Mumbai: Discarding the Centre’s notification to stop distributing ready to use therapeutic food to tackle malnourishment in the region, Nandurbar administration has been acting in contradiction to the directives. Nandurbar administration has procured stocks of the readymade food paste for children with severe acute malnourishment in the tribal district. According to officials, the procurement has been made using District Planning Committee funds.
On September 14, responding to a public interest litigation against RUTF, the state’s women and child development (WCD) department had assured the Bombay High Court that it had halted the process of procuring RUTF, also called energy dense nutritious food (EDNF), as directed by the Central government.
On August 28, the central WCD ministry had asked all states to strictly comply with the notification cautioning against implementation of therapeutic food for malnourished children stating that “enough evidence is not available” to indicate its benefits. Health experts have also pointed towards small scale studies that have shown hot-cooked meals are better alternative to ready-made therapeutic food.
RUTF comes in the form of a paste made out of micro nutrients, vitamins, peanuts, milk solids and vegetable oils having 520-555 kcal per 100 gram of energy. While the Central notification came in August, the state WCD department issued a government resolution in September end to start the RUTF facility in village child development centres (VCDC) in non-tribal districts across Maharashtra.
A budget allocation of Rs 21.19 crore for 2017-18 has been proposed to run VCDCs in non-tribal districts, of which Rs 17 crore has been allocated to procure the readymade therapeutic food for 54,283 children with severe acute malnutrition (SAM).
The Nandurbar district, which has 1,609 SAM children and 4,857 children with moderate acute malnutrition, procured RUTF from the Jalgaon-based Matrix Health Care Products company. Matrix had in turn purchased the stock from Nuflower Foods and Nutrition Pvt Ltd in New Delhi, documents with The Indian Express show.
Since last year, at least 1,428 children in Nandurbar have been admitted to 528 VCDCs and given RUTF to improve their nutrition content under a pilot project. Nandurbar, along with Palghar, records maximum number of malnourished cases and deaths in state.
The RUTF procurement, however, was to stop following the Central government notification in August.
An official from Matrix Health Care said, “We provided the packaged therapeutic food as per contract order in September. We are yet to receive payment. If the district officials ask to return the food, we will recall it from all anganwadis. But so far no such order has come.” The shelf life of the therapeutic food, in this case, is two years.
According to the Nandurbar chief executive officer, “no official order has been given for purchase of RUTF”. “We heard of reports that RUTF was being supplied to children. I have ordered an inquiry,” said CEO Ravindra Bhinwade.
District anganwadi workers said RUTF was procured locally by the child development project officer concerned at block levels. Until Friday, RUTF was being given to children with severe acute malnourishment in several blocks such as Dhadgaon and Shahada.
Pradip Prabhu and NGO Jan Arogya Abhiyan, who had moved court against RUTF, are set to challenge the Maharashtra government GR. “If state WCD assures the HC it has halted all procurement procedures, then it is contempt to issue a GR on same issue stating it will start RUTF facility,” said Prabhu.
Meanwhile, the state WCD department has written to the Union ministry to reconsider its decision to halt RUTF. In August, the Maharashtra government had issued a GR to start RUTF facility in tribal districts at a cost of Rs 18.7 crore. A month later, another GR said RUTF would also be initiated in non-tribal districts. The cost of RUTF per day per child is Rs 75.
In its circular to all states in August, the Ministry of WCD had quoted the Ministry of Health and Family Welfare which stated in 2009 “the use of RUTF for management of malnutrition is not an accepted policy of the Government of India”.“Enough evidence is not available for use of RUTF vis-a-vis other interventions for management of several acute malnourishment. RUTF may replace nutritional practices and family foods that children would normally be eating,” the circular states.
In July, the Maharashtra government had floated tender to appoint a contractor to provide RUTF for non-medical cases of severely malnourished children. It however halted the process in September after the Central notification. It announced in HC that it would wait for Central nod before resuming the process.
In Nandurbar, RUTF was distributed in September, and also this month, in contradiction to the state’s assurance.