Even as a central government circular issued last month asked for strict compliance against use of Ready-to-use Therapeutic Food (RUTF) for combating severe acute malnourishment (SAM), the Maharashtra Women and Child Development (WCD), that had floated a tender for RUTF in July, is set to send recommendations to the central ministry for reconsideration.
“We will make a reference to the government of India as per our experience. We will not go ahead with the purchase of RUTF until the government gives a go-ahead, but the tenders have not been canceled,” said Vinita Singhal, secretary of WCD.
In its circular issued to all states on August 28, ministry of WCD quoted Ministry of Health and Family Welfare that had, in 2009, stated “The use of RUTF for management of malnutrition is not an accepted policy of the Government of India”.
“Enough evidence is not available for the use of RUTF vis-a-vis other interventions for management of several acute malnourishment. RUTF may replace nutritional practices and family foods that children would normally be eating,” the circular states.
Maharashtra government in July floated tender to appoint a contractor to provide RUTF for non-medical cases of severe malnourished children in six regions – Amravati, Konkan, Aurangabad, Nashik, Nagpur and Pune. The beneficiaries are estimated to be 85,452 children, all aged under six. RUTF, also called energy-dense nutritious food, is a paste of peanuts, oil, sugar, vitamins, milk powder and mineral supplements. It was implemented on pilot basis in Palghar and Nandurbar, along with a few hospitals in the state. Social activists have argued that RUTF will cost more and may not be effective in tribal pockets. A malnourished child is admitted in a village child development centre and given food six times a day costing Rs 40. In contrast, RUTF will cost the government Rs 75 per day.A public interest litigation (PIL) has been filed against RUTF in August by Pradip Prabhu and NGO Jan Arogya Abhiyan. The petition states that enough research is still required before the paste is administered widely for SAM children. In addition, the petition claims that children may become dependent on it.
“There are researches that show the success of RUTF in Bihar and Jharkhand. Sion hospital has used it for its children. We need a holistic plan to handle malnutrition,” WCD secretary Singhal told The Indian Express.
The state WCD has decided to hold the purchase until they receive the Center’s clearance. Currently, officials were being trained on the use of the ready-to-eat paste. The policy was set to be launched in a few months for the malnourished children who do not require hospitalisation. A survey in Nandurbar had shown that RUTF had 49 per cent success amongst 7,927 malnourished children. A small study by Janarth Adivasi Vikas Sanstha showed that of the 14 SAM children given RUTF in a pilot project, only nine consumed the entire packets.