Emmanuel Hospital Association

Position Paper on Food and Nutrition Security Final Draft Abraham Dennyson, B.Tech (Agri. Eng.) Programme Manger (Food & Nutrition Security)

An introduction
more than 1 billion people are hungry, six million children die of hunger every year -- 17,000 every day UN Secretary-General Ban Ki-moon1 (2009). Recent projections from FAO show 1.02 billion hungry people globally. That is one in six of all humanity and up to 2 billion people lack food security (source: FAO, 2010). India ranks 66th of the total 88 nations surveyed in

Global Hunger Index lower than Bangladesh and other sub-Sahara nations. More than one third of the worlds children who are wasted live in India. Micronutrient deficiencies are widespread in India and 43.1 % of Indias children are underweight. 48 % (i.e. 61 million children) are stunted due to chronic undernutrition. It is a sobering picture Article 25 (1) of UDHR (Universal Declaration of Human Rights, 1948) and the ICESCR (International Covenant on Economic, Social and Cultural Rights, 1966) stated the right of everyone to adequate food and specifying the fundamental right of everyone to be free from hunger. India is an active member of the United Nations and is a state party to ICESCR. Hence there is an obligation to respect, protect and fulfil the right to food for every citizen of India. Article 21 of the Indian Constitution provides the fundamental right to the protection of life and personal liberty. This article mandates the state to ensure the right to life of citizens. Article 47 of Directive Principle of State Policy specifies that the duty of the state to raise the level of nutrition and the standard of living and to improve public health. The orders of the Apex Court of India interpret the right to food as part of the right to life, which is a fundamental right as per the Indian Constitution. In Dec 2011 the Indian union cabinet had cleared the drat National Food Security Bill 2011 which is yet to be tabled in the parliament. Food security refers to a situation where all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. Food availability and stability were considered good measures of

http://edition.cnn.com/2009/WORLD/europe/11/17/italy.food.summit/

food security till the seventies and the achievement of self-sufficiency was accorded high priority in the food policies of developing countries. Such an emphasis, however, is only correct in so far as it deals with the production of food by the poor for themselves. Often the poor lack access to food as a result of their marginal resource base. The yield per hectare on the fields of the rich and the overall availability of food is irrelevant for them, if they are too poor to buy this surplus. India was successful in achieving self-sufficiency but it could not solve the problem of chronic household food insecurity. Another consideration is whether the accessed food is adequate in terms of a number of variables, such as nutritional quality, quantity and cultural acceptability. Nutrition Security can be described as an outcome of good health, a healthy environment, good caring practices and household-level food security. A family (or country) may be food secure, yet have many individuals who are nutritionally insecure. Food security is therefore often a necessary but not sufficient condition for nutrition security.

Identification of the issue

The reasons people go hungry are not mysterious. Mass starvation is not an act of God. Hunger is created and maintained by human decisions. 2 Over 96% of the worlds hungry masses live in the Global South which consumes about 1/5 of the worlds resources (e.g. food & oil) while the Global North consuming the 4/5 of the resources.

Susan George and Nigel Paige, "Food for Beginners", (London: Writers and Readers Publishing Cooperative Society, Ltd, 1982).

Figure 1: Number of Starving people in some regions of the World

Figure 2: Starvation - Source FAO 2011 (2010 data are estimates)

"Close to 500 million small-scale farmers constitute the backbone of food production, yet often lack the means to support themselves," says Graziano da Silva FAO Director-General to the G20 Leaders. Of total starving population, 50% are small farmers, 20% are landless rural dwellers, 10% are nomadic herders, or small-scale fishermen, and 10% live in urban poverty.

Barely 5% are affected by food emergency situations arising from armed conflicts, by exceptional climatic conditions (mainly drought or floods) or by violent economic transitions. Of the 5 million children dying each year from hunger and the side effects of malnutrition, only 10% are victims of armed conflict or famine3 Josu de Castro (1908-1973) a Brazilian sociologist and chairman of the executive committee of the United Nations Food and Agricultural Organization (FAO), summed it up thus: Hunger is exclusion exclusion from the land, from income, jobs, wages, life and citizenship. When a person gets to the point of not having anything to eat, it is because all the rest has been denied. This is a modern form of exile. It is death in life ...4 Soaring food prices affect poor consumers directly by reducing the amount of food they can purchase. Causes of undernourishment and of death from hunger and malnutrition are immensely complex, and cannot be simply attributed to war or natural catastrophes. They are primarily due to social injustice, to political and economic exclusion and to discrimination. Hundreds of millions of undernourished persons suffer from political and social exclusion while their right to food is violated National Food Security Act 2013: The National Food Security Act 2013 received ascent of the President on 10 Sep 2013. However it deemed to have come in force as on 5 July 2013. This act introduces eligible households (instead of BPL/APL) called Priority & Antyodaya households. Each member in the priority household is entitled to 5 kgs of food grains per person per month, and Antyodaya to 35 kgs per household per month. The combined coverage of Priority and Antyodaya households shall extend up to 75% of the rural population and up to 50% of the urban population. The PDS issue prices are given in Schedule I: Rs 3/2/1 per kg for rice/wheat/millets. These may be revised after three years. This act also brings other food schemes under this act like the Integrated Child Development Services (ICDS) Scheme (for 6 months to 3 years and 3 to 6 years age group) Mid Day Meal Scheme (for school children) and Take Home Rations (for pregnant women and lactating mothers). Under the name of women empowerment eldest woman, who is not less than

