COVID-19 calls for increased budget provisioning for child health, nutrition: Experts

Puja Marwaha, CEO, CRY elaborated on the challenges of ensuring health and nutrition security for children and adolescent girls, based on the on-ground experiences from CRY’s intervention areas across 19 States in the country.

Puja said, “CRY efforts focus on providing nutritional security to vulnerable families by providing seeds and manure to develop household level kitchen gardens. These efforts paid off especially during the pandemic, as they have helped make vegetables more affordable, improved dietary quality and is a sustainable source of nutrition. While interventions at the micro-level are critical, we feel that unless challenges related to adequacy in budgetary allocations, and bottlenecks in utilisation are addressed, we will be unable to mitigate the loss caused due to pandemics such as COVID-19. Unless systemic resilience is built and strong mechanisms for public provisioning are ensured, the cumulative effect of community-level interventions would not be visible.”

“With COVID-19 pandemic having impacted nutrition delivery services and nutritional status of pregnant women, children below 6 years and adolescent girls significantly, we are hopeful that allocations towards child development and nutrition will see an exponential increase in the coming years,” Puja added.  

Highlighting various facets of Public Financing for Child Nutrition, Shruti Ambast, Senior Policy Analyst of CBGA said, “CBGA’s District-level budget analysis of 5 districts and 4 states) shows high fund utilisation in important centrally sponsored schemes like SSA. ICDS MGNREGS, etc. in 2017-2018 and 2018-2019. But, fund utilisation was relatively lower for MDM and NHM, indicating that resource absorption capacity is good in certain schemes and some districts/states perform better than others. Sustaining demand for higher allocations therefore becomes crucial.”

Highlighting, the vulnerability of adolescents, Mini Varghese, Country Director, Nutrition International said, “Out of school adolescents is a group which is vulnerable to under-nutrition amid the pandemic. And it is not just girls, out of school adolescent boys are equally vulnerable and there are no mechanism to reach to boys. Evidence suggests that in low income countries, supplementation, dietary diversity and food fortification are possible solutions to address nutrition challnges”

Talking about the reforms needed to address bottlenecks in public financing, Avani Kapur, Director, Accountability Initiative said, “Fund release, approval, reporting and allocation need to be streamlined for better public financial management (PFM). We can start small but I feel that in schemes like nutrition, decentralization is always key.”

Avani Kapur especially highlighted the critical role played by the women frontline workers like Anganwadi workers, ASHAs and ANMs and lauded their role in reaching out to the households during the pandemic. One is hopeful that adequate budgets will be allocated to address their challenges related to safety and working conditions.

Stressing on the need to invest in improving nutrition, Shweta Khandelwal, Head of Nutrition Research, Public Health Foundation of India said, “Women in India face multiple challenges including poor food, health and care environments along with early marriage, early conception, multiple pregnancies and social status. Hence it is critical to ensure pre-pregnancy well-being for good maternal and child outcomes. Only giving ration to pregnant women, mothers won’t help. We also need to strengthen the social safety nets for women and relook at nutrition component.”

Dipa Sinha, Assistant Professor, Ambedkar University, Delhi spoke about food insecurity and shedding light on different determinants to address the issue. She said, “Most people in our country cannot afford a healthy diet. We have not attained the level where we can access wholesome food. On ground research highlights that hunger is increasing post COVID. Whatever nutritious food people were consuming before COVID, has been decreasing. We need to understand that malnutrition has different determinants and solving one is not going to address the whole issue but it is vital to do all.”