Introducing The Concept Of Nutri-gardens To Address Rural Malnutrition .
Draft ReportProject Code 2012MC10Indian Oil Corporation Ltd, MumbaiIntroducing the concept of Nutri-gardens toAddress Rural Malnutrition by InvolvingIOCL’s Kisan Seva Kendras2013-14 P a g eThe Energy and Resources InstituteWestern Regional Centre, Navi Mumbai
Introducing the concept ofnutri-gardens to address ruralmalnutrition by involvingIOCL’s Kisan Seva KendrasPrepared forIndian Oil Corporation Ltd.Bandra, Mumbaii P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva Kendras The Energy and Resources Institute 2014Suggested format for citationT E R I 2014Introducing the concept of nutri-gardens to address rural malnutritionby involving IOCL’s Kisan Seva KendrasNavi Mumbai: The Energy and Resources Institute. 45 pp.Team Members:1. Dr. Anjali Parasnis:2. Ms. Swati Tomar:3. Mr. Yatish Lele:Principal Investigator (PI)Co-PIProject ConsultantPhoto credits: Google Images, Ms. Swati Tomar, Mr. Yatish Lele and Mr. Prathmesh ChoureyFor more informationMs. Swati TomarTERI318, Raheja Arcade,Sector 11, CBD-Belapur,Navi Mumbai – 400614Indiaii P a g eTel: 275800 21E-mail: swati.tomar@teri.res.inFax: 27580022Web: www.teriin.orgIndia 91 Mumbai (0)22
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasContentsAcknowledgement . viExecutive Summary .viiBackground . 1Programme objectives . 1Kisan Seva Kendra (KSK) . 2Introduction. 3Malnourishment . 3Malnourishment in India . 3Nutri-gardens . 7Study area . 7Importance of selected crops . 8Programme Activities . 9Workshop for Awareness Generation: Long term approaches . 11Workshop 1: Interaction and Analysis of Dietary patterns of the Stake-holders . 11Workshop 2: Distribution of the Nutri-Garden kits. 14Workshop 3: Interaction and Inspection Visit with stakeholders . 16Workshops for capacity building . 16Workshop 1: Workshop for easy-to-cook and healthy recipes. 16Workshop 2: Demonstration and training on mushroom cultivation . 18Project outreach . 20Results: Long term sustainable approaches . 20Additional activities of the project: Short term strategies . 23Photo Gallery . 26Annex 1: List of the SAM and MAM Children . 30Annex 2: WHO growth standards . 35iii P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasList of TablesTable No 1: Observations of some surveys conducted to assess malnourishment in Maharashtra . 4Table No 2: Observations of some projects conducted for women empowerment in India . 6Table No 3: Demographic details of Khanivali village, Wada . 8Table No 4: Listing of the various workshops undertaken by TERI in the project area . 10Table No 5 : ProtineX distribution in September . 30Table No 6: ProtineX distribution in December . 32List of FiguresFigure No.1: Importance of selected crops . 8Figure No. 2: TERI’s approach and types of workshops undertaken for the awareness generation andcapacity building of the tribal communities . 9Figure No. 3: Comparison between the Recommended Dietary Pattern and Standard Dietary Patternof the villagers of Khanivali, Wada . 11Figure No. 4: Project outreach in the Wada block . 20Figure No. 5: Percentage conversion of total 140 targeted SAM category children into Normal andMAM category . 24Figure No. 6: Increase in weight of SAM children under study . 25List of PicturesPicture No. 1: Mr. B. Ashok, Executive Director (Retail Sales), Mr. M. Srinivas, General Manager(Retail Sales) from IOCL and Dr. Anjali Parasnis, TERI after signing the MoU. 1Picture No. 2: Gurukripa KSK at Khanivali village, Wada, Thane . 2Picture No. 3: Analysis of the daily diet of the villagers . 12Picture No. 4: Healthy bhel prepared at the Gurukripa KSK with the help of locals . 12Picture No. 5: Spinach cultivated on community temple land by anganwadi sevika. 13Picture No. 6: Dr. Anjali Parasnis, Associate Director, TERI introducing the concept of the project . 14Picture No. 7: Mr. Srinivas, General Manager, IOCL, addressing the gathering . 15Picture No. 8: Distribution of kits to the parents and malnourished child . 15Picture No. 9: Demonstration by Mrs. Bindu Kesarkar and Ms. Swati Tomar on healthy cooking. . 17Picture No. 10: Women practising palak paratha (Left) and children enjoying the parathas (Right) . 17Picture No. 11: Mr. Yatish Lele briefing the participants about the technique of mushroom cultivation. 18Picture No. 12 : Participants with the spawn bed . 19Picture No. 13: Preparation of spawn bed . 19Picture No. 14: Sterilization of paddy straw under TERI’s guidance . 19iv P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasPicture No. 15: Mrs. Prajakta with her daughter during the workshop. 21Picture No. 16: Women with the plantation of spinach in their backyards . 22Picture No. 17: Woman with the papaya tree in her backyard and sweet potatocultivation . 22Picture No. 18: Distribution of ProtineX cans to the SAM children . 