be supported with travel allowance. As part of

the coalition building, he informed that national coalition meeting have been planned for

building the pressure on the government for enhancing allocation and improving nutrition

governance.

Ms. Sonam Bamnele , District Nutrition Leader of NACDOR led National Campaign on

Nutrition for Dignity and member of the State Coordination Committee , National Campaign

on Nutrition for Dignity shared the social audits in the six panchayats .She felt that



convention has generated a new energy. Impacts are visible in terms of regularity and much

more work has to be done for ensure delivery of the entitlements.

Mr. Pramel Gupta of Vrutti and member of the State Coordination Committee , National

Campaign on Nutrition for Dignity reflected on the impact of market in determining the

cropping pattern. He bemoaned how

eating packed namkeen had become

more normal across the rural and

urban areas. He called for supporting

diversity in the cropping pattern in

order to build in nutrition in

agriculture while encourage

vegetable cultivation, animal

husbandry. With the formation of

producer companies focussing on

small and marginal farmers,

Mr. Acchelal Kol shared on the results

of the social audit in the panchayats of Jatri, Chataini, Sohawal Plot, Madri ,Kota and

Geduraha. Pump was installed, teacher became regular. He called for sustained support for

social audits in order to ensure that there on slackness in the delivery of services. Ms. Sarah

Hasan , Assistant Professor ,SGHC College ,Bhopal ,Programme Officer ,Food ,Sports and

Nutrition called for engagement of nutrition expert in all stages of the capacity building ,

nutrition messaging. She highlighted to need to have simple communication on nutrition

that is understandable and suggested communication on nutrition in order to ensure that

people at large and Dalits, Adivasis and vulnerable communities receive best information on

nutrition. Nutrition is not treatment rather an comprehensive approach .Experts are needed

to monitor the

progress on nutrition.

There are simple

inductions that can be

made to food for

improving nutrition

such as inclusion of

Soya products and

eggs in the breakfast

for children for

improving the

nutritional status of

children. With the

sharing of Ms. Sarah

Hasan, Mr. Sukant

Chandra Behera ,

Team Leader,

NACDOR delivering the vote of thanks and summed up the discussion with an expression of

hope for contributions from all side in order to realise the vision of malnutrition and hunger

free Madhya Pradesh.

Recommendations:

Location of Nutrition Care and nutrition rehabilitation



Community based rehabilitation of malnourished children while maintaining the

institutionalized rehabilitation centres

Securing sustainability of nutrition in order to prevent relapse of malnutrition.

Support for households in nutrition care for malnourished children in the case of

nuclear families having both parent

Financing for Nutrition

Rate revision for MDM is needed in order to adjust with inflation in the prices so that

MDM delivering agencies and self-help groups are not constrained in cut in quantity,

quality and access for delivering of nutrition at ICDS and MDM.

Enhance per quintal commission for PDS dealers so that s/he is not forced to divert

the supplies under PDS and run many shops.

Inclusion in service providers for Nutrition

Ensure allocation of PDS shops to Dalit, Adivasi and minorities in order to ensure

inclusion and ensure access considering the reports that some upper castes

individuals owning shops are harassing Dalits , Adivasis and not giving the supplies as

per the provision.

Ensure procurement from through the food producer companies customizing

nutritional intake as much as possible while ensuring the fulfillment of calorie needs.

Balance should be maintained.

Cropping Pattern:

Cropping pattern that was devised for fulfilling nutritional needs to be supported

with the diversity of crops as per the native knowledge system while integrating

learning from the state of art research in nutrition.

Sustainability of nutrition inducing cropping patterns is more important than to

allocate all land for market oriented cropping pattern.

Land Right for Landless Dalit and Adivasi household across the religions

Land is a source of sustainable livelihood, nutrition and food security and therefore

special measure needs to be taken for Dalits and Adivasis across the religions who

are being forced out from traditional livelihoods in sector heavily influenced with

mechanization and industrialization.

Using the existing provision land titles should be given to Dalits and Adivasis enabling them to have conditions for growing nutrition food, fruits and vegetable and engaging in animal husbandry.

Monitoring

Community led social audit groups to be supported through NGOs engaging

village health ,sanitation and nutrition committee, panchayat leader, Dalits and Adivasis like the social audits under National Campaign on Nutrition for

Dignity led by NACDOR

Addressing systemic issues in monitoring bridging gaps in financing for monitoring visit cost of supervisors.

Nutritional Intake

Customization of nutrition intake depending on the preference. For example egg should be given for children rather than generalizing for some who are

vegetarian and preventing access to easily available eggs.



Ensuring delivery of breakfast at ICDS as this was found absent is most of 24

social audits conducted by NACDOR in the 24 panchayats of four districts of Madhya Pradesh

Inclusive Nutrition Delivery Business Model:

Involving Dalits, Adivasis and malnutrition and under nutrition prone

vulnerable communities, there is a need to develop a sustainable business

model for nutrition delivery across the rural and urban areas.

Engagement of marginal Dalit and Adivasis in forming food producer

companies and procurement of nutrition products for ICDS.

Engagement of Nutrition Experts

It is important to engage nutrition experts in the capacity building

programmes organized for all stakeholders in nutrition governance and delivery.

It is important to measure the progress in order to take the corrective action. Monitoring the growth and taking rapid corrective action is most important

ensuring reduction in malnutrition and under-nutrition. Infrastructure:

In order to have dignity for children, best infrastructure should be given for

Anganwadis addressing all the gaps. All incomplete buildings should be completed soon. All the Anganwadis should have well-furnished room in order

to function as Anganwadi and Arogya Kendra as per the existing provision in

Madhya Pradesh.

Building that have not been completed should be completed soon with new

allocation while recovery process should be initiated from the contractors who were contracted to complete the Anganwadi building like the one in

Ansara village of Chataini panchayat in Rewa district. Research and Development:

Support for research and development that contribute in realizing the goal of

malnutrition and hunger free Madhya Pradesh.

Nutrition governance research should be conducted engaging NGOs and

institutions.

Advocacy:

Seamless advocacy by organization for bridging the administrative and policy

gaps identified through social audits.

Regular follow up on the advocacy communications.

Integrating nutrition advocacy in the political processes and communication

of political parties.

Adopting innovative advocacy instruments in order to ensure its

effectiveness. Networking:

Supporting networks on nutrition and campaigns in order to ensure

engagement of Dalit, Adivasi and minority community led CSOs having ensuring effectiveness in eliminating exclusion and discrimination.

Report on Madhya Pradesh State Nutrition Convention for Hunger and Malnutrition Free Inclusive...

Government & Nonprofit

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