Feeding Families in Need During COVID-19 Pandemic

 

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There are many hungry bellies to feed around the world and we are merely scratching the surface to nourish the vulnerable populations of the world. Due to the current COVID-19 pandemic triggering lockdowns around the world, issues in nutrition such as food systems and malnutrition have been heightened and are now more of a global urgency than ever before. Here at Sight and Life, we are working on initiatives in Rwanda, South Africa and India to help improve the lives of those in need during this crisis.

“The only silver lining during this grave crisis has been how quickly and effectively we’ve been able to work together as a team and with our partner organizations to identify food insecurity hotspots and mobilize resources for emergency hunger relief. The guiding principle behind our efforts has been to look beyond just filling bellies but make sure adequate and critical nutritional needs are met,” expresses Sight and Life team members.

In India, we have partnered with grassroots NGOs across India, such as Aahawaan Foundation, based in Bangalore, and Kutumb, working in Uttar Pradesh, to donate grocery kits and nutritious food to the affected communities.

Kutumb is an organization attending to abandoned and slum children by giving them a sense of family. They are also dedicated to strengthening all units of marginalized and underprivileged families, realizing that children can be nurtured best in a family setting. Together with Kutumb, we provided nutritious food to over 1500 children with moderate acute malnutrition in 75 villages located in Uttar Pradesh. 

In Bangalore, we teamed up with the Aahawaan Foundation who is committed to providing basic requirements and facilitate the development of the overall potential of people and their communities. Together, we delivered 15-day grocery kits with staples and fortified kernels as top-up was delivered to migrant workers and their families ensuring that the nutritional needs are met, beyond just filling stomachs.

 “I was unsure of how I would provide for my own children and was hence, worried about feeding my neighbor’s children as well. This ration will help me cope with this crisis for some more time,” explains Sita Ben, one of the many women workers our partner reached with an essential food kit. She spoke about her difficulties during this pandemic as she is responsible for her children and neighbor’s children as they are unable to return due to the lockdown in India. Now she can sleep a little bit knowing she has the ability to feed her and her neighbor’s children.

Meanwhile, in Delhi, monthly ration kits made it to 200 daily-wage households. The kits contain additional essential supplies such as oil for cooking, grains, lentils, and an egg for a family of four in order to help ease the pain of many in unfortunate situations.

 “A great number of my fellow countrymen are forced to walk a thousand miles, often hungry, just to reach the safety and comfort of their families. We are grateful for the opportunity to raise funds on their behalf and support them with nutritious meals,” explains the Sight and Life team. 

We are committed to doing more however, we need support. Please donate to via our Milaap or GoFundMe crowdfunding page to further our efforts. We are also interested in partnering with organizations that have similar initiatives and are located in Rwanda, South Africa, or India.

Five-step plan to prevent an impending nutrition famine during COVID-19 in India

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India’s isolation measures in response to COVID-19 are having a far-reaching impact and is among one of the largest initiatives globally to impose strict limitations on its 1.3 billion citizens. People with pre-existing vulnerabilities, marginalized communities, pregnant and lactating women (PLW), daily wage earners, migrant workers, and the elderly have been the hardest hit as the protective measures disrupt the economy.

To ease the effects of the pandemic, the national and state governments have announced extensive stimulus packages and policy measures. The national government on 12th May announced a $265 billion relief package aimed at injecting liquidity into the economy. The first tranche of $ 22.6 billion included several social protection measures such as payment of ex gratia amount to marginalized populations, increased wages for workers under the National Rural Employment Guarantee Act, doubling rations for three months, collateral-free loans to women’s Self Help Groups (SHGs), the inclusion of support to COVID-19 under Corporate Social Responsibility (CSR), and financial assistance to villagers through farmer cooperatives. These aid benefits are aimed to help more than 810 million Indians and are a step in the right direction.

In addition, integrating nutrition in the current policies will be fundamental to improving nutritional status and building immunity of the population, especially high need groups like PLW and children under 5 years of age. The WHO guidance on diet during the COVID-19 pandemic states that “good nutrition is crucial for health, particularly in times when the immune system might need to fight back”. India is already battling a high prevalence of malnutrition (Table 1). As India, in unison with the rest of the world, battles an evolving pandemic of unprecedented proportions, policymakers must be vigilant, agile, and innovative to halt our population from sliding into hunger and acute malnutrition due to the COVID-19 outbreak.

Table 1:

Source: Comprehensive National Nutrition Survey 2016-2018, Ministry of Health and Family Welfare Govt. of India.

