Children suffering from severe acute malnutrition (SAM) in urban areas are likely to get ready-to-eat energy dense nutritious food (EDNF) paste to fight deficiencies. While the plan has been approved in principle by the Maharashtra government, it is awaiting a nod from the Centre.
The ready to eat EDNF is a paste made of peanuts, oil, sugar, milk powder, nuts, and other nutrition-rich ingredients. Used as a medical intervention, the paste is given to SAM-affected children along with other meals in anganwadis.
“SAM affected children are 10 times more susceptible to infections and diseases. We needed interventions for them in the urban areas as well,” said Idzes Kundan, secretary, Women and Child Development Department, adding that the idea is to have urban child development centres on the lines of village child development centres where SAM children get the therapeutic paste. “We have sent the proposal to the Centre and we hope that approval will come soon,” she said.
In Maharashtra, 22 districts have recorded high incidence of stunting and the worst affected are Nandurbar, Yavatmal and Parbhani. As far as SAM is concerned, Gadchiroli, Chandrapur and Beed remain the worst affected. While malnutrition in tribal and rural areas is mostly triggered due to inadequate food or lack of it, in urban areas, lack of proper micronutrient-rich food, high intake of junk food have been the common reasons.
Through the anganwadis, the government gives take-home ration to children between six months and three years of age, SAM-affected children between six months and six years, and pregnant and lactating mothers. Additionally, a morning snack and hot cooked meals for lunch are given to children between three and six years.
According to the World Health Organization, ready-to-use therapeutic food (RUTF) has revolutionised the treatment of severe malnutrition — providing foods that are safe to use at home and ensure rapid weight gain in severely malnourished children. A January 2019 study carried out in Urban Health Centre at Dharavi and two day care centres in the city had concluded that “indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) appeared to be superior to Standard Nutrition Therapy in promoting weight gain in children with SAM”.
But not all responses are in favour of the therapeutic paste. Some activists have labelled these initiatives as a nexus between the food industry and the government, while some have questioned its efficacy. “The taste preferences of our children vary. We have observed that some don’t like the peanut-based paste while some have a tendency to get addicted to it,” said Mukta Srivastav, Maharashtra convenor of Anna Adhikar Abhiyan and member of Jan Arogya Abhiyan.
She said a study carried out early this year looked at 40 SAM-affected children in one block each in Amravati and Nandurbar. “Overall, 27 children had stopped consuming the paste midway,” said Ms. Srivastav adding that most children were given three packets in a day which became an overload and they could not consume anything else after that. Some even complained of diarrhoea and vomiting.
“There is definitely a lobby behind this unnecessary promotion of RUTF. The government should instead focus on local recipes for nutrition,” she added.
