Tuesday, May 26, 2009

Performance of the Mid Day Meal Scheme

The National Programme of Nutritional Support for Primary Education—NPNSPE (i.e. the national Mid Day Meal Scheme—MDMS) was initiated by India in the year 1995. Since then the number of states providing cooked meals rose sharply from early 2002 onwards, after a Supreme Court order (dated 28 November 2001) directed all state governments to introduce cooked mid-day meals in primary schools (NAC, 2004)[1]. The MDMS dates back to 1925 when Madras Corporation developed a school lunch programme [Deodhar et al, (2007)][2]. After Independence, school-feeding programme commenced in the state of Tamil Nadu during the year 1956 and got impetus under MG Ramachandran in the year 1982 [De, Noronha and Samson (2005)][3].

Effectiveness of MDMS
The purpose behind the MDMS was to enhance enrolment, retention, and participation of children in primary schools, simultaneously improving their nutritional status. The MDMS was revised and universalized in September 2004 and central assistance was provided at the rate of Re. 1.00 per child per school day for converting food grains into hot cooked meals for children in classes I–V in government, local body, and government-aided schools. The number of children covered under MDMS has increased from 3.34 crore in 3.22 lakh schools in 1995 to 12 crore in 9.5 lakh primary schools/ EGS (education guarantee scheme) centres in 2006–07. It is speculated that MDMS will cover about 18 crore children by the year 2008–09. The nutritional value of meals for upper primary children has been fixed at 700 calories derived from 150 gm of cereals and 20 gm of protein. The maximum permissible transport subsidy has been revised for Special Category States from Rs 50 to Rs 100 per quintal and for other States to Rs 75 per quintal. The scheme was revised in June 2006 to enhance the minimum cooking cost to Rs 2.00 per child per school day to provide 450 calories and 12 grams of protein. It has been reported that the MDMS has benefited 8.1% of rural population and 3.2% of urban population. The MDMS has catered to the nutritional needs of low-income groups in both rural and urban areas (Planning Commission, 2007)[4].

Benefits of MDMS
The MDMS has many positive attributes such as a. Promoting school participation; b. Preventing classroom hunger; c. Facilitating the healthy growth of children; d. Intrinsic educational value; e. Fostering social equality; f. Enhancing gender equity; and g. Ensuring psychological benefits. In order to ensure transparency and accountability, it is required to display the following information suo-moto: a. Quality of food grains received, date of receipt; b. Quantity of food grains utilized; c. Other ingredients purchased, utilized; d. Number of children given mid day meal; e. Daily Menu; and f. List of community members involved in the programme. The Department of Science & Technology (DS&T) has been entrusted the Thrust Area item TA24 on ‘Firming up Science & Technology Application in Mid Day Meal’ by the Prime Minister’s Office. The overall objective under the identified Thrust Area is to develop appropriate technologies and operational models that will improve the administration of Mid Day Meal Scheme i.e. ensure delivery of warm healthy meals to target groups without incurring high cost.

From the table 1, one can decipher that rice and wheat allocations for MDMS have declined in between 2001-02 and 2006-07. Rice allocation has declined from 18.67 lakh tonnes in 2001-02 to 17.17 lakh tonnes in 2006-07. Wheat allocation has declined from 9.96 lakh tonnes in 2001-02 to 4.17 lakh tonnes in 2006-07. Rice offtake as a percentage of rice allocation has declined from 72 percent in 2001-02 to 61 percent in 2006-07. Wheat offtake as a percentage of wheat allocation has declined from 73 percent in 2001-02 to 68 percent in 2006-07.

From the graph 1, one can decipher that allocation of foodgrains for the MDMS has steadily declined from 28.63 lakh tonnes in 2001-02 to 21.34 lakh tonnes in 2006-07, which appears dismal. If the MDMS is supposed to be responsible for ensuring enrolment, attendance and retention in schools, then a declining allocation for the MDMS is expected to adversely affect students' participation in primary education under the Sarva Shiksha Abhiyan (SSA).