We propose a five-point plan to put nutrition-sensitive policy measures in place to combat the adverse effects of COVID-19:

1. Increase budget and coverage for essentials

Many state and national governments have gone beyond the entitlement provisions under the National Food Security Act – 2013 to announce a stimulus package, the key elements of which are grain and pulses, and cash transfers to lower-income households. While this is a necessary and commendable step, a much stronger nutrition-sensitive hunger mitigation and food programming scheme is crucial. A basic, nutritious diet, recommended by the EAT-Lancet Commission, would cost at least INR 33.69 per day. Accounting for a family of 4, cash transfer of INR 500 per month would only satisfy a family’s requirement for approximately four days a month! Most states’ announcement of transferring an additional INR 1,000 only satisfies their requirement for an additional eight days. India has surplus food grains to weather the current crisis. Universal access and 3x more rations, irrespective of possession of ration cards, will be effective in addressing hunger including the 70 million poor households who lack an identification document.

2. Address malnutrition through dietary diversity, supplementation, and fortification:

Current food supplies through the Targeted Public Distribution Systems (TPDS) are predominantly comprised of grain and pulses. In the current situation where farm supply chains are expected to take at least four months to be restored, essentials such as vegetables, milk, and eggs, could be sourced directly from the farmers and made available in the open markets, supplied through public distribution systems and provided as weekly take home supplies to children and PLW. A few state governments such as the Telangana government have directed Anganwadi workers to provide eggs to mothers and children. Scaling such initiatives to a national level will help improve nutrition outcomes during the pandemic.
 
The honorable Prime Minister of India, in his address to the nation, ‘Mann ki baat’ on 25th August 2019, announced fortification of rice that is distributed to India’s poor through the public distribution systems, Integrated Child Development Services (ICDS) and mid-day meals. This would be the right time to implement the policy and improve access to fortified products including salt, edible oil, flour, rice, and milk. The aforesaid initiative is critical in the current scenario when nutrient consumption is bound to be erratic due to cash and food shortages.

3. Create awareness about nutrition practices:

Increasing evidence suggests that malnutrition increases susceptibility to infections including COVID-19. We, therefore, need to create awareness about better nutrition practices. The National Nutrition Mission (POSHAN Abhiyaan)’s Jan Andolan movement is a platform to engage in civil society and engage people to be committed to better nutrition. The Jan Andolan initiative can be utilized to implement a social behavior change campaign addressing food safety and feeding practices at the household level. Second, front-line workers can be empowered to halt the rise of malnutrition. They can be trained and equipped with behavior change communication equipment on nutrition care during pandemics. Empowering them with the right information and communication technology (ICT) equipment will enable them to spread information through digital platforms while following social distancing norms.

4. Incentivize farmers and small enterprises to produce nutrition-rich crops and food:

The following initiatives can improve the livelihoods of small-scale farmers and enterprises while improving access to nutrition. Incentivize smallholder farmers to produce nutrition-rich crops and staple foods and thus improving access to safe and nutritious diets across the value chain. Micro small and medium enterprises (MSMEs) can be motivated to produce and process nutritious and culturally appropriate foods using millets and legumes such as lentils, chickpea, groundnut, ragi which contain many nutrients and can store for long periods. They can also be prepared by women self-help groups authorized to prepare take-home rations and then the ICDS channel can distribute these foods to PLW and young children.


5. Harness technology for better nutrition:

India has a successful history of using technology to improve socio-economic and public health outcomes. For example, the Arogya Setu app, recently developed by the National Informatics Centre, uses technology to track coronavirus infections, thus providing a valuable tool in the fight against the pandemic. The government can similarly engage entrepreneurs to develop technologies to forecast the trend and pattern of disease burden in future months, rectify supply chain management of key food and nutrition supplies, revitalize already introduced software in public distribution systems to monitor food supplies.
 
Nutrition is a great equalizer. It can create the right environment to stimulate growth, economic development, and progress of an entire generation, thus propelling India on a path towards excellence. India has demonstrated early successes in managing the pandemic through strict isolation measures, innovative use of technology, and public health services. As we fight a pandemic of epic proportions, accounting for the nutritional needs of the world’s most vulnerable will not only give us the strength and immunity to fight COVID-19 but also save lives and give more babies the healthy start they deserve, irrespective of their socio-economic status.
 

Spotlight: Gratitude to frontline workers at the time of coronavirus

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At nearly six months pregnant, Vidyarani learned that her neighborhood anganwadi center was closing due to the coronavirus (COVID-19) control measures. She depends on the anganwadi for a daily hot cooked meal to feed herself and her two-year-old daughter. Adding to her growing concerns, the lockdown caused her husband to lose his job. 

