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There was significant anticipation surrounding the interim Union budget this year with the elections round the corner. The anticipation primarily revolved around bolstering measures for addressing popular concerns and grassroots level issues. This included providing a boost to people’s needs such as essential food and nutrition services, particularly for children and pregnant women, as the lingering effects of the pandemic continue to persist.

However, the interim Union budget placed a much higher emphasis on achieving developed country status, which contrasts with the pressing issues of hunger and malnutrition, and creates a paradox.

If one looks at the data from the National Family Health Survey-5 (NFHS-5), the situation remains concerning. A report recently released by the Food and Agricultural Organization stated that 74.1 per cent of Indians were unable to afford a healthy diet in 2021.

Furthermore, in the Global Hunger Index 2023 which is based on an analysis of four key indicators — undernourishment, child wasting, child stunting and child mortality, India’s position has descended to 111th out of 125 countries. These figures highlight the nutrition challenges we face.

This article examines the budgets allocated towards nutrition schemes and programs within India's recently announced interim Union budget.

Budgetary support to nutrition programmes, schemes
Saksham Anganwadi, the flagship scheme of the government offers a range of services following the life cycle approach to address the nutrition related needs of children under 6 years of age, pregnant women & lactating mothers, and adolescent girls. Saksham Anganwadi and Mission Poshan 2.0 are operating in mission mode since the components of these programmes were reformulated signifying a strategic shift aimed at improving nutritional outcomes.

Trend in Union budget allocation for Saksham Anganwadi and Poshan 2.0 and Samarthya (in Rs crore)

Both Saksham Anganwadi and Poshan 2.0 have faced budget cuts compared to last year's revised estimates. The reduction in funding for these initiatives, when adjusted for inflation, amount to a notable 1.77 per cent decline in real terms. The low priority given to nutrition is a matter of concern, given the challenges on the ground.

A significant gap between the allocated budget and the projected demand of the Union Ministry of Women and Child Development was already highlighted by the Parliamentary Standing Committee of the ministry, which noted that the allocation was only 92.5 per cent of the projected demand set by the ministry in 2023-24.

The report asserted that it is the Union budget's responsibility to meet the needs of state governments and stressed the necessity for increased budgets. Despite this, there was a dip of 2.5 per cent against 2023-24 BE for Samarthya, which encompasses the PM Matru Vandana Yojana to provide cash transfers to pregnant women and lactating mothers.

Issues with supplementary nutrition programme
There has been a widespread concern about lack of adequate quality in the freshly cooked meal offered to children aged 3-6 years at Anganwadi Centers (AWC), as meals primarily consist of cereals.

Optimal nutrition outcomes require a relook of Integrated Child Development Services (ICDS) dietary norms. It has been emphasised in many recommendations to incorporate food groups such as eggs, fruits, milk, and locally sourced foods in order to help meet these needs. To support these dietary improvements, increasing budgetary allocations is vital.

The Take-Home Ration (THR) component of the supplementary nutrition programme provides food grains in dry ration form or as a powdered mix of selected cereals. However, the quality of the mixture has remained an issue, along with challenges associated with delays.

The issue of irregularities in THR supplies prevalent across various locations is primarily attributed to delays in payments and clearances. To address this, there is a need, it has been proposed, to raise the cost of THR to cover transportation expenses.

Outlays for other key interventions contributing to improved nutritional outcomes
To effectively combat malnutrition, a comprehensive approach spanning multiple sectors is required. This approach should address various factors such as ensuring food availability, improving feeding practices, enhancing household conditions such as access to clean water and sanitation facilities etc.

Expenditure trends of other centrally sponsored schemes contributing to nutrition

The mid-day meal renamed as ‘Pradhan Mantri Poshan Shakti Nirman’ scheme (PM Poshan Scheme), which also covers balvatika children in the 3–5 year age group, showed a 17.48 per cent increase. The Jal Jeevan Mission (JJM), another key scheme which aims to provide functional household tap connection to every household, experienced a negligible increase of 0.23 per cent as compared to the 2023-24 BE.

MGNREGS is the most crucial scheme which plays a vital role in providing income and employment security for rural residents. Apart from bolstering livelihoods, it supports essential infrastructure development, including the construction of AWCs.

Its allocation of Rs 86,000 crore remains the same as the previous year’s revised estimate. This falls well below the actual needs on ground, as can be seen when one looks at Actual expenditure of Rs 98,467 crore for 2021-22, which was even higher than RE.

Despite legally mandated increases in demand for employment, the ongoing decrease in allocations raises concern about the government's commitment to addressing urgent issues.

The National Social Assistance Programme (NSAP), which offers income security to vulnerable groups like the elderly, widows and persons with disabilities below the poverty line (BPL), has consistently grappled with limited funding. The minimal 0.16 per cent increase in NSAP allocations in the current budget corresponds with with the trend of consistent decline in funds.

Anganwadi workers’ unfulfilled demand
The budget announcement has expanded health insurance coverage under Ayushman Bharat Jan Arogya Yojana to include Anganwadi workers (AWW), helpers, and Accredited Social Health Activists (ASHA) workers. The government’s decision to introduce a health insurance cover poses its own challenges.

It highlights concerns regarding the empanelment of hospitals in the insurance scheme, as well as the strength and capacity of these empanelled hospitals. Several primary surveys have revealed that the majority of private hospitals in the country are small establishments.

AWWs have been the cornerstone of ICDS for nearly five decades since the inception of the programme. They bear the vital responsibility of providing nutrition services, and a wide range of other tasks. These include using smartphones and applications, delivering nutrition and health education, coordinating with auxiliary nurse midwives and other healthcare professionals, besides playing a crucial role in various other community welfare programmes. They are given a fixed amount as honorarium (Rs 4,500) per month under the scheme. The current rate was revised last in 2018, and is inadequate for the heavily burdened workforce.

The Union Budget falls short considering the periodic protests by AWWs and helpers across various states for an increase in the honorarium. Some states provide significantly higher fund support from their own sources over and above the amount given by the Union government. These economically strong states have the means to provide the support but the disadvantaged states lack the financial capacity to provide adequate support, resulting in lower wages for their workers.

The interim budget missed the opportunity to address the urgent issues such as lack of quality meals provided at Anganwadi centres, higher wages for workers and inadequate infrastructure. Given these pressing demands, it is hoped that the full budget for 2024-25 to be presented in July will take measures to adequately address these concerns.