From the table 2, one can decipher that foodgrains allotted for MDMS under Central Assistance varies from 75,453.93 million tonnes in Uttar Pradesh to 21.01 million tonnes in Mizoram during 2007-08. The cooking cost varies from Rs. 10,060.52 lakh in Uttar Pradesh to Rs. 3.22 lakh in Mizoram. States like Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh have been allocated Rs. 124.00 lakh, Rs. 120.00 lakh, Rs. 109.00 lakh and Rs. 258.00 lakh, respectively for management, monitoring and evaluation.

A new privately funded programme named Akshaya Patra School Meal Initiative, which has been started by Akshaya Patra Foundation (TAPF) is now a national programme. It is spread over six states, namely: Karnataka, Andhra Pradesh, Uttar Pradesh, Rajasthan, Gujarat, and Orissa—with 14 locations within these states. It caters to nearly 9.1 lakh children. The Naandi Foundation provides mid-day meal to more than a thousand government schools in Andhra Pradesh and about a thousand in Madhya Pradesh and Rajasthan (SSMI, 2008)[5].

Lacunae in MDMS
The MDMS, like other schemes of the government, has been a victim of corruption and leakages. According to the Wikipedia (2009)[6]:

In January 2006, the Delhi Police unearthed a scam in the MDMS.
In December 2005, the police seized eight truckloads (2,760 sacks) of rice meant for primary schoolchildren being carried from Food Corporation of India (FCI) godowns in Bulandshahr district of Uttar Pradesh to North Delhi.
In November 2006, the residents of Pembong village under the Mim tea estate (around 30 km from Darjeeling), accused a group of teachers of embezzling mid-day meals.
In December 2006, The Times of India reported a scam involving government schools that siphon off foodgrains under the mid-day meal scheme by faking attendance.

According to a study of MDMS (termed as noon-meal scheme in Kerala) running in Kerala, which has been done by Gangadharan (2006)[7]: a. The physical facilities for MDMS are available only in 50% schools; 94% schools depend on firewood for cooking; separate building for kitchen outside class rooms are rare; adequate space is not there in 50% schools. School verandah is the main venue for serving food; b. The government grant is far less than the total expenditure in many schools. The average annual financial deficiency in schools is around 15%; c. Schools with less number of students have higher per day student expenditure; d. The Panchayati Raj Institutions (PRIs) have yet to show active interest in the management of the programme; e. The average MDMS enrolment rate is between 85 and 95 percent; f. There is a demand that the menu should be improved and made more attractive and the noon meal programme be made a full-fledged School Lunch Programme meant for all teachers as well as students with partial or free packages; g. Storage provisions are rarely available in most of the schools; and h. The cooks engaged in schools are untrained, inexperienced, aged and educationally under-qualified.

A study of MDMS in Rajasthan by CUTS (2007)[8] found: a. Initially, students were distributed boiled wheat supplemented with groundnut and jaggery (Gur) under the MDMS; b. More than 90% parents and students were satisfied with the MDMS; c. Each school is required to send a monthly expenditure statement and vouchers to the Panchayat Samiti, which is supposed to reimburse the amount within 15 days; d. Only 21% of the schools received the funds every month, in time. The rest got funds in a time ranging from 2 to 6 months (12% got funds once in 6 months); e. 97% of the teachers reported receiving good quality food grains; f. Only 23% of the schools were able to receive food grains after getting them weighed before delivery; g. The absence of a weighing mechanism in most schools makes it difficult to measure the quantity of food grains delivered; h. Most schools lack adequate cooking and storage facilities; i. 62% of the cooks interviewed said that the MDM was cooked in the open, which is unhygienic; and j. Teachers are spending close to 20% of their time or more on managing MDMS instead of teaching.