Anganwadis, or courtyard shelters, are primary childcare centers providing basic health care activities and nutritious meals for families while also serving as a pre-school for young children. Across all states in India, anganwadis serve either hot cooked meals or provide monthly rations that can be cooked at home. The Telangana state government, for instance, serves approximately half a million hot cooked nutritious meals daily to pregnant and lactating women through the anganwadis. As a part of this program, all beneficiaries also receive one egg every day. Here at Sight and Life, we know the importance of including eggs in a diet.

As COVID-19 quickly spreads around the globe, India has enforced a nation-wide lockdown to contain the disease creating unprecedented challenges for people like Vidyarani and their families. In addition to the closure of primary schools and anganwadi centers, children in rural India are now not attending school and therefore have to do without their guaranteed school meal, potentially worsening an already “severe” malnutrition problem in India. Even though the government has ordered state authorities to ensure provision of take-home rations and cash allowance during the lockdown, efforts to tackle acute malnutrition could still take a hit. It is in times like these that India’s frontline workers are making sure that no one in their communities goes hungry. Many anganwadi teachers are going door-to-door to deliver their weekly rations of rice, lentils, oil and eggs to beneficiaries.

COVID-19 Essentials Delivery

In this photo, tweeted by the Women and Child Development Ministry of Telangana, an anganwadi teacher delivers take-home rations including eggs to the homes of lactating mothers in the tribal region of Mulugu district via her scooter. Women like Vidyarani and their families are grateful for these workers delivering essential food items.
 

An Eye-Opening Research Experience through India

Learning Along the Way

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Hello, my name is Shannon King and I am working with Sight and Life as an intern while completing my Masters of Science in Public Health with a focus in human nutrition at Johns Hopkins Bloomberg School of Public Health.

The Assignment in India

During the late summer of 2017, I spent 2 months in India where I was working with our local partner, Karuna Trust, to conduct research on the implementation of the PATH “Feeding the Future through Fortified Rice Program”. Within this intervention Sight and Life has designed three school-based nutrition and WASH strategies to develop healthy eating habits while improving hygiene and sanitation behaviours. The intervention uses peer role modeling and cues to action; games and helper crews; and problem-based learning within the school environment to promote behaviour and attitude change.

The study required visiting 50 schools in four different areas of Karnataka in order to understand how the program is being implemented. Our observations allowed for us to examine to what extent each school had executed program activities- such as having soap available for the students, and how the program materials are being used around the school. Further, in-depth discussions with the implementing teachers provided detailed descriptions of how the program is being used and their experiences thus far.

Impact of my Experience

Overall, it was an incredible experience allowing me to engage first-hand in the entire research process from protocol design, to ethics review, data collection, and data analysis. As a graduate student, I have had the opportunity to work on studies in the past; however, this was the first time I have been given ownership of a study and the ability to work on it from initiation to conclusion. It has been very rewarding to work through each step of the process and overcome all the associated challenges and roadblocks.

During my time in the field, I found it fascinating to see a wide range of implementation processes used in the schools despite the fact that each school was provided with the same program materials and instructions. As researchers, a better understanding of the factors influencing implementation allows us to develop programs in a manner that will optimize delivery.

While the research did not involve any formal data collection from the school children, I will always cherish the moments I was able to engage and play with them. The opportunities were few and far between, however, at one school we arrived early and the teachers were having lunch so the facilitators and myself played one of the nutrition and WASH games with the children. Despite needing a translator to help facilitate the process, it was an hour filled with laughter and joy. It was also an incredible opportunity to see the program in action and how much the children were enjoying to learn.

Working through Barriers

The biggest challenge, and the most eye-opening experience of the trip, was working as a young female researcher. In several different contexts and settings, comments and suggestions made by females were treated less seriously than those put forward by males. Or sometimes women’s opinions were simply ignored, and it was eye-opening and aggravating to experience. Witnessing an individual’s esteem being judged primarily on their gender and seniority is quite the contrast to a working environment where your capabilities are judged primarily on your education, experiences and work ethic. It provided me with an even stronger appreciation of the efforts made to promote gender equality. India has an incredible, young female population with the potential to be strong leaders and change-makers, if given the opportunity.  

Lastly, this experience highlighted the need for implementation research to better understand how the nutrition community can optimize the delivery of nutrition interventions rather than purely conducting before-and-after data collection to assess the success of a program. I look forward to sharing the results with both project partners, in the hopes of allowing for mid-course corrections to improve program implementation, and sharing the findings with the greater research community to help build the literature base of implementation research in nutrition.

Enjoy this gallery of pictures showcasing my visit to Indian schools.

Photo credits: Prachi Katre

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