The document discusses the supplementary nutrition program in Anganwadis (childcare centers) in Maharashtra, India. It notes that the meals provided by Anganwadis can only meet one third of a child's daily nutritional needs, so home meals are important. It outlines the typical meal schedule and describes challenges like inadequate funding, declining meal quality, and strained relations with self-help groups contracted to provide meals. It also discusses "take-home ration" programs that have faced issues with proper usage. Several districts have tried community involvement models with some success to address gaps. Overall, the document examines the gains and pains of the supplementary feeding system and challenges of improving and sustaining it.

1. Child Malnutrition in
Maharashtra (India)
August 2013- January 2014
2013-
Situation, Efforts, Decline and Challenges
A Review
For the State Nutrition Mission
PowerPoint4/6
The supplementary nutrition component
Dr Shyam Ashtekar,
MD (Community Med)
shyamashtekar@yahoo.comnganwadi-supplementary feed--Dr Shyam
A
ashtekar jan 2014
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2. Supplementary Nutrition
Program in the
Anganwadi (AWC)
in Maharashtra
PowerPoint 4/6
Jan 2014

3. SNP -Importance and limitations
The supplementary feed in the Anganwadi can only
provide a third of the child’s requirements.
But the AWC feeds help to attract children and parents.
It also answers the need for the two meals in 4 hours of
the AWC
But for malnutrition prevention it is a secondary support.
The major feeds must come from home
Anganwadi-supplementary feed--Dr Shyam ashtekar jan 2014
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4. Schedule of AWC Feeds
Breakfast is served when the Anganwadi starts and there is a
meal before AWC closes in the afternoon.
For the breakfast they serve cooked legumes (usal), porridge
or daliya (broken wheat).
The meal has either khichadi (rice and dal) or similar items.
Every district has almost similar time schedule.
This schedule is displayed on the AWC wall.
Anganwadi-supplementary feed--Dr Shyam ashtekar jan 2014
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5. Schedule of the weekly AWC Meals
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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6. Supplementary feed & AWC Assistant
Till sometime ago it was the AWC who cooked the
meals.
For this she got some resources and provisions.
Even now the assistant prepares the meals where
there is no SHG.
Many AWCs have a small kitchen for this purpose.
A Chullah or kerosene stove is used if there is no
gas. (usually)
But there are some limitations about what an
assistant can cook.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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7. The Current provision is only
4.92Rs.
Currently the per child daily provision for
supplementary feed is only 4.92 Rs.
This includes grains, dal, salt, spices and oil.
In tribal projects, Rs1 is added to this.
For severely malnourished children ,
additional provision of Rs1 is available.
The assistants get 60ps. per child per day,
firewood / kerosene included.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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8. Fair Price Grain
Supply from
PDS
In Some districts AWC have managed to get foodgrains and
some dal, oil, sugar, rockel etc. from the PDS.
In some districts these items are purchased from other shops.
But the AWC or SHC can not afford this.
Possibly the food security scheme will solve this problem.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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9. Supplementary Feeds and
Self Help Groups
The Hon Supreme Court has mandated the local
SHGs for supplementary meals and THR
Consequently SHGs provide all the meals to AWCs.
But in the end even the SHG delegates the cooking to
the AWC assistant.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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10. Supplementary feeds and Self Help
Groups (SHG)
But many SHGs cannot afford to provide
theses meals in the meager budget, they either
avoid this or are reluctant.
Some prefer other employment.
There are complaints about quantity and
quality of meals supplied by SHG to AWC.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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11. AWC Worker & Self Help Groups
The AWC-SHG relations are strained on the issue
of supply of meals.
Financial loss, late payment, decline of AWC
attendance and inevitable loan arrangement with
the local grocer are all factors of friction.
In some districts SHGs are merely working for
their husbands, causing more corruption and strike.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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12. Quality of AWC meals
The quality of meals is declining.
Difficult to afford food, especially oil, peanuts, Moong dal etc.
At times sub standard food items are used to save on costs.
There are many complaints about bad test or insufficient meals.
In some places they combine breakfast and lunch to save on costs.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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13. Protests about Meals
In Jawhar some political activists gheraoed an ICDS Officer for
complaints about food. The ICDS Officer referred the problem to
the SHG and pleaded helplessness.
Political activists may not understand this complexity.
Many AWC sevikas and supervisors insist on closing the SHG
arrangement and hand over the task back to AWC. This also
causes complaints.
Even raising the provision will not solve this problem, since there
is also corruption factor.
There is no solution in sight
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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14. Solutions tried in some districts.
Aurangabad, Akola, Ahmednagar, Latur are
some districts where some solutions were
found for this problem.