3 http://www.fao.org/documents/show_cdr.asp?url_file=/docrep/007/y5650e/y5650e00.htm Ibid. 4 Right to Food Case Study: Brazil, February 2004, p. 9, FAO Documents IGWG RTFG /INF 4/APP.1: www.fao.org/righttofood/common/ecg/51629_fr_template_case_study_Brazil_Annex.pdf

eighteen years of age, in every eligible household, shall be head of the household for the purpose of issuing ration card. While this is something but not sure issuing ration card in the name of woman will empower her. The Act does not specify criteria for the identification of households eligible for PDS entitlements. The identification of eligible households is left to state governments, subject to the schemes guidelines for Antyodaya, and subject to guidelines to be specified by the state government for. Food Schemes5: Starvation deaths have become extreme manifestation of widespread hunger and malnutrition vis-a-vis failure of government measures designed to augment the condition of the poorest of the poor. Indias food schemes are were converted by the Supreme Court into legal entitlements in its order dated 28 November 2001. Embedded in this order is a direction to State Governments to fully implement them according to official guidelinesi. Mahatma Gandhi National Rural Guarantee Employment Act (MGNREGA) - which provides a work guarantee to the rural people deemed the most destitute segment of the population is enacted to improve their purchasing power and eventually alleviate their poverty. However the implementation of these schemes remains questionable. Estimation of Poverty Line: The current poverty line is based on a survey of consumer behaviour conducted in 1973-74. Based on this survey, a consumption basket was proposed that would ensure, on an average, 2100 calories per person per day in urban areas and 2400 calories per person per day in rural areas. The poverty lines that were then established have been criticized for being too low, and for focusing exclusively on food consumption norms, with no allowance being made for expenditure on, inter alia, health, education, and other basic needs (Saith, 2005) In November 2009, the Report of the Expert Group to Review the Methodology for Estimation of Poverty (chaired by Professor Suresh Tendulkar) was submitted to the Planning Commission (GoI, 2009). The poverty line that it proposes actually depends on reduced calorie consumption, and fails to provide for reasonable household expenditures on schooling and health. The revised minimum calorie norm or minimum dietary energy requirements (MDER)

5 Food Schemes = Targeted Public Distribution System (TPDS), Antyodaya Anna Yojana (AAY), National Old Age Pension Scheme (NOAPS), National Family Benefit Scheme (NFBS), National Maternity Benefit Scheme (NMBS), Integrated Child Development Services (ICDS), Mid-Day Meal Scheme (MDMS)

for developing countries recommended by FAO is 1800 calories per capita per day. However MDER is defined as the amount of energy needed for light or sedentary activity. Given that we do have a high level of under-nutrition in India, drawing a poverty line at the MDER is clearly problematic, since taking a slightly higher cut-off will increase the number of poor people substantially. This leads to gross underestimate and led to large exclusion of the poor (Madhura Swaminathan 2010) 6 Under pressure from all sides over its estimate of people living below the poverty line, the Planning Commission in Mar 2012 proposed to constitute a new committee to revisit the methodology to estimate poverty. Cash Cropping: Indian agriculture is moving away from diverse producers to a mono-crop plantation system dependent on cash from its rice, wheat & maize. Coarse grain production and consumption has literally vanished from the needy section of the community. This kind of mono cropping leads to land degradation and equally worse communities lose their indigenous and balanced dietary habits. Pulses Production: India is the worlds largest producer, consumer and importer. The production has been stagnant from past 20 years. Per capita consumption is declining, from 60 g in 1950-51 to 32 g at present.

http://agrarianstudies.org/UserFiles/File/madhura_the_new_poverty_line.pdf

Demand 25

Production

Import

20

15

10

Figure 3: Demand Supply of pulses

Procurement: The procurement of food grains is open ended and government agencies purchase all the quantities offered by the farmers at MSP. Because of such a policy the actual stock position vis--vis minimum buffer norm in the central pool is consistently higher. In Apr 2010 it recorded 202% higher than the minimum buffer norm. Government of India introduced a scheme in 1997-98 called decentralized procurement scheme. Under this scheme, only 10 State Governments are undertaking procurement of specific amount of paddy/rice and wheat on behalf of Government of India. The Central Government reimburses the entire expenditure incurred by the State Governments on the procurement operations. MSP for Pulses & Coarse Grain: In order to encourage pulse production the government has increased the MSP and it is now comparable with the import prices of same. Which was otherwise only 50% of the import prices (Tur or Arhar) till 2010. The MSP for coarse Ragi & Jowar has been increased by almost 50%. Will the latest increase in MSP achieve anything? Between 2007 and 2009 Kharif, MSP for the three pulses was raised (45-55 per cent); but output numbers are far from impressive. Acreage

http://nfsm.gov.in/Presentations/BrainStorming/JS_CROPS.ppt

has stagnated output of the three pulses actually declined from 2007 levels. Yields continue to be rather low at about 600 kg per hectare while Canada averages around 2000 Kg per hectare Rs/Q Tur Bajra /Maize Ragi/ Jowar 2010-11 3000 880 880 2010-12 3200 980 980 2012-2013 3850 1175 1500