23Picture No. 19: Dr. Anjali Parasnis, Associate Director, TERI explaining the importance of healthy andbalanced diet to the villagers at Khanivali at IOCL’s Gurukripa KSK . 26Picture No. 20: Dr. Anjali interacting with the mothers of malnourished children at Vikramgad KSK 26Picture No. 21: Ms Swati Tomar, Research Associate, TERI interacting with aanganwadi sevikas andgetting their feedback . 27Picture No. 22: Dr. Milind Chavan examining a six-month old SAM child . 27Picture No. 23: Release of the Nutri-kit at the hands of Mr. Srinivas . 28Picture No. 24: Officials of IOCL, TERI in discussion with the Sarpanch and Doctors of Khaniwalivillage at PHC . 28Picture No. 25: Regular monitoring of the malnourished children during the program period . 29Picture No. 26: Anganwadi workers and mothers of SAM and MAM children at Khanivali PHCattending the ProtineX distribution workshop . 29AbbreviationsFAOFood and Agriculture OrganizationICDSIntegrated Child Development ServicesIOCLIndian Oil Corporation Ltd.ITDPIntegrated tribal development ProjectKSKsKisan Seva KendrasMACMedium Arm CircumferenceMAMModerate Acute MalnourishedMoUMemorandum of UnderstandingNNMBNational Nutrition Monitoring BureauPHCPrimary Health Care CentreRDARecommended Dietary AllowanceSAMSevere Acute MalnourishedSHGsSelf Help GroupsTERIThe Energy and Resources Institute.TZPThane Zilla Parishad.UBIUnion Bank of Indiav P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasAcknowledgementTERI would like to express its sincere gratitude to IOCL for providing financial and logisticsupport towards execution of this pilot study. We sincerely thank Mr. B. Ashok, ExecutiveDirector (Retail Sales), Mr. M. Srinivas, General Manager (Retail Sales), Mr. Sandeep Sharma,Chief General Manager (Retail Sales), and Mr. A. V. Vijayan, Manager (Retail Sales) for theirguidance, encouragement and active involvement.Our sincere acknowledgements are due to Mr. Ajay Singh, Gurukripa Kisan Seva Kendra,Khaniwali, and Mr. Avneesh Shrinath Singh, Vikramgad Kisan Seva Kendra, Vikramgadwho extended all the possible support in arranging for venue logistics and coordination ofvarious project activities.The project would not have been a success without active participation of the PHC (PrimaryHealth Care Centre) of Khanivali area. Our Sincere thanks are due to, Mr. Milind Chavan,Taluka Medical Officer, Wada and Dr. Dilip Ingle, 2nd Medical Officer, Khanivali, ThaneZilla Parishad for their value addition, which has greatly enhanced our insight into theproject concept.Furthermore TERI would also like to acknowledge the crucial role of the staff at IOCL’sKSK, PHC and all the anganwadi sevikas, who gave all the necessary support to organizevarious workshops from time to time.TERI owes a special thanks to Ms. Sayali Velankar who helped in translating thecomprehensive “Nutri-manual”, which was an important part of the whole project and Mrs.Bindu Kesarkar, an active social worker who helped TERI in organizing a workshop todemonstrate health food recipes to the tribal women.Last but not least, we thank our associates who extended their services and support whiledata collection/analysis, translation, typing, proof reading, report compilation, and so on.The Energy and Research Institutevi P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasExecutive SummaryMore than a third of children aged three or younger in the state of Maharashtra are stuntedpermanently by undernourishment, states UNICEF. Moreover, around 5,400 deathsoccurred in the state due to malnourishment in 2013 alone. It is an issue of great concern,especially in the tribal blocks, since more than 60 percent of the population is malnourished.To address this critical issue, TERI (The Energy and Resources Institute) in collaborationwith IOCL (Indian Oil Corporation Ltd.) and TZP (Thane Zilla Parishad) initiated a projectto address malnourishment in the tribal blocks of Maharashtra. With the help of KSKs(Kisan Seva Kendras) of IOCL, two cursory workshops were organized in Wada andVikramgad blocks in Thane district to appropriately identify the cause and points ofinterventions to address malnourishment. Subsequently, Khanivali village in Wada blockwas shortlisted to implement a pilot project titled “Introducing the concept of nutri-gardens toaddress rural malnutrition by involving KSKs (Kisan Seva Kendras)”. The pilot study includedimplementation and observation for eight months (June 2013 to February 2014).The project aimed to address the prevailing issue of malnourishment among SAM (SevereAcute Malnourished) and MAM (Moderate Acute Malnourished) children, throughshort-term and long-term strategies. As a long-term approach, it was essential to sensitizethe women in the area to tackle malnourishment, ensure tenacious impact of theinterventions and develop a sustainable solution.Only consumption of nutritious crops does not help. Appropriate dietary intake at regularintervals along with appropriate cooking methods help retain