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November 25th, 2013

Are nutrition programmes serving children in Bihar?

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Estimated reading time: 5 minutes

Editor

November 25th, 2013

Are nutrition programmes serving children in Bihar?

0 comments

Estimated reading time: 5 minutes

A recent IGC Working Paper by Andrew Fraker, Neil Buddy Shah, and Ronald Abraham assesses the performance of Bihar’s ICDS Supplementary Nutrition Programme as a first step toward designing policy interventions to address the state’s malnutrition crisis.

Child malnutrition is a critical problem in Bihar, where the prevalence of underweight children is far worse than the Indian average and higher than any country in the world. Recognising this, the Bihar State government (along with the Central government) commits over 1,100 crore rupees per year (US$200 million) to the Integrated Child Development Services (ICDS) Supplementary Nutrition Programme (SNP). But the government is aware that programme funds are regularly pilfered, and it is common for anganwadi (government pre-schools) centre staff to fail to provide meals and dry rations to the intended beneficiaries.

biharSNP

Based on random, unannounced visits by independent surveyors, this assessment quantifies the shortcomings of ICDS’ SNP by providing in-depth analysis of ground-level realities.

The main findings from this quantitative assessment are:

  • 53 per cent of the SNP budget was “missing” due to leakage
  • 71 per cent of the budget for food served at anganwadis was missing
  • 38 per cent of the budget for take home rations was missing

The main sources of fund leakage were:

  • Anganwadi centres were open 76.5 per cent of the time they should have been
  • Meals were only served 77 per cent of the time when centres were open, and 59 per cent of the time overall
  • When meals were provided, only 386 calories (77 per cent of stipulated amount) and 11.7 grams of protein (78 per cent of stipulated amount) were served per child per day
  • On days when the centres served meals, child attendance was only 56 per cent of the number of children for which the centres get funds
  • 84 per cent of beneficiaries received take home rations (THR), and those that got THR only received 61 per cent of the stipulated amount, on average

Nutrition levels were very low:

  • 43 per cent of children are underweight-for-age, 58 per cent have low height-for-age, and 20 per cent have low weight-for-height, a prevalence beyond “critical” as per the World Health Organisation
  • 39 per cent of nursing mothers are underweight

There are no easy solutions guaranteed to reduce leakage and increase the provision of nutritious food to Bihar’s millions of malnourished children and mothers. This quantitative assessment was a first step toward providing evidence of the sources of leakage and areas of concern are overall. This report provides the foundation for the design of interventions by ICDS to improve the nutrition programme. Ideally, each intervention should be piloted, refined, and rigorously evaluated for impact before scaling across the state. The Government of Bihar and ICDS’ eagerness to innovate and to improve the performance of SNP provides hope that the status quo can improve, ultimately benefiting millions.

For the complete quantitative assessment, see: A. Fraker, N.B. Shah, & R. Abraham, Quantitative assessment: Beneficiary nutritional status and Performance of ICDS Supplementary Nutrition Programme in Bihar, International Growth Centre Working Paper (February 2013).  

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