A study of MDMS in Delhi by De et al (2005)[9] show: a. MDMS was officially implemented on 1 July 2003 in only 410 Municipal Corporation of Delhi (MCD) schools. In the next phase, starting from September 2003, more schools were brought under the scheme, and all schools were covered since April 2004; b. MCD began with as many as 72 suppliers, which was whittled down to 56, then to 32 and presently consists of only 11 NGOs (non-government organizations), running 13 kitchens; c. The quality of rajma and vegetable pulao has not been upto the mark; d. Parents were never allowed to taste the meal distributed; e. Hygiene was seldom maintained in the case of MDMS; f. Some teachers preferred dry food instead of cooked meal; g. Most of the schools lack adequate infrastructure (including toilet facilities) for the successful implementation of MDMS; h. Serving of meal by various contractors under the disguise of NGOs has become a business venture; i. A few school children found the food very unattractive. Some said that eating the food made them ill; and j. Some parents felt that the food served was not sufficient for growing children.

A field survey so as to assess and monitor MDMS in Rajasthan, Karnataka, and Chattisgarh, was conducted by the Centre for Equity Studies[10] (Delhi) in early 2003. The main findings are: a. In 76 of the 81 sample schools, investigators found that mid-day meals were being served regularly; b. Infrastructural facilities (cooking shed, water supply, etc.) vary widely, and are often inadequate; c. Class I enrolment increased by 15% in the three states combined, between the 2001-02 and 2002-03 academic years; d. Since children often come to school without any breakfast, they find it difficult to concentrate on an empty stomach. Mid-day meals seem to have resolved this problem; e. Mid-day meals have also helped to avert an intensification of child undernutrition in many drought-affected areas; f. The experience of sharing a meal together may help overcome caste barriers. The survey found little evidence of open discrimination; g. Most lower-caste parents did not feel that their children had been subject to discrimination; and h. There has been upper-caste resistance to the appointment of dalit cooks.

A study conducted by Thorat and Lee (2004)[11] at Indian Institute of Dalit Studies (IIDS), New Delhi show: a. Uttar Pradesh and Bihar, where one third of India’s dalits live, deny dalit and other poor children access to their legislated entitlements from the very beginning, by simply refusing to implement the shared, cooked, MDMS; b. The distribution of dry grain to government school children under the MDMS takes place in dominant caste localities; and c. Employment of dalit cooks is problematic in Rajasthan and Andhra Pradesh.

A study conducted by Pratichi Trust (2005)[12] in West Bengal show: a. The MDMS was started in some 1,100 primary schools in five districts (Murshidabad, Birbhum, Bankura, Paschim Midnapore, and Jalpaiguri) and extended to some other districts. A total of 5,200 primary schools were brought into the fold of the programme till March 31 2004; b. Only a few of the richer households, mainly of Caste Hindu background, were against the continuation of the MDMS; c. There were a handful of upper caste children, who in unison with their parents’ inhibition towards the meal showed their disliking towards the cooked meal; d. Some children highlighted the need for a change in the monotonous menu of khichuri (made of boiled rice, pulses, turmeric, little oil and local vegetables) everyday; e. Inadequate salaries were paid to the cooks; f. In most of the schools, it was reported that the conversion cost was found too inadequate to make a proper meal; and g. The scope for involving the parents in the process of implementation of the programme was very limited.

Recently, it has been noticed that Ms. Renuka Chowdhury, the Union Minister of State for Women and Child Development, has become keen on public-private partnership for delivering ready-to-eat packaged food in schools instead of cooked meal. Many feel that such a move would lead to intensification of Contractor Raj and would create obstacle towards decentralization. The Ministry has tried to project that hot cooked meal has failed to address malnutrition in order to introduce ready-to-eat packaged food under the MDMS (SSMI, 2008)[13]. In Chattisgarh, the involvement of Mithanins has contributed to reduction of teacher absenteeism and misbehavior of teachers in the schools and has increased effectiveness of the MDMS.

Recent policy measures
In 2007-08, Central Government approved the inclusion of Inflation Adjusted Index (Consumer Price Index) for calculation of central assistance towards cooking cost once in every two years, which will be applicable from 2008-09 for primary and upper primary stages (Economic Survey, 2007-08). An allocation of Rs. 8000 crore for the MDMS has been done during the Interim Budget 2009-10.