nutrition levels. Hence, TERIdeveloped the concept of “nutri-gardens” to promote consumption of nutritious crops bycultivating them locally. Around 120 “easy-to-use “nutri kits” were designed, developedand distributed amongst the tribal women, especially mothers of malnourished children andaanganwadi sevikas of Khanivali village. The kit comprised the following:A manual elaborating their significance (in Marathi), method of cultivation usingavailable resources and different recipes to encourage integration of the ingredientsin daily dietSeeds/saplings of nutritious crops (mushrooms, spinach, sweet potato and papaya)Doctors of TZP expressed an urgent need for nutrient supplements for 140 SAM and MAMchildren and hence, as a short-term strategy, a commercially-available protein concentratewas supplied immediately.PHC (Primary Health Care Centre) in Khanivali under TZP caters to almost 30,000 peoplefrom 42 villages and maintains a monthly record of diet, height, weight, MAC (MediumArm Circumference) and family history for children and pregnant women. The PHCinformed there were around 80 SAM and 60 MAM children, when the project was initiated.These children were targeted on priority and provided health supplements. “Nutri-kits”were distributed amongst mothers and anganwadi sevikas responsible for providing mid-daymeal to these malnourished children.vii P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasAwareness and training workshops were conducted regularly for mothers of the identifiedchildren to sensitize them on the use of the nutri-kits. During the feedback survey, we notedthat many families had not only started cultivating spinach, papaya and sweet-potato intheir backyard but had also started integrating the recommended ingredients in their regulardiet through judiciously-cooked recipes.Eight months after the project was implemented, the results began to show. Regularawareness and monitoring helped bring down the count of the malnourished children. Itwas recorded that in just 3 months, 68 percent children were re-designated to a normalcategory and 32 percent children were considered in MAM category out of targeted 140malnourished children, as a result of short term strategy.It can be concluded that both long-term and short-term strategies need to be integrated toeffectively to address the issue of malnourishment amongst tribals. Given the ease ofadopting the concept of “nutri-kits”, its long-term impact and encouraging results, theconcept of “nutri-gardens” has tremendous potential for replication in other areas.viii P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasBackgroundTERI (The Energy and Resources Institute) signed the MoU (Memorandum ofUnderstanding) with IOCL (Indian Oil Corporation Ltd.) on January 24, 2013 to implementthe project entitled, “Introducing the concept of nutri-gardens to address rural malnutritionby involving KSKs (Kisan Seva Kendras)” in the tribal regions of Thane district. The functionwas graced by the presence of Mr. B. Ashok, Executive Director (Retail Sales), Mr. M.Srinivas, General Manager (Retail Sales), Mr. Sandeep Sharma, Chief Manager (Retail Sales)and many other dignitaries form IOCL. Dr Anjali Parasnis and Ms Swati Tomar representedTERI on this occasion.Picture No. 1: Mr. B. Ashok, Executive Director (Retail Sales), Mr. M. Srinivas, General Manager(Retail Sales) from IOCL and Dr. Anjali Parasnis, TERI after signing the MoUProgramme objectivesThe programme objectives are:1. To introduce an unique nutri-garden programme through IOCL’s KSK2. Determine the baseline to assess the level of malnourishment, especially amongstwomen and children at selected clusters/ groups (around KSK) with the help ofmedical practitioners3. To provide a specialized kit comprising of selected nutrition crops, methods of itscultivation, use and preservation4. To conduct training programmes for women on use of those kits and its components5. To assess the impact of this programme after 6-8 months of implementation1 P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasKisan Seva Kendra (KSK)Kisan Seva Kendra is an award-winning retail outlet model pioneered by Indian Oil to caterto the needs of customers in the rural segment. Today, KSK outlets have emerged asdominant players in the rural markets, riding on the rapid growth of upcoming second andthird tier roads in the rural areas. The KSK come with a fresh perspective, enabling dealersto tap the huge demand driven in by consumers there. In addition, non-fuel retail facilitieslike convenience stores have been added to the KSK to sell pesticides, vegetables, bankingproducts and stationery items.TERI and IOCL involved the KSK to target the remote areas. Also, KSKs have a strongnetwork in the rural areas. Due to that bond, people have faith in the outlets.Picture No. 2: Gurukripa KSK at Khanivali village, Wada, ThaneKSK dealers have actively participated in the project