A Policy Memo to help bring down malnutrition in Melghat, Maharashtra
Melghat in Amravati, located in the north-eastern part of Maharashtra, is infamous for its high levels of malnutrition among children. Malnutrition has been the cause of 508 deaths in children and 153 stillbirths in the year 2018. Dr. Abhay Bang who has extensively worked on the issue of malnutrition has stated that malnutrition has significantly contributed to high levels of child deaths in Melghat.
Among other causes of malnutrition, micronutrient deficiency is a major cause as it directly affects the health & nutrition of the child. Micronutrient deficiency is attributed to several reasons, for example – dietary patterns of households, inferior quality of supplementary nutritional interventions through Aanganwadi meals and Amrut Aahar meals, and insufficient quantity as well as inferior quality of grains provided through Public Distribution System (PDS). Due to the supplementary nature of institutional nutritional interventions, it is essential to focus on the primary source of nutrition. It has been found through various studies that the dietary patterns of the people in Melghat mainly comprise of chapati, rice and cereals with low consumption of fruits, vegetables, meat, etc (Birdi et al, 2014), and the same has been corroborated by first-hand observations of the author. This has led to micronutrient deficiency amongst the children and women of Melghat, making them increasingly vulnerable to malnutrition. In the study conducted by Birdi and Shah (2014) in Melghat, it was found that the main causes for the low consumption of vegetables and fruits were affordability and accessibility . The greater consumption of cereals or staple crops isn’t due to greater nutritional value, but because of its low prices making it affordable to poor households. It has been seen that micronutrient deficiency increases as the prices of food increases, since an increase in the prices of vegetables, fruits, etc. makes it unaffordable to consume (Bodnar, 2013). Accessibility is also a vital issue, since most villages in Melghat are located in hilly and remote areas, away from the main market areas.
Micronutrients – first line of defence against malnutrition
Micronutrient deficiency affects approximately 2 billion people worldwide, with approximately 7% of children in India exhibiting symptoms of Vitamin A and iron deficiency (Vijayaraghavan et al, 1987). In a survey conducted in Maharashtra and Andhra Pradesh, it was found that depending on the sample village, as high as 15% of children below 12 years consumed fewer calories than the critical level of energy, while approximately 29% children in Maharashtra and 49% children in Andhra Pradesh faced Vitamin A and B-complex deficiency symptoms(Walker & Ryan, 1990). In the first of its kind nationwide survey done by the government, it was found that 14% of pre-school children and 31% of adolescents suffer from Vitamin B12, Vitamin D, or Vitamin A deficiency. The numbers for folate deficiency are much higher with 23% of pre-school children and 37% of adolescents suffering from it, similar is the case for zinc where numbers are 19% for pre-school children and 32% for adolescents (Bhuyan, 2019). The consequences of micronutrient deficiency are far-reaching and can have serious implications on the physical and cognitive development of individuals, especially children. Vitamin A deficiency can hamper normal eye functioning, normal growth of the body and it also increases the risk of diarrhea, respiratory mortality, and morbidity (ACC/SCN, 1993; Alderman and Garcia, 1994; Olson, 1990; Sommer et al., 1983, 1984). In a study conducted by Rahmatullah (1992), it was shown how a modest increase in Vitamin A consumption in children who were chronically undernourished increased the chances of their survival. There has also been a negative relationship established between the incidence of fever and the consumption of carotene and Vitamin-C (Bouis, 1991). Through these studies, the importance of micronutrients can be understood and the consequences of not consuming enough micronutrients can also be understood.
Therefore, the only sustainable way of tackling micronutrient deficiency and the ensuing malnutrition is through the incorporation of micronutrient-rich foods in the diets of the people. Vegetables and fruits are considered the most sustainable and cost-effective dietary sources of micronutrients and they also have the ability to release “bound’’ nutrients in other staple crops (usually cereals) for efficient absorption of foods (Chadha & Oluoch, 2003). In order to prove that vegetables are more micronutrient-rich than cereals, a study was conducted in Taiwan wherein micronutrients per 100gms of edible portions from vegetables and cereals were multiplied by the average per day and per hectare yield of the crop (Ali & Tsou, 1997). It was found that vegetables on an average produced twice more iron than cereals, for example, mung bean sprouts provide 45% more protein than cereals. Vegetables are also more cost-effective in providing vitamins and iron than meats such as chicken and beef.
