Sidhi, Madhya Pradesh: For two years, Santlal Singh has not received the monthly food packets for his daughters from the local anganwadi in Mankisar village of Churhat block in Sidhi district, in north-eastern Madhya Pradesh. “Last year, I went to the anganwadi centre to ask about it, but the madam said that they are out of stock,” said Santlal Singh, a farmer and father of two daughters, Sangeeta, 15, and Lalli, 12.

The girls are eligible for food packets under the Scheme For Adolescent Girls (SAG), a project initiated in 2010 in 200 districts  selected on the basis of nutritional indicators of adolescent girls aged 11 to 18 years.  

Santlal Singh, who also has a 14-year-old son, owns 2 acres of land on which he sows paddy and maize in the kharif season and wheat and arhar (pigeon pea) in the rabi season.

There was insufficient rain at the time of sowing his latest crop, he said, anticipating a low output. Misfortune had struck the previous season too, with stray cattle destroying much of his crop. 

“Ghar me teen bache hain, unka paalan poshan nahi ho pa raha.” (I have three children, I’m struggling to feed and raise them),” he told Article 14.

Sangeeta and Lalli have dropped out of school and spend the day helping around the house and the fields. Singh admitted that his poor financial condition is one of the reasons why his daughters quit school. The boy, Prateek, attends a private school in Churhat town.

In September 2022, the accountant general of the Madhya Pradesh state government discovered a scam worth Rs 110 crore in the distribution of ‘take home ration’ (THR), a key tool in the supplemental nutrition programme.  

The record of beneficiaries was inflated, the audit report found that—29,000 girls were reported to have been provided the rations, but only three girls were registered for the scheme—and a key baseline survey of beneficiaries skipped altogether. It found that recorded production of the packets was beyond plants’ permitted capacity with a discrepancy of Rs 58 crore in ration packets claimed to have been produced; and transportation vehicles’ data had been falsified.

Experts and health workers told Article 14 that the scam was emblematic of Madhya Pradesh’s poor record in tackling child malnutrition, infant mortality and anaemia among adolescent girls.

Madhya Pradesh had an Infant Mortality Rate (IMR) of 46 per 1,000 live births in 2019, compared to the national average of 30, according to data published by the Registrar General of India. The Sample Registration System’s statistical report for 2018, coinciding with the occurrence of the alleged irregularities, estimated MP’s under-5 mortality rate at 56/1,000 live births (the worst ratio among all states) and the third highest maternal mortality rate (173/100,000 live births). Additionally, over 58% of adolescent girls aged 15-19 years in MP are anaemic, according to NFHS-5 data (2019-21).

The audit recommended that the government initiate an investigation by an independent agency and “fix the responsibility of officials at all levels—child development project officers (CDPOs), district project officers (DPOs), manufacturing plants’ officials, and officials who arranged for transportation, etc, and all other officials who were directly or indirectly involved in these frauds or facilitated the frauds due to their negligence…”

Usha Singh Solanki, joint director of the Rewa division of the women and child development department, acknowledged that beneficiaries had been denied their right under the scheme. “There were irregularities in the supply of ration packets by plants over the last few months,” she told Article 14.

“The take home ration packets have been made available,” said Solanki, “but if the anganwadis do not distribute them, strict action will be taken.”

How The State Exchequer Was Milked 

Under the SAG component of the Integrated Child Development Services (ICDS), one of the world’s largest nutrition support programmes with 89 million beneficiaries, the Indian government provides supplementary nutrition through ‘take-home rations’ for adolescent girls in select district, in addition to nutrition for all children up to the age of 6 years. The other components of the ICDS include health education, pre-school non-formal education, immunisation programmes, etc. A separate scheme of the ICDS also provides supplementary nutrition for pregnant and lactating women.

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In MP, the take home rations include eight varieties of packets, including a wheat-soya premix, a khichdi (rice and lentil preparation) premix, and a premix flour of wheat and chickpea for aata-besan laddoos. All these are fortified foods that provide essential nutrients. 

