Morthala (Rajasthan): When the women of this village sit down to eat, it is usually after the rest of the family had finished its meal — the men first, the children next and themselves last.
This is a common practice in many households, but among the rural poor it makes women and children — some of the weakest in the world — hungrier and sicklier, sparking a cascade of slow development, eventually implicated in holding back national economic progress.
A two-year-old project in Rajasthan used an unusual strategy to break this pattern among poor tribal communities in Sirohi and Banswara districts. Instead of simply increasing their food supply and access — the standard approach for dealing with malnutrition — it attempted to break the tradition of prioritising men’s needs first.
“We were advised to serve meals only after all the family members are seated so that everyone gets served equally and we discuss food,” said Rukmani, one of the project beneficiaries.
Behind this strategy of the Rajasthan Nutrition Project, launched in 2015, was a baseline survey of 403 women. It revealed that those with a lesser say in running their households were more likely to have less food for their children and were themselves vulnerable to malnutrition.
So, the Rajasthan campaign, executed by Freedom from Hunger India Trust and Grameen Foundation, both non-profit outfits, made women more health- and nutrition-aware and sensitised their husbands to gender equality.
“We chose to address intra-household food consumption disparity — the fact that in one household alone, the women and children could be food insecure while the men are food secure,” said Saraswathi Rao, CEO, Freedom From Hunger India Trust.
Over two years, the project has touched the lives of 30,000 people and among the 403 women who were sampled, more than doubled the number of women and children who always have enough to eat.
Before the intervention, 31 per cent women had reported that their husbands alone decided how much food to serve the family. After being told to make decisions jointly, no more than three per cent of men continued to take this call alone, while the number of couples making joint decisions increased from 12 to 19 per cent. Also, 53 per cent households reported eating more meals together as a family.
The project’s approach is significant in another respect. Economists have long wrestled with a problem often referred to as the India Enigma: Despite greater economic progress child health indicators fare worse than those of sub-Saharan African nations.
So, the solution does not appear to lie in increasing household food supply and access to food — as the government does through the Public Distribution System and Integrated Child Development Services (ICDS), respectively.
Interviews with the 403 women revealed who made household decisions about food, mobility and communication. This, in turn, was found to closely correlate with their own and their children’s food security.
Among the women who reported having greater autonomy, 39 per cent respondents and 42 per cent of their children had enough to eat. Only 12 per cent women with lower levels of autonomy and 17 per cent of their children reported having enough to eat.
The study revealed that any effort designed to improve food security and nutrition had to aim at improving women’s autonomy and decision-making within the household, said Kathleen Stack, Executive Vice President of the Grameen Foundation.
One of the project’s aims was to increase the food available for the sample set of women and children. This was measured by moving them up at least one point on a four-point scale.
Women were also encouraged to use the food distributed to pregnant and lactating women and young children under the ICDS. Some women had not used this service because they did not know of it, others because their families restricted their movements.
“We never knew that the anganwadi provides children (aged 3 to 6 years) a free daily meal, a variety of meals like daliya (porridge) and khichdi (a rice and lentil preparation), and take home rations for infants,” said Meera, leader of a self-help group (SHG) involved in the project.
To improve their family’s nutrient intake, women were advised dietary diversity, especially to eat more fruit and vegetables. This was unthinkable for many of the tribal women, who had no money to buy extra food.
So seeds were sourced from local government agencies and then women were helped to create kitchen gardens; even those with limited water supply started using waste wash water to grow a few vegetables.
Women now reported consuming an average of three additional foods a day. Their intake of green leafy vegetables increased 344 per cent, their consumption of yellow/orange coloured veggies rose 940 per cent and their milk intake rose 70 per cent.
Nutrition tips the women took to implementing included guidelines such as “cook in an iron pot” and “make more nourishing rotis by mixing a couple of grains like wheat, corn and pearl millet instead of using only wheat” and “breastfeed your children in the first hour after birth”.
Among the 403 study participants were 21 pregnant women, an intentional inclusion to gauge how women’s autonomy affected breastfeeding.
When the women were first interviewed, it turned out that those with a say in their household finances were more likely to report exclusively breastfeeding their child for six months. Over the course of the engagement, the percentage of new mothers who breastfed infants within the first hour of birth increased from 47 per cent to 83 per cent.
“We found the methodology effective because it involves the community; making local women a part of the solution always works better than advocacy by an external agent,” Roli Singh, Secretary, Department of Women and Child Development, Rajasthan, told IndiaSpend.
At recent national and state level consultations in Delhi and Jaipur, Arun Panda, (then) Additional Secretary and Mission Director, National Rural Health Mission, released a policy brief and a technical guide based on the Rajasthan project.
“Simple and cost-effective solutions can easily be understood, adopted and sustained,” he said.
Back in Morthala, women’s lives have changed forever. Thanks to a small change in their mealtime routine.
(In arrangement with IndiaSpend.org, a data-driven, non-profit, public interest journalism platform. Charu Bahri is a freelance writer and editor. The views expressed are those of IndiaSpend. Feedback at respond@indiaspend.org.)