Kitchen Gardens – a simple solution to a complex problem
From the above analysis, it can be deduced that the consumption of vegetables and fruits is required in order to address the issue of micronutrient deficiency. From all the available options, the most viable solution to the micronutrient-deficiency induced malnutrition in Melghat is the method of Kitchen Gardens (KG). Kitchen Gardens are spaces where vegetables and fruits are grown for personal consumption. In Melghat, where affordability and accessibility are major impediments to the consumption of micronutrient-rich foods, the introduction and development of Kitchen Gardens is a well-suited solution. In Melghat, Kitchen gardens can be developed in every household through the aid of the state government through the provision of fertilizers, seeds, etc, and can be monitored through the Gram Sabha initiative. However, some families may not have land to develop KGs in which case community land available in the village, can be utilised to develop KGs under the supervision of the Gram Sabha. Zilla Parishad school premises as well as Aanganwadi premises can also be utilised for KGs. Using school premises benefits in a twofold manner. Firstly, it enables the utilisation of the garden produce for the meals of the children in Aanganwadi & mid-day meals, improving the nutritious value of these meals. Secondly, it enables children to learn about the benefits of nutritious food items through these gardens and also teaches them to maintain and further develop these gardens. An example of this is the Zilla Parishad School of Jaitadehi village of Chikhaldara Taluka of Melghat, which has developed a KG within their premises and the children actively participate in the maintenance of the garden and the produce is used to cook their mid-day meals. A study conducted by the MS Swaminathan Research Foundation, from 2013-2018 in seven villages of Koraput district in Odisha and five villages of Wardha in Maharashtra – where kitchen gardens were introduced at the household, schools and at community land level – the end line survey conducted in 2017 stated that the average consumption of vegetables and fruits increased amongst households who participated in the intervention as opposed to before the intervention (MSSRF, 2019). Apart from the issue of land, often the resources required by the state and households to develop KGs might be inadequate. The inadequacy of resources can be addressed in a manifold manner. Non-governmental organizations play an important role in aiding social-welfare programs such as these. Nationally as well as internationally, NGOs have played a very important role in the establishment and maintenance of Kitchen Gardens to reduce the incidence of micronutrient malnutrition. The Peoples’ Vigilance Committee on Human Rights (PVCHR) have started kitchen gardens in Musahar communities of Varanasi to include fresh fruits and vegetables in their diet. The Committee has taught the community how to grow vegetables on a vacant plot, drainage & sunlight management, how to take care of seedlings, manure etc. (Raghuvanshi, 2019). This intervention has led to sufficient availability and increased consumption of vegetables such as sponge gourd, bitter gourd and snake gourd amongst others. Another such initiative taken is by MAHAN Trust in Dharni Taluka of Amravati District. In villages of Dharni Taluka, MAHAN has established and maintained 4102 nutrition gardens (see Figure 1) by providing villages with low-cost sustainable agricultural products. They have also trained the tribal women to maintain these gardens by teaching them how to create compost fertilizers for these gardens. MAHAN has seen significant success in the development of these KGs and there have been instances where surplus produce from these gardens has been sold in the market for supplementary income.
The development of KGs also depends on the climatic conditions and the water supply in the area. Melghat falls under the arid climatic zone and most agriculture in this area is dependent on rainfall. In such a situation, where water is scarce, using the available resources efficiently and developing inexpensive irrigation techniques becomes important. This can be done through micro-irrigation and use of treadle pumps wherein micro-irrigation involves providing appropriate water directly to the roots of the plants to avoid water loss due to evaporation and runoff, leading to higher yields in vegetables and water-saving by approximately 50%. (Hug, 2010). Treadle pumps are also a low-cost irrigation system that enable extraction of water from shallow depth water resources such as ponds, lakes, canals, catchment basins, etc. The fertility of the soil is also an important component for the proper maintenance of KG. Chemical fertilizers contain all the macronutrients required for healthy production of plants like nitrogen, potassium and phosphorous, however, it is extremely expensive and can have negative environmental implications. Thus, there can be the use of biological fertilizers such as ‘Bioferty’ which are based on the inoculation of microorganisms and are very cost-effective and efficient (Hug, 2010). Just like bio-fertilizers, biopesticides are also gaining more prominence due to their low cost and environmentally friendly nature. Green Muscle is an example of such a biopesticide that is not only harmless to the environment but also to the non-target organisms. Green Muscle is also known to adapt very well to arid climates and its properties have made it one of the top recommendations by the Food and Agriculture organization (FAO) (Hug, 2010). Considering Melghat’s climatic conditions, Green muscle will be a suitable fit to deal with pests in KGs.