and provided all the support in termsof logistics, venue, refreshments, travel arrangements and so on. They helped TERI insuccessfully organizing different workshops at the project site.2 P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasIntroductionGlobal population increase is severely affecting the world’s resources, which is ultimatelyleading to problems like environmental degradation, risk to health, food security and so on.It is difficult to meet the growing demands of food, clothing and shelter, the basic necessitiesof life for the growing population even in the developed countries. A number of scientistshave argued that the current global population expansion and accompanying increase inresource consumption is threatening the world's ecosystem and straining humanity's abilityto feed itself.1A research states growing populations, falling energy reserves and food shortages wouldcreate a ’perfect storm’ by 2030. It was estimated that food reserves in 2009 were at a fiftyyear low and that the world would require 50 percent more energy, food and water by 20302.According to a 2009 report by the United Nations Food and Agriculture Organisation (FAO),the world will have to produce 70 percent more food by 2050 to feed a projected extra 2.3billion people.3 This shortage in meeting the food demands of the population ultimatelyaffects the nutritional status of the population. As a result, nearly 30 percent of the world’spopulation suffer from one or the other form of malnutrition4.MalnourishmentMalnutrition is the condition that results from eating a diet in which certain nutrients arelacking, are in excess (too high in intake) or in the wrong proportion. The term malnutritionencompasses both over-nutrition and under-nutrition. Although under-nutrition is generallyobserved amongst the rural and under-developed part of the world, it is a major challenge tohuman and economic development. It is estimated that almost one billion people globallyface hunger5 and are unable to get enough food to meet their dietary needs. Another onebillion people do not get enough vitamins and minerals which, over a period of time, canlead to complications like night blindness6.Malnourishment in IndiaWith almost 42 percent children (0-6 years of age group) under-nourished, childmalnutrition is one of the major concerns of India. India ranks second in the world fornumber of children suffering from malnutrition, states the World Bank.Malnourishment in Maharashtra: ThaneOf the total population in Maharashtra, almost 36.7 percent of children are underweightand 27 percent population is under-nourished (2009).7 Maharashtra ranks second in termsof tribal population in India and houses more than 10 percent (approx. 83 lakhs) of tribals ofthe country8. Out of the total tribal population in the state, approximately 14.5 percent1 "Planetary Boundaries: Specials".Nature. September 23, 2009. Retrieved February 18, 20132 "World faces 'perfect storm' of problems by 2030, chief scientist to warn".The Guardian. March 18, 2009. Retrieved February 18, 20133"Global food production will have to increase 70% for additional 2.3 billion people by 2050". Finfacts.com. September 24, 2009. Retrieved February h/fsheets/malnutrition.pdf5FAO, 2010, The State of Food Insecurity in the World. FAO Rome 20106Government Office for Science/ Foresight, 2011, The Future of Food and Farming: challenges and choices for global sustainability. ects/Nutritional Crisis in Maharashtra Report.pdf8Statistical profile of schedule tribes in India, 2010 by Ministry of Tribal Affairs, GoI3 P a g e
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva Kendras(12.07 lakh) 9 reside in Thane district of Maharashtra (Census, 2001) spread across thetalukas of Jawhar, Mokhada, Vikramgad and Wada. More than 90 percent of the totalpopulation in these talukas are concentrated with tribes of Kathkaris, Warlis, Koknas andKolis. Hence, these regions have been classified as a tribal belt. Tribals are generallycharacterized by economic and social marginalization, primitive existence, geographicalisolation and educational backwardness. Several studies have been conducted and reportspublished in the context of tribal communities, especially emphasizing on variousparameters like socio-economic condition, land-related issues, health status and so on.In Thane district alone, almost 14 percent of children (age 0-6) are moderatelymalnourished, while in Jawhar taluka, the percentage of malnourished children (of sameage group) is as high as 30 percent10. This high percentage can be attributed to their dietaryhabits. 