The state government plans to give severely malnourished children in cities readymade therapeutic paste to curb malnutrition, after claiming to notice the good impact of energy-dense nutritious food (EDNF) amongst rural and tribal malnourished children. The children will be treated in urban child development centres just like the village child development centres in rural pockets.
According to Idzes Kundan, secretary, Women and Child Development department, a proposal to start readymade therapeutic paste for urban anganwadis is ready. It, however, has to undergo the approval process by the government. Therapeutic paste or EDNF is fortified paste made of peanuts, oil, sugar, vitamins, milk powder and mineral supplements. The therapeutic food, as prescribed by doctors, is being used in several African countries for critical cases of malnourished children. In India, the paste remains contentious. It was rolled out for severely malnourished children in 2018 in tribal and rural pockets.
Earlier this month, the Maharashtra Integrated Child Development Services (ICDS) submitted an affidavit to the Bombay High Court, in response to a public interest litigation against EDNF. The affidavit said that of 14,802 severely malnourished children who were administered the therapeutic paste, 49.13 per cent (7,272) have improved to a normal weight and 32.6 per cent (4,835) have improved to moderate malnourishment. The government expressed its willingness to expand the paste to all severely malnourished children.
A contrary report by Jan Arogya Abhiyan found that side effects such as vomiting, diarrhoea and refusal to eat the paste were high amongst tribal children. The report was presented in a core committee meeting to the principal secretary this year.
Indra Mallo, ICDS commissioner, said they are waiting for the Centre’s approval to expand the scope of therapeutic food to anganwadis in urban areas. Maharashtra has 97,379 anganwadis. The therapeutic food will be provided across 104 urban anganwadis for an estimated 8,545 severely malnourished children, the state government said in its affidavit. This will be in addition to roughly 50,000 existing malnourished children in tribal and rural pockets. The Maharashtra government has so far spent Rs 16.7 crore in 2018-19 and allocated Rs 14 crore for 2019-20 to provide the therapeutic paste.
Experts said that while rural and tribal malnourishment is caused due to hunger, in urban areas, intake of junk food has contributed to malnourishment. Data as of May 2019 shows that of 57.2 lakh children screened in Maharashtra, 78,989 are severely underweight.
“We have received the ICDS affidavit. We are analysing the data given by the government. We found a poor response of EDNF in our survey,” said Dr Abhay Shukla, convenor of Jan Arogya Abhiyan.
Meanwhile, WCD officials also said that while they are expanding the readymade paste to cover urban areas, they plan to limit it to severely malnourished children. Another proposal to expand this paste for moderately acute malnourished children has been put on hold.