DEPLOYING THE POWER OF SOCIAL PROTECTION TO IMPROVE NUTRITION: WHAT WILL IT TAKE?

Children at a mid-day meal (Photo credit: POSHAN team)

Despite reasonable economic growth over the past decade or more, the nutritional status of women and children in India continues to be poor. Social protection programmes are ideal vehicles for tackling this problem, and improving the underlying determinants of malnutrition. Not only are they designed to target families at risk of malnutrition, but they are also allocated considerable governmental resources. With their coverage and their legal mandate, India’s social protection programmes have the potential to tackle the issue of malnutrition; however, these programmes do not always fulfil this promise. Strengthening the contribution of social protection programmes to nutrition requires careful consideration of design elements.

In a recently study published in the Economic and Political Weekly, Kalyani Raghunathan, Suman Chakrabarti, Harold Alderman and Purnima Menon of the International Food Policy Research Institute (IFPRI) discuss how three major flagship social protection government programmes—the Targeted Public Distribution System, the Mid-day Meal Scheme, and the Mahatma Gandhi National Rural Employment Guarantee Act—can be made more nutrition sensitive. They organize their findings based on three potential approaches to making these programmes deliver better nutrition outcomes, as outlined by Ruel and Alderman (2013):

1. The first approach—addressing underlying determinants of fetal and childhood nutrition—involves strengthening the delivery of the primary mandates of these programmes. While program coverage and targeting has improved over the recent years, all the three programmes suffer from incomplete coverage of their target population, from basic problems related to the quality of services provided and inadequate local level monitoring and vigilance. These will need to be improved substantially before additional components can be added on.
2. Under the second approach, programmes can incorporate specific nutrition goals and actions, such as micronutrient fortification and commodity basket diversification for the TPDS and MDMS respectively, the building of pit latrines through MGNREGA, or the provision of health and nutrition information through all the three schemes.
3. Under the third approach, these programmes can serve as delivery platforms for nutrition-specific interventions, such as providing deworming tablets, handwashing training, and micronutrient supplementation to school going children. This approach involves adding actions that are not within the traditional purview of these programmes and may encompass convergence with nutrition-specific programs.

Overall, the literature on these different approaches in the Indian context is thin, and there is scope for studies to strengthen the evidence-base. Studies could focus on deploying the potential of social protection for improved nutrition through evaluations, operations research, cost studies and more. The researchers conduct an analysis of the costs involved with each approach, and show that fortification of cereals under TPDS and MDMS and the provision of deworming and micronutrient supplementation through MDMS are highly cost-efficient interventions (costs range from 1 to 5 percent of budgets). Adding appropriate context-specific components to these flagship programmes via the framework of approaches discussed in this paper might allow untapped potential to be effectively unleashed.

For those who subscribe to the Economic and Political Weekly, the paper can be downloaded here. If you don’t have a subscription, you can get the full paper by emailing us at IFPRI-POSHAN@cgiar.org clearly stating “Request for EPW paper on social protection and nutrition” in the subject line.

Written by Suman Chakrabarti and Kalyani Raghunathan