About women, work and wages
Community action, witha focus on women's well-being,.can fightmalnutrition
UMA MAHADEVAN DASGUPTA
ON AN MGNREGA worksite in Kolar,
Karnataka,a male worker came uptome and
said that men ought to be paid more than
women. I asked him why. "Adhu yaavaagalu
hange," he replied: 1hat was how it always
was. Not so in MGNREGA, I told him.
With equal wages for women and men,
and direct payments to workers' bank ac-
counts, MGNREGA helps to increase women's
incomes. Another major programme which
can improve women's livelihood, their social
empowerment and their lives is the National
Rural Livelihood Mission (NRLM). Increased
incomes gve women more voice intamily de-
Cisions, and the ability to care better for their
families and themselves.
Data from the fifth round of the National
Family Health Survey (NFHS-5) shows gains in
some importantareas. In most of the 22 states
and Union teritories surveyed, infant mortal-
ity rates and under-five mortality rates have
fallen; and institutional births and child im-
munisationrates have increased. Access to im-
proved drinking water and sanitation has in-
Creased in almost allareas surveyed.
Onchild malnutrition, the NFHS's findings
are worying Beyond behaviour change com-
municationand regular monitoring, directnu-
trition interventions are key, especially dur-
ing pregnancy, breastfeeding and in the early
years ofa child's life. Pregnant women, lactat-
ing mothers and young children need hot
cooked meals with adequate protein, milk,
and green leafy vegetables. States like
Karnataka, Andhra Pradesh and Telangana
have replaced take-home rations formothers
with daily hot cooked meals.
While providing hot cooked meals front-
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linehealth workers also have the opportunity
togive pregnant women iron, folic acid and
calcium tablets.They are also engaged in early
childhood stimulation activities and parent-
ing sessions. Instead of frontline workers go-
ing to each woman's house, women coming
tothe anganwadi makesiteasier to provide all
women with appropriate services and coun-
selling. Mothers' lunch groups at the angan-
wadi can also function as informal social net-
works. A study by the Public Health
Foundation of India (PHF) of Karnataka's
Mathrupoorna programme for pregnant
women and breastreeding mothers found a
reduction in anaemia, improved gestational
weight gain, improved birth weight, and re-
duced depression amongwomen participants.
Beyond the "tirst thousand days", the in-
tergenerational cycle of malnutrition and its
social determinants call for a life cycle ap-
proach. Such an approach should address the
complex social ill ofchild marriage. One of the
bestways to prevent child marriage is by sup-
porting girls to stay in highschool. Grass roots
social empowement programmes should fo-
cus on increasing girls'enrolment, access and
retention in secondary education. The nutri-
tional status of adolescent girls could be im-
proved by extending the mid-day meal pro-
gramme to secondary educational
institutions, as some states have done.
Malnutrition should also be understood
inthe context of women's work. Childcare en-
ables women to earna livelihood. Longer
working hours for the anganwadi, such as in
Kamataka where it runs from930 amto4 pm,
will help women go out to do paid work, in-
cluding on MGNREGA worksites. Mobile
creches for younger children at these work-
sites and construction sites will help women
to workwithout anxiety about their children's
safety and well-being
The anganwadi system needs strengthen-
ing. Anganwadi supervisors can be supported
withinterest-free loans and fuel allowance for
two-wheelers, enabling them to provide reg-
ular guidance to their cluster. Their skills
should be upgraded with certificate courses
onnutrition and early childhood stimulation.
Online training at scale has been the discovery
ofthe pandemic year. Anganwadiworkers and
supervisors can be supported for proressional
development through live online sessions on
nutrition, growth monitoring and early child-
hood education.
Anganwadi infrastructure needs atten-
tion: Sturdy buildings, kitchens, stores, toilets,
play areas and fenced compounds, functional
water connections and arTangements for
handwashingare urgent imperatives. To cater
to multiple meal requirements, anganwadi
kitchens need double-bumerstoves, gas cylin-
ders, pressure cookers and sufficient steel
cooking vessels. Kitchen gardens should be
planted withdrought-resistant and highly nu-
tritive plants like moringa.
The most effective platform for commu-
nity action on the ground is the gram pan-
chayat. We often talk of the "last mile" for
communication services. The panchayat
should be the first mile for social welfare serv
Ices. There are around gram pan-
chayats in India, and nearly 14 lakh angan-
wadis, the majority in rural areas. The
anganwadi committee, chaired by a stake-
holder mother and including other parents,
grandparents and the panchayat wardmem-
ber, should be a subcommittee of the gram
panchayat. It should meet every month on a
fixed day, and its discussions should be pre-
sented to the gram panchayat for action.
Exclusion and convergene are two major
challenges in social welfare programmes. Local
governments are the best placed to address
the problemofexclusion. They can ensure cov-
erage of the poorest women and children, es
pecially nomadic and semi-nomadiccommu-
nities, and seasonal migrants such as brick
workers and sugarcane harvesters. Panchayats
are also the best forum to prevent child mar-
riage and ensure that all girls stay in school.
Convergent action on the ground is one of
the strengths of gram panchayats. Anganwadi
Workers, ASHAs, ANMs and anganwadi super-
visors can work together with panchayat
members to ensure that allchildren and moth-
ers are covered with immunisation, antenatal
care, matemity benefits and nutrition services.
Gram panchayats can use their funds, con-
verged with MGNREGA, to strengthenangan-
wadis. They can engage women's collectives
under NRIM foranganwadi and school needs,
and provide panchayat services such as end-
to-end solid waste management, water pump
operations, surveys, bill collections and man-
agement of fair price shops. Such steps will in-
crease women's individual and groupincomes
in sustainable ways. They will also lead to
greater social and economicempowementor
women, their participation in localgovernance,
and, eventually, better nutrition for al.
The writer is in the Indiam Administrative
IVSenvice, and based in Bengaluru
@rkptr