|Bridging the nutritional divide 3|
Building a Sustainable Community Nutrition Security System
Conferring the right to food — and thereby an opportunity for a productive and healthy life — on those who go to bed undernourished now, is the fundamental duty of the State and the more fortunate sections of the population. Thanks to technological advances and the spread of democratic systems of governance at the grassroots level, we now have a rare opportunity to foster a community-centred and controlled nutrition security system. Such decentralised community management will help improve delivery of entitlements, reduce transaction and transport costs, eliminate corruption and cater to the twin needs of introducing a life-cycle approach to nutrition security and meeting the challenge of seasonal fluctuations in nutritional status. The basic guidelines for such a system are:
Adopt a whole life-cycle approach to nutrition security
n Pregnant mothers. Overcoming maternal and foetal under-nutrition and malnutrition is an urgent task, since nearly 30 per cent of children born in South Asia are characterised by low birth weight (LBW), with the consequent risk of impaired brain development. Ramalingaswamy et al (1997) have pointed out that half the world’s malnourished children are in India, Pakistan and Bangladesh. LBW is a proxy indicator of the low status of women in society, particularly in terms of their health and nutrition status during their entire life-cycle (Rama Narayanan, 2001).
n Nursing mothers. Appropriate schemes will be necessary to provide support to enable mothers to breast-feed their babies for at least six months, as recommended by WHO. Policies at workplaces, including the provision of appropriate support services, should be conducive to achieving this goal.
n Infants (0-2 years). Special efforts will have to be made to reach this age group through their mothers, since they are the least served at present. Eighty per cent of brain development is completed before the age of two. The first four months in a child’s life are particularly critical, since the child is totally dependent on its mother for food and survival.
n Pre-school children (2-6 years). A well-designed, integrated child development service will help cater to the nutritional and healthcare needs of this age group (Measham and Chatterjee, 1999).
n Youth (6 to 20 years). A nutrition-based noon meal programme in all schools (public and private, rural and urban) will help to improve the nutritional status of this group. However, a significant percentage of children belonging to this age group are not able to go to school due to economic reasons. Such school ‘push-outs’ or child labourers need special attention.
n Adults (20 to 60 years). The nutrition safety net catering to this category should consist of both an entitlements programme like food stamps and the Public Distribution System (PDS), as well as a food for eco-development programme (also called ‘food for work’ programme). The food for eco-development programme can promote the use of food grains as wages for the purpose of establishing water harvesting structures (Water Banks) and for the rehabilitation of degraded lands and ecosystems. Thus, many downstream benefits and livelihood opportunities will be created. In designing a nutrition compact for this age group, persons working in the organised and unorganised sectors will have to be dealt with separately. Also, the intervention programmes will have to be different for men and women, taking into account the multiple burdens on a woman’s daily life.
n Old and infirm persons. This group will have to be provided with appropriate nutritional support, as part of the ethical obligations of society towards the handicapped.
The above whole life-cycle approach to nutrition security will help ensure that the nutritional needs of everyone in the community and of every stage in an individual’s life are satisfied.
Adopt a Holistic Action Plan to achieve sustainable nutrition security at the level of each individual
The major components of such an integrated action plan are the following:
n Identification: Identify those who are nutritionally insecure through local communities. Trained Community Volunteers of the kind mobilised in Thailand will be useful for this purpose.
n Education and information empowerment: Empower those who are not aware of their entitlements about the nutritional safety nets available to them and also undertake nutrition education. An entitlements database can be developed for each area and household entitlement cards can be issued, indicating how to access nutritional, healthcare and educational programmes. The educational programmes should also stress the conservation of essential nutrients in cooked food.
n Overcome protein-calorie under-nutrition: The various steps indicated under the whole life-cycle approach will have to be adopted. The problems of child labour and of persons working in the unorganised sector will need specific attention.
n Eliminate hidden hunger caused by the deficiency of micronutrients in the diet: Introduce an integrated approach, including the consumption of vegetables and fruits, millets, grain legumes and leafy vegetables and the provision of fortified foods like iron and iodine-fortified salt and oral doses of Vitamin A. The basic approach should be a food-based one, with an emphasis on home and community nutrition gardens, wherever this is socially and economically feasible (Gopalan, 2001).