Provision of dry rations and biscuits, which were part of the NPNSPE before the Supreme Court order on cooked meals has shown that children often did not consume these. Although MDMS has ensured enrolment but it had little impact on attendance and retention levels [Baru et al (2008)][14]. Records at the Department of Public Instruction show that school attendance has improved since the introduction of the MDMS by 2-10% across Karnataka (Ravi, 2006)[15]. Since the Supreme Court says that the onus to monitor the implementation of the scheme essentially lies with the Central government, as it is the Central government that is providing assistance, it is important that leakages from the MDMS should be stopped at all cost. The quality of cooked food served needs to be enhanced. More allocation of funds for MDMS would be able to attract students in the Sarva Shiksha Abhiyan (SSA) and increase retention in schools (Zaidi, 2005)[16]. Free mid-day meals for school students were first introduced in a Japanese private school in the late 1800s, in Brazil in the year 1938 and in the United States in the year 1946 (Parikh and Yasmeen, 2004)[17]. Seeing the experiences of countries like Brazil, the United States and Japan, the MDMS should not be discarded by the government.

[1] NAC (2004): Recommendations on Mid-day Meals (based on deliberations of the National Advisory Council on 28 August 2004, http://pmindia.nic.in/nac/communication/meal.pdf
[2] Deodhar, Satish Y et al (2007): Mid Day Meal Scheme: Understanding Critical Issues with Reference to Ahmedabad City, Working Paper No. 2007-03-03, Indian Institute of Management, Ahmedabad
[3] De, Anuradha, Noronha, Claire and Samson, Meera (2005): Towards more benefits from Delhi’s midday meal scheme, CORD—Collaborative Research and Dissemination, New Delhi, October, http://www.righttofoodindia.org/data/cord2005mdmdelhi.doc
[4] Planning Commission (2007): Chapter 1: Education, Government of India,
[5] SSMI (2008): Brief Report of the National Seminar on Feeding the Child, Organized by the Swami Sivananda Memorial Institute (SSMI), India International Centre (IIC), New Delhi, 26 February,
[6] Wikipedia (2009): Mid day Meal Scheme, http://en.wikipedia.org/wiki/Mid-day_Meal_Scheme
[7] Gangadharan, VA (2006): Noon Meal Scheme in Kerala,
[8] CUTS (2007): Measuring Effectiveness of Mid Day Meal Scheme in Rajasthan, India, CUTS Centre for Consumer Action, Research & Training (CUTS CART) in partnership with the World Bank, March
[9] De, Anuradha, Noronha, Claire and Samson, Meera (2005): Towards more benefits from Delhi’s midday meal scheme, CORD—Collaborative Research and Dissemination, New Delhi, October, http://www.righttofoodindia.org/data/cord2005mdmdelhi.doc
[10] Centre for Equity Studies (2003):
[11] Thorat, Sukhdeo and Lee, Joel (2004): Dalits and the right to food: Discrimination and exclusion in food related government programs, Indian Institute of Dalit Studies (IIDS), http://www.righttofoodindia.org/data/thorat_dalitsrtf.doc
[12] Pratichi Trust (2005): Cooked mid-day meal programme in West Bengal–A study in Birbhum district, http://www.righttofoodindia.org/data/mdm_pratichi_birbhumstudy.doc
[13] SSMI (2008): Brief Report of the National Seminar on Feeding the Child, Organized by the Swami Sivananda Memorial Institute (SSMI), India International Centre (IIC), New Delhi, 26 February, http://www.righttofoodindia.org/data/Report_of_the_seminar_on_feeding_the_child08.pdf
[14] Baru, Rama et al (2008): Full Meal or Package Deal?, Economic and Political Weekly, 14 June, http://www.righttofoodindia.org/data/baruetal08full-meal-or-package-deal.pdf
[15] Ravi, Padmalatha (2006): School meals make slow progress, India Together,
[16] Zaidi, Annie (2005): Food for education, Volume 22 - Issue 05, Feb. 26 - Mar. 11, Frontline, http://www.frontlineonnet.com/fl2205/stories/20050311000704900.htm
[17] Parikh, Kalpana and Yasmeen, Summiya (2004): Groundswell for mid-day meal scheme, India Together, http://www.indiatogether.org/2004/jan/pov-midmeal.htm