KGs can also become cost-effective by incorporating fruits and vegetables that are indigenous in nature. The problems of limited vegetable supply (especially during the off-season) and the high prices of vegetables can be solved through the cultivation and consumption of indigenous food-items. The rationale behind preferring indigenous food items is that they can easily adapt to adverse local climatic conditions and they are often resistant to pests and pathogens found therein (Chadha & Oluoch, 2003). Apart from that, indigenous food items hardly require any extra external support for their growth. Not only do they add diversity to the meals but they’re also an inherent part of the local population’s culture. This familiarity makes the cultivation, utilization and acceptability of indigenous foods easy for the locals. Indigenous foods also have a higher shelf life than non-indigenous foods. All these qualities of indigenous foods will reduce the costs of developing a KG significantly, as there will be lesser monetary costs associated with pesticides, fertilizers and training programs. Apart from the nutritional importance of Kitchen Gardens, they can also be instrumental in facilitating employment within the region. Constructing a KG usually requires basic infrastructure such as fencing etc. to save the produce from stray or wild animals, etc. Thus, these activities can be performed under MGNREGA, in a way that will generate local employment. Income generation through employment will indirectly lead to consumption of more nutritious food due to the increased affordability among households.
From the foregoing analysis and the above figure it can be understood that Kitchen Gardens are the most efficient way to improve the nutritional value of household diets. Its cost-effectiveness and its ability to adapt and overcome various functional issues makes it a viable option of dealing with micronutrient malnutrition. The studies conducted at various points have shown us the benefits accrued from vegetables on the health of individuals. Thus, policymakers should focus on the efficient and effective functioning of Kitchen Gardens where consumption & diversity of vegetables is limited.
(Prutha is currently pursuing Masters in Public Policy from the Institute of Public Policy, NLSIU, she is interested in the issues of employment, malnutrition & food policy in India. She also keeps a keen interest in addressing social issues at the intersection of Public and Private owing to her dedicated work on PPPs. When she is not thinking policy she can be found anywhere where there’s spicy food or a gang playing PubG. Prutha can be reached at firstname.lastname@example.org)
Ali, M., & Tsou, S. (1997). Combating micronutrient deficiencies through vegetables—a neglected food frontier in Asia. Food Policy, 22(1), 17-38. doi: 10.1016/s0306-9192(96)00029-2
Birdi, T., Joshi, S., Kotian, S., & Shah, S. (2014). Possible Causes of Malnutrition in Melghat, a Tribal Region of Maharashtra, India. Global Journal Of Health Science, 6(5). doi: 10.5539/gjhs.v6n5p164
Chadha, M., & Oluoch, M. (2003). Home-based vegetable gardens and other strategies to overcome micronutrient malnutrition in developing countries. Retrieved 15 December 2019, from https://www.researchgate.net/publication/283994302_Home-based_vegetable_gardens_and_other_strategies_to_overcome_micronutrient_malnutrition_in_developing_countries
Vijayaraghavan, K., Naidu, A., Rao, N., & Srikantia, S. (1975). A simple method to evaluate the massive dose vitamin A prophylaxis program in preschool children. The American Journal Of Clinical Nutrition, 28(10), 1189-1193. doi: 10.1093/ajcn/28.10.1189
Bodnar, A. (2013). Solutions for micronutrient deficiency. Retrieved 26 December 2019, from https://blogs.scientificamerican.com/guest-blog/solutions-for-micronutrient-deficiency/
Walker, T., & Ryan, J. (1990). Village and household economies in India’s semi-arid tropics. Baltimore: Johns Hopkins University Press.
Rahmathullah, V. (1992) Effects of frequent, low-dose vitamin A uptake on child survival: implications for community- based programs. In Frontiers of Nutrition and Food Security, ed. N. G. Kotler, Chap 2. International Rice Research Institute, Manila.
Bouis, H. E. (1991) The Determinants of Household-level Demand for Mieronutrients: An Analysis fi~r Philippine Farm Households. International Food Policy Research Institute, Washington, DC.
MSSRF (2019), Nutrition Gardens to Address Micronutrient Deficiency – MSSRF Thirty Years. Retrieved 26 December 2019, from https://www.mssrf.org/mssrfthirtyyearsnew/nutrition-gardens-to-address-micronutrient-deficiency/
Raghuvanshi, L. (2019). Kitchen Gardens – The Way To Fight Hunger And Malnutrition. Retrieved 26 December 2019, from https://www.outlookindia.com/website/story/kitchen-gardens-the-way-to-fight-hunger-and-malnutrition/331795
Hug, C. (2010). Family Gardens Against Malnutrition. Retrieved 26 December 2019, from https://www.antenna.ch/wp-content/uploads/2017/04/Family-Gardens-against-Malnutrition_Antenna_2010.pdf
Bhuyan, Anoo (2019). Government Surveys Micronutrient Deficiency Among Children for the First Time. The Wire. Retrieved 21 March 2020, from https://thewire.in/health/government-surveys-micronutrient-deficiency-among-children-for-the-first-time