n Drinking water, hygiene and primary healthcare: Attend to the provision of safe drinking water and to the improvement of environmental hygiene. Also, improve the primary healthcare system.
n Sustainable livelihoods: Improve economic access to food through market-linked micro-enterprises supported by micro-credit. Also, create an economic stake in the conservation of natural and common property resources. Ensure that agreements under the World Trade Organisation (WTO) provide a level playing field for products coming from decentralised small-scale production (production by masses or farmers’ farming) as compared to those emerging from mass production technologies or factory farming. Promote job-led economic growth and not jobless growth.
n Pay special attention to pregnant and nursing mothers and pre-school children: Measure progress through monitoring MMR, IMR, incidence of LBW children and male-female sex ratio. Iron-folate supplements during prenatal care should be accompanied by steps to overcome protein-energy deprivation. Mina Swaminathan (1998) has proposed a maternity and childcare code, which if adopted, will help to bring down speedily MMR, IMR, LBW and stunting. The sex ratio is a good index of the mindset of a society in relation to the girl child.
Community Food Bank as an instrument of sustainable food and nutrition security
Community Food Banks (CFB) can be started at the village level, with initial food supplies coming as a grant from governments and donor agencies like the World Food Programme. Later, such CFBs can be sustained through local purchases and from continued government and international support for food for eco-development and food for nutrition programmes. CFBs can be the entry point for not only bridging the nutritional divide, but also for fostering social and gender equity, ecology and employment. They can also be equipped to cater to emergencies like cyclones, floods, drought and earthquakes.
The CFBs can be organised with the following four major streams of responsibilities.
1. Entitlements: The benefits of all government and bilateral and multilateral projects intended for overcoming under-nutrition and malnutrition can be delivered in a coordinated and interactive manner (as for example those intended to overcome deficiencies of macro and micro-nutrients.)
2. Ecology: Food for eco-development with particular reference to the establishment of Water Banks, land care, control of desertification and afforestation. Thus, grain can be used to strengthen local-level water security.
3. Ethics: This group of activities will relate to nutritional support to old and infirm persons, pregnant and nursing mothers and infants and pre-school children.
4. Emergencies: This activity will relate to the immediate relief operations following major natural catastrophes like drought, floods, cyclones and earthquakes, as well as to meet the challenge of seasonal slides in livelihood opportunities.
Each of the above four streams of activities can be managed by four separate self-help groups of local women and men. This will help to generate a self-help revolution in combating hunger. The overall guidance and oversight may be provided by a multistake-holder Community Food Bank Council.
Resource centres for CFBs
For the CFB movement to succeed there is need for training managers of such food banks and for building the capacity of the Community Oversight Council to plan and monitor the different programmes. Training modules will have to be prepared for this purpose. Accounting and monitoring software will have to be developed and the members of the self-help groups will have to be trained in the use of the software and in managing computer-aided knowledge centres linked to CFBs. Four training modules relating to entitlements, eco-development, ethics and emergencies will have to be developed, so that each SHG is headed by a professionally trained woman or man. A network of institutions which will provide the necessary managerial, technical and training support to managers of self-help groups and CFBs will have to be organised in every country where there is a strong political commitment to ending the nutritional divide as soon as possible.
M.S. Swaminathan, a founding father of the Green Revolution in India, worked to develop the nation’s food security as Secretary for Agriculture. He has also been Director General of the Indian Council of Agricultural Research and the International Rice Research Institute, Independent Chairman of the FAO Council, and President of the International Union for the Conservation of Nature and Natural Resources. He is a member of the Royal Society, the US National Academy of Sciences, the Russian Academy and the Italian and Chinese Academies. His honours include the World Food Prize, UNEP’s Sasakawa Award and the Tyler and Honda Prizes. He lives in Chennai, where he heads the Centre for Sustainable Agricultural and Rural Developmen