The supplementary nutrition is to be provided for a minimum of 300 days each year at anganwadi centres—12-15 grams of protein and 500 calories per day for children aged 6 months to 6 years, and 20-25 grams of protein and 800 calories per day for severely malnourished children. Pregnant/lactating women and adolescent girls are provided food with 18-20 grams of protein and 600 calories per day.

The ICDS schemes are administered by the state’s women and child development department, currently under chief minister Shivraj Singh. 

The main findings of the audit report:

1. MP’s department of women and child development did not complete a baseline survey to identify out-of-school adolescent girls (OOSAGs) for the distribution of take-home rations by the April 2018 deadline set by the state and central governments. The department estimated that there were 3.608 million beneficiaries among this category of adolescent girls, though the school education department had estimated the number of out-of-school adolescent girls at 9,000 in 2018-2019.

2. While the department  claimed to have distributed take-home rations to over 29,000 out-of-school adolescent girls in the period 2018 to 2021 , the audit revealed that there were only three such girls registered at 49 anganwadi centres in the eight districts for which the audit was conducted.

3. Several manufacturing plants where the take-home rations were produced and packaged had recorded production beyond their permitted capacity. The audit report said officials at these plants falsely reported production of ration packets  worth 580 million rupees during the period 2018 to 2021.

4. Six manufacturing plants surveyed, located in Badi, Dhar, Mandla, Rewa, Sagar and Shivpuri, claimed to have transported ration packets at a cost of Rs 269.4 million, but an investigation of vehicle registration databases showed that vehicles not registered as trucks were claimed to have been used. Some vehicles recorded as having transported the packets were not in the vehicle registration database at all.    

5. All samples sent to independent laboratories, from 38,304 metric tons of ration packets produced at a cost of Rs 2.37 billion in the period 2018 to 2021, did not meet nutritional requirements.

6. As many as 2,865 ration packets were still available in the Shivpuri and Sagar districts’ warehouses though these were marked as having been distributed.

7. In all of eight audited districts, the child development project officer (CDPO) and the district project officer (DPO) failed to conduct inspections of anganwadi centres during the period 2018-2021.  

Pregnant Women Failed To Get Nutritional Supplements 

The Singhs of Mankisar village were not the only family struggling to access a government scheme guaranteeing nutrition for their girl children. 

Rajvanti Devi, a 25-year-old housewife in Rampur Naikin block of Sidhi district, lost her child while giving birth in April 2022. Doctors told her she was anaemic during her pregnancy, advising her to eat a healthy diet before attempting another pregnancy . 

“During the nine months of my pregnancy, I received ration packets from the anganwadi only twice,” she told Article 14. On asking the anganwadi staff, she was told stocks were not available. 

The ICDS scheme for pregnant women and lactating mothers aims to empower them in providing better nutrition for their children, and to reduce the rates of mortality, morbidity and malnutrition.

Rajvanti confessed that she had been unable to eat green vegetables, nuts, milk or other nutritious foods during her pregnancy.

Rajvanti's husband Rajesh Singh works as a migrant labourer in Surat, at a saree-manufacturing plant. He sends Rs 2,500-Rs 3,000 every month to run the household. This barely suffices for essential expenses, and was never enough to purchase additional nutritious food for herself, she said. 

Amulya Nidhi, an expert on health policy and convenor of the People’s Health Movement India, said it was the government’s responsibility to ensure food security in order to reduce malnutrition. “The government should survey the food patterns in the area and provide pulses, milk products, eggs, etc,” he said. 

Madhya Pradesh’s Poor Child Health Indicators 

According to Nidhi, the state government has done little to reduce anaemia. In fact, a comparison of data from the NFHS-4 and NFHS -5 showed anaemia among adolescent girls rising by 5% in the state.

Santlal Singh said his daughter Lalli fell severely unwell  four months ago. When they went to the doctor, he said  she was underweight and suffering from malnutrition. “She was anaemic due to a poor diet,” the tired father told Article 14.

As per NFHS-4, released in 2015, 42% of Madhya Pradesh's under-5 children are malnourished, higher than the national average (35 percent). 