Sunday, May 10, 2009

Mexican swine flu—A new threat to humanity

In order to counter the outbreak of Mexican flu or what has been popularly termed as "swine flu", the Mexican government has been provided recently with a relief aid amounting to $ 25.6 million by the World Bank. This is expected to enable Mexico to instantly buy drugs such as Tamiflu, medical supplies and equipment, and to beef up testing capacity in an effort to combat H1N1 flu at the national level (World Bank, 2009)[1]. The reputed Centers for Disease Control and Prevention (CDC), based in Atlanta, United States has decided to abandon the term "swine flu" and refer to the present outbreak as the "H1N1 flu" from now onward. It is debatable whether the present virus actually originated from pigs. In fact, the virus, which is circulating, is suspected to be a cocktail of genetic components of human, avian and swine origin, according to the World Organisation for Animal Health (OIE). The OIE (2009)[2] has stated that ".. the currently circulating A/H1N1 influenza virus is not simply a swine influenza virus (it has reassortant genetic material of human, avian and swine origin).." The OIE has noted that ".. swine influenza has not been shown to be transmissible to people through eating pig meat or other products derived from pigs .." Hence, it has requested members against culling of pigs. The usage of the term "swine flu" has led countries like Russia and China to ban pork imports from Mexico and the US (Sinha, 2009)[3], thus affecting international trade as well as world tourism in the backdrop of global economic slowdown.
Smithfield Corporation, the largest pig producer in the world, whose farm is being alleged as the source of the H1N1 outbreak, denies any connection between the pigs they produce and sell, and the flu that has spread. In the year 1997, Smithfield was fined $12.6 million for violation of the federal Clean Water Act (Foley, 2009)[4]. A new report titled: 'The Trouble With Smithfield: A Corporate Profile', which has been brought out by the consumer advocacy group 'Food & Water Watch', provide the details of the damage the world’s largest pork producer—Smithfield Foods has caused to the environment, animal welfare, public health, family farmers, and workers around the world (Food and Water Watch, 2009)[5]. However, Granjas Carroll, a firm managed by the US-Mexican company Smithfield, has issued a statement in April, 2009 saying none of its employees had shown any signs of illness and noting that the sick are people who had no contact with its pigs. It is one of the numerous farms operating in the region. The new form of flu is suspected to have caused the deaths of 149 people and that 1,995 possible cases have been reported at hospitals in Mexico, all patients suffering from serious pneumonia; of those, 172 have been confirmed as infected with the new strain of virus. Some health experts feel that masks do little to prevent the spread of the virus (Wilkinson and Sánchez, 2009)[6].
Experts feel that industrial animal husbandry, which involves keeping the animals in close confinement, injecting them with antibiotics so as to keep them alive in the crowded conditions and creating of vast pools and piles of waste might have promoted the spread of disease. Intensification of large-scale industrial hog farming for more and more profits took place around Mexico during the recent years. The Centers for Disease Control and Prevention (CDC) finds that "people who work with livestock may develop adverse health effects, including chronic and acute respiratory illnesses and musculoskeletal injuries, and may be exposed to infections that travel from animals to humans. Residents in areas surrounding CAFOs (concentrated animal feeding operations) report nuisances, such as odour and flies". The usage of antibiotics may contribute to the development of antibiotic-resistant pathogens. Pesticides and hormones used in CAFOs may lead to hormone-related changes in fish. Nutrients such as ammonia, nitrogen, and phosphorus, that are used can reduce oxygen in surface waters, encourage the growth of harmful algal blooms, and contaminate drinking-water sources. Trace elements, such as arsenic and copper, can contaminate surface waters and cause harm to human health (CDC, 2009)[7]. Workers employed in hog farms of North America and Europe are more likely to be infected with potentially lethal pathogens such as MRSA (Methicillin-resistant Staphylococcus aureus), drug resistant E. coli and Salmonella, along with swine influenza (Kirby, 2009)[8].
According to an extensive 2½-year examination conducted by the Pew Commission on Industrial Farm Animal Production (PCIFAP), in a study released on 29 April, 2008, the current industrial farm animal production (IFAP) system often poses unacceptable risks to public health, the environment and the welfare of the animals themselves. The study notes that the IFAP system has given monopoly power to certain large companies that process and sells animal products. Streamlined processing and standardization led to vanishing of "open markets" for animal products. The new production system runs by depending on less skilled employees. The IFAP system can be harmful to workers and neighbours. The workers employed in hog farms can serve as a bridging population, transmitting animal-borne diseases to a wider population (Pew Commission, 2008)[9].
In order to know the human cases of H1N1 influenza in the European region, one can look at the graph 1. One can decipher from the graph that most of the human cases of influenza A(H1N1) were reported from Spain (88) and United Kingdom (34). Cases were found among people who have traveled to affected areas in the Americas. On 4 May 2009, WHO/Europe was informed of the first laboratory-confirmed case of influenza A(H1N1) in Portugal. On 7 May 2009, WHO/Europe was informed of the first laboratory-confirmed case of influenza A(H1N1) in Poland. The new strain of the virus has spread beyond Mexico and the US, with confirmed cases in eighteen countries and suspected cases in more than forty-two. Officials from World Health Organisation (WHO) and Centers for Disease Control and Prevention (CDC) believe that the outbreak may become pandemic. Prior to the swine flu outbreak, the WHO worldwide pandemic alert was set at Phase 3 due to H5N1 "avian flu", which spread widely in birds with occasional cases in humans. After the outbreak of "swine flu", the WHO raised its alert level to Phase 5 out of 6 possible, which it defines as a "signal that a pandemic is imminent" (Wikipedia, 2009)[10].
India has recently kicked off a massive containment exercise, screening all international passengers arriving from the US, Canada and Mexico with influenza-like symptoms (Sinha, 2009)[11]. The Centre has deployed 165 doctors and 86 paramedics at 67 counters of different airports across the country. After keeping 4 different persons, who have traveled to India recently, under observation, Government health officials & WHO have subsequently stated that there is no "swine flu" in India (Wikipedia, 2009)[12]. In the meanwhile, the Government of India has declared that it has taken necessary steps to thwart the rising price of Oseltamivir phosphate or Tamiflu—an oral anti-viral drug, to combat "swine flu". It has issued a circular to ban the retail sale of Tamiflu.