Essentially the villagers contributed food
items to the AWC to bridge the gap.
For this some methods were used..
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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15. 1. Akola- handful of grain from each home
AkolaIn 2011 the ZP officers in Akola district appealed to all
villages / families to donate food items to AWCs.
This easily met the food requirements of the AWC.
The excess food was donated to other needy people.
But in 2013 the excessive rains forced heavy damage and
AWC sevikas had no heart to ask for help.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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16. 2. The Aurangabad
Experiment
Aurangabad district also asked for food donations to
the AWC.
AWCs have essential items donated by families.
Many mothers and families learned to prepare various
foods recipes from these provisions.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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17. 3. The Gopalpangat in
Ahmednagar & Latur
districts.
The ICDS Officers requested community meals in
every village 1-2 times each week.
The children enjoyed this Gopalpangat and
learned to eat and taste many food items.
Families queue up for this opportunity as an
honor.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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18. Gopalpangat ……….
Villagers have learned to feed the children and the
importance of the issue of malnutrition.
Additionally this may help to reduce the social
divides in villages
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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19. The Child’s Food
corner
The food corner is also called the child corner (Balkopra)
Ready to eat food items are stored in plastic jars in a corner of the
house.
Children can see this and eat as they want.
Mothers learnt this trick of feeding the child.
In some places THR was used for this purpose.
Laddus and sweets were made and kept in the plastic containers.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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20. But in tribal districts...
No such scheme worked in tribal areas.
Not that tribal families have no food to eat or
give.
But poverty and migration did not allow such
participatory schemes in tribal blocks.
Hence the constraints remain in tribal areas
(additional grant of 1 Rs is available in tribal
projects, also 1 more Rs for the malnourished
child)
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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21. The Supplementary meals in AWC-Gains
AWCand Pains.
Some Problems.
Some Advantages
Causes some carelessness about
Laboring families get some
feeding at home.
respite from child care/ feeding.
The needs to be guarded against
Children learn to eat together.
The middle class in the village
Child learns to eat with own
turns it’s back on the AWC
hands.
Child learns different tastes.
We can give micronutrients
through the meals.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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22. SHG and Take Home
Ration
As per Supreme court decision and Govt.
order only SHGs should prepare THR.
The provision for THR costs is also 4.92Rs.
per child per day.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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23. Take Home
Ration
Children under 3 years can not attend sit in the AWC.
Hence children 6 to 36 months get THR for home use.
THR packets are also given for severely malnourished child of
any age under 6.
THR comes in three packs of 1kg. Shira, Upma and Sattu.
Pregnant and Nursing mothers also get THR.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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24. Take Home Ration
It is expected that a small portion of the THR from the pack is
mixed in hot water and or cooked fed to the child.
Mothers are expected to eat their own THR provided from the
AWC.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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25. Take Home Ration-- Complaints
Ration-There are complaints about the quality of THR
Many people refuse to take THR.
Some others throw it to cattle or to the chickens.
Some families cook and share THR in the entire family.
Thus somehow the child hardly benefits from the THR.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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26. Experiments with THR
Mothers were taught to prepare sweets
and spicy food items from the THR and
the children like this.
Frying involves oil and ghee which adds
more calories.
In some districts THR was put to good
use.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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27. Does THR help?
But many families are unable to prepare
such food items.
Hence it is a big question mark on the
THR.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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28. Only big SHGs can bag THR
contracts.
Local SHGs can not
secure THR
contracts.
Only big units can
get the contracts.
So the original idea
of SHG
empowerment no
longer works.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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29. Challenges of Supplementary
Feeding.
How to improve and sustain the quality of AWC
meals.
How to sustain the social participation in
supplementary feeding programme.
How to increase the protein factor in the meals.
Will increasing of provision ensure better
compliance?
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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30. RUTF? Better Protein Foods?
Can we give RUTF (Ready to Use Therapeutic Food) in
AWCs to satisfy quality and quantity of supplementary feeds?
There are debates about RUTF
Milk or egg powder is also a good idea for ALL children (not
just the malnourished)
Can we think of better quality and smaller packs of THR?
We must think about providing a solution that works.
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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31. Best Wishes
Dr Shyam Ashtekar (MD,
Community Medicine)
21 Cherry Hills Society, Anandwalli,
Nashik 422013
shyamashtekar@yahoo.com
Cell +919422271544
Website:
arogyavidya.org,
bharatswasthya.net
A study of Anganwadis and campaign against malnutrition
in Maharashtra for and with support of
Rajmata Jijau Mission,
August to Dec 2013
Anganwadi-supplementary feed--Dr Shyam
ashtekar jan 2014
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