In a written reply to the assembly on 16 March 2022, minister of state for horticulture and food processing, Bharat Singh Kushwah, said the state has over 6.5 million children under five years of age; 1.032 million of them are malnourished; and 632,000 children suffer from severe malnutrition. As many as 264,000 are stunted and 1.3 million show severe wasting. 

Opposition Charges BJP Govt With Overlooking Corruption 

“It does not seem as if the BJP government intends to improve the horrendous IMR and MMR records,” Digvijay Singh, Congress leader and former Madhya Pradesh chief minister, told Article 14. “Their agenda is based on Hindu-Muslim divisive politics, and they don't care about poor and tribal people.”

Singh charged the BJP government with corruption in various health and wellness schemes. “There is a big racket of corrupt ministers and government officers who profit from these scams. This case will be forgotten, just like other corruption cases, including Vyapam.” The Vyapam scam was a corruption scandal in entrance examinations and recruitment in 2013-14, with the accused including ministers, middlemen, medical college owners and bureaucrats.

“Corruption and scams are common in every scheme, in every work under the BJP government in Madhya Pradesh,” former chief minister Kamal Nath tweeted on 5 September 2022. “Now a nutritious meal scam has been revealed in the Shivraj Singh Chouhan government.”

Narottam Mishra, home minister and the MP government’s spokesperson, said the audit report was not final.

Mishra said the audit report was based on a preliminary probe, and auditors had not taken into account all the stocks.  

“Auditors took into account only those poshan-aahar (supplementary nutrition) packets whose bills were paid, but did not record those whose payments were pending,” he said at a press conference on 7 September 2022. “This poshan-aahar was transported and was not listed in the stock books.”

Poor wages reduce efficiency of workers on the  ground

Anganwadi workers in MP protested for more than 45 days in April 2022, demanding Rs 1,500 in addition to their honorarium of Rs 4,500, and regularisation of their jobs. The demand for arrears since October 2018, based on a government promise to hike the allowance of anganwadi workers by Rs 1,500 per month, was not met. Anganwadi workers also said the government had failed to pay the promised incentives for additional work they did during the Covid-19 pandemic and lockdowns. 

There are a total of 80,160 anganwadi centres and 12,070 sub-anganwadi centres in MP that have been approved for use in 453 child development projects.

Shanti Sahu, an anganwadi worker from Madwa village of Sidhi district, said, “Char mahina se kuch nahi mila. Baap-mahtari gohar maare ha, ham log ka jawab de. (We have not received any food packets for the last four months. Parents often ask us about take-home ration packets, and we don't know what to tell them.)” 

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She said her centre received packets for children up to the age of three years, and for pregnant women and lactating mothers, but had not received the packets for adolescent girls for two years.

She told Article 14 that she had raised the issue of non-availability of the ration packets with her seniors several times, but to no avail.

Another anganwadi worker who wanted to stay anonymous said the government had introduced cellphone app-based attendance monitoring of anganwadi workers, a measure that had already been a challenge since many women do not know how to operate the application. “The government didn’t provide us a mobile phone,” she said. “We hardly earn Rs 10,000 per month, and we have to buy the monthly data and phone ourselves.” She said working as an anganwadi worker had posed a new  financially strain. 

Ratan Singh, project officer from Rapur Naikin of Sidhi district, confirmed that his  centres had also not received the ration packets for adolescent girls for four months. “I have raised the issue with senior officers and they have assured me that it would be resolved in a few days,” he said. 

Meanwhile, in April 2021, Santlal Singh contracted Covid-19 and was seriously ill. He spent nearly Rs 4 lakh on his hospitalisation and treatment. He continues to visit Nagpur for monthly check-ups, spending at least Rs 2,000 on medicines every month.

“Kangali me padha likha kaise payenge ab?  (How do I afford their education in my current financial condition?)” asked Santlal Singh. “Both girls help their mother.”

His poor health has meant he cannot find work as a daily wage worker during the non-farming season. “I’m taking loans from friends and family members for my medical expenses,” he said.

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(Anil Kumar Tiwari is an independent journalist based in Madhya Pradesh.)