70 percent of the rural population, as reported by NNMB (National NutritionMonitoring Bureau, 1978), consumes an unbalanced diet because of poverty stress.Table No 1: Observations of some surveys conducted to assess malnourishment in MaharashtraYearstudyofFocus tritionMonitoringBureau(NNMB)Prevalence of under nutrition in tribalpopulation is more than 80%112004ThaneITDP (Integrated tribaldevelopment Project)ReportAlmost 0.43% of children (0-5 years)are severely malnourished.122006ThaneIndian Human RightsReport, 2007Over 1,700 children reportedly died ofmalnutrition in Thane district in justone year (April 2005- April 2006).132008Jawhar,Mokhada,Vikramgad andWada/Koli,Warli, ThakurA. L. Khandare et.al.The average calorie and protein intakeper Consumption Unit (CU) by tribalpopulation was significantly less by23% and 30% respectively as againstthe RDA (Recommended DietaryAllowance)142007-09MaharashtraSATHI organizationMore than 50% of tribal children areseverely stunted (height for age) andmore than 51% are underweight. 152010Thane,C.J. SonowalThe study reveals that shortage of 11Report by NNMB “Nutritional Status of Tribal es/20050923006500400.htm13Malnutrition claims nine kids in a week in Thane, The Free Press Journal, 8 April port by SATHI organization “Nutritional status of Maharashtra”, 20094 P a g eObservation
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasYearstudyofFocus ndurbar d forest resources, lack of suitablejob opportunity at local level andexposure to non-tribal domain hasmade tribal people suffer from healthand nutritional problems.16Ghorude et.al.(Report published in2011)In just four years (2006-10) the numberofchildrensufferingfrommalnutrition has increased by almostthree i, ThakurThe observations from the above mentioned studies indicate that in the past 12 years, thestatus of malnourishment in the tribal population has barely changed. In fact, Ghorude et al(2011) reported increase of more than three times in the number of children suffering frommalnutrition. As per the RDA (Recommended Dietary Allowance) by Food and NutritionBoard, USA, the protein consumption and the calorie intake amongst the tribal population isvery poor.According to a report by the Department of Philosophy, University of Pune,18 Governmentof India has implemented several schemes to address problems like poverty, unemploymentand malnutrition in tribal communities. However, TERI found a lack of understanding ofthese schemes amongst the tribal communities due to religious beliefs and a fixed mind set.Also, it was observed that the communities were demotivated by the complicatedprocedures associated with sanctioning of the schemes.A study conducted by the Marathwada University, Aurangabad stated that tribaldevelopment programmes and schemes in Maharashtra state have not brought anyperceptible changes in the life of majority of tribal population. Educational schemes like“Ashram schools and scholarship scheme for tribal” have a penetration of only 13-15 percent inthe tribal areas.Few studies have indicated that (Table No 2) if the project targets the women education andempowerment, it has a direct impact on the overall well-being of the family includingenhanced living standard, additional income, improved nutritional status of the childrenand so on.16C.J.Sonawal,Ethno Med, 4(1): 21-36 (2010) “Factors Affecting the Nutritional Health of Tribal Children in earchProjects/LataChhatre.pdfavailable on the internet.5 P a g e(Department of Philosophy, University of Pune)*As per the reports
Introducing the concept of Nutri-gardens to Address Rural Malnutrition by Involving IOCL’s Kisan Seva KendrasTable No 2: Observations of some projects conducted for women empowerment in IndiaSr.No.1.2.3.Name of the projectArea/ StateYearObservation/BenefitsNeed of Educationand Awareness: AStudyofLocallyMadeTherapeuticFood for Treatment )2010Awareness or knowledge base inwomen results in a change of attitudeand then in behavioural change. It isvery important to educate womenregarding healthy eating practicesand utilizing available resources tothe best of her ability to achieveoptimum healthPoultry training andgeneralawarenessabout agriculture towomenMadhyaPradesh2009Along with improved d decisions, visitingthe village market to gain access toagriculture related information etc.World Bank aidedNational AgriculturalUdaipur,Rajasthan2006The project had made significantimpactontechnologicalempowerment of tribal women asknowledge of the beneficiaries wasfound to be higher than nonbeneficiaries in all the components ofcattle, goat and poultry rearingpractices.19Mokhada andJawhar2006The percentage of low-birth weightalong with infant mortality in projectvillages has reduced considerably.Weight gain was observed in all thetarget groups including children,adolescent girls and pregnant orlactating women. The
developed the concept of "nutri-gardens" to promote consumption of nutritious crops by cultivating them locally. Around 120 "easy-to-use "nutri kits" were designed, developed and distributed amongst the tribal women, especially mothers of malnourished children and aanganwadi sevikas of Khanivali village. The kit comprised the following:
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