[1] World Bank (2009): World Bank Transfers $25 Million to Mexico for H1N1 Flu
[2] OIE (2009): The OIE strongly counsels against the culling of pigs, World Organisation for Animal Health, http://www.oie.int/eng/press/en_090430.htm
[3] Sinha, Kounteya (2009): Name dilemma: Swine flu or Mexican flu?, The Times of India, 30 April
[4] Foley, Stephen (2009): For La Gloria, the stench of blame is from pig factories, The Independent, 29 April
[5] Food and Water Watch (2009): New Report Highlights the Trouble with Smithfield
[6] Wilkinson, Tracy and Sánchez, Cecilia (2009): Mexico tries to focus on source of infection, Los Angeles Times, 28 April
[7] CDC (2009): http://www.cdc.gov/cafos/about.htm, Centers for Disease Control and Prevention, Atlanta
[8] Kirby, David (2009): Swine Flu Outbreak: Nature Biting Back at Industrial Animal Production, Huffington Post, 26 April
[9] Pew Commission (2008): Putting Meat on The Table: Industrial Farm Animal Production in America, A Report of the Pew Commission on Industrial Farm Animal Production, 29 April, http://www.ncifap.org/
[10] Wikipedia (2009): 2009 swine flu outbreak
[11] Sinha, Kounteya (2009): WHO puts swine flu on higher alert level than bird flu, The Times of India, 29 April
[12] Wikipedia (2009): 2009 swine flu outbreak by country