Hoarding and black-marketing: Hoarding and black-marketing by intermediaries in the distribution systems has been a major cause for food inflation. The Prevention of Blackmarketing and Maintenance of Supplies of Essential Commodities Act, 1980 is being implemented by the State Governments/UT Administrations for the prevention of unethical trade practices like hoarding and black-marketing. 119 detention orders were issued under the Act during the year 2007. The Government had imposed stock limits in 2008 on sugar, pulses, onions, paddy and edible oils to control prices. The restrictions were withdrawn since 2009 on improved supply and higher production. Storage and agro-processing: About 65-70% of total food grains produced in the country are stored at farm level. The planning commission claims that 108.75 million MT warehousing capacity is available with India and estimates 35 million MT additional capacity would be required in next 5 -10 years. There are estimates that substantial quantity of food grains (about 6.0% to 10% of total production) `are damaged due to moisture, insects, rodents and fungi. 8 ii That makes the rice & wheat loss alone to an extent of 62 million MT. The total production of fruits and vegetable is over 45 million tones and 85 million tonnes respectively. The losses are estimated to the extent of 20 -30 per cent due to lack of proper harvesting, processing and storage facilities, which is valued at Rs. 230 billion.9

8 9

http://planningcommission.nic.in/aboutus/committee/wrkgrp12/pp/wg_ware.pdf http://ageconsearch.umn.edu/bitstream/47429/2/8.pdf

Commercializing Malnutrition intervention

Food fortification: Deficits in three key micronutrients vitamin A, iron and iodine prevent nearly three billion people from achieving their full potential. Fortification is not an alternative to improving nutrition through policy and programming responses that encourage the consumption of a nutritionally adequate diet composed of a variety of available foods. Poor are known to suffer from multiple micronutrient deficiencies, all of which cannot realistically be addressed by fortified foods. As most traditional diets are normally able to provide the micronutrients required for normal function and growth, micronutrient deficiencies generally result from inadequate intakes of the overall diet. Fortied foods often fail to reach the poorest segments of the general population who are at the greatest risk of micronutrient deciency. This is because such groups often have restricted access to fortied foods due to low purchasing power and an underdeveloped distribution channel. Ready to eat food: Jharkhand government in compliance to the directives by the Ministry of Women and Child Development, Govt. of India, did a pilot to prepare Ready to Eat food (RTE) to be distributed for undernourished children as Take Home Ration (THR) and also for preschool children at center. There is increasing inclinations from policymaker towards ready to eat food. While ready-to-use therapeutic food (RUTF) has a place in the treatment of severe acute malnutrition, promotion of RUTF and its wider use will well undermine breastfeeding, which for children between 6 to 24+ months of age, is the best safeguard against malnutrition. This will also undermine the community based approach and their self determination capability in addressing the nutrition security issue. As things now are, scaled up delivery of commercial or foreign packages of nutrition interventions is being aggressively promoted, inside the UN, and outside by major governments, their agencies, foundations, and other big non-government organisations. Branded, commercial ready-to-use therapeutic food (RUTF) is now part of these packages. In contrast, the promotion of community-based and local government-supported empowerment of people living in poverty to claim their human rights to good nutrition, which is the rational way forward, is neglected10

10

http://www.wphna.org/downloadsfeb2011/11-02%20WN3%20Comm%20RUTF%20pdf.pdf

Cash Transfer Scheme (CTS): There is a growing inclination among government groups that cash transfers instead of food is a cheaper, faster, and more efficient way to deliver help to the hungry. The UNDP paper advocates conditional cash transfers to improve education levels, health indicators and social wellbeing.11 The Indian government plans to roll out the cash transfer scheme in 51 districts from the stipulated date of January 1. It would be extended to 18 states from April and the rest of the country later in 2013. The government aims to cover the entire country by the end of next year, ahead of the 2014 elections. Subsidies on fertiliser, LPG, kerosene, pension payments, scholarships as well as payments under MGNREGA and other government welfare programmes would be made directly. The scheme for cooking gas subsidies will also cover eligible APL or above poverty line families. There is no reason to expect that cash transfers solve all the existing problems. One of the most significant problems existing now is the identification of beneficiaries. In a situation where many of the small and marginal farmers do not have proper land records, especially in the case of tenancy, it is not sure to whom the benefits of the cash transfer will go. Issues like what if when people do not posses enough documentation or do not have Adhar Cards (UID), even if they managed to get one the situation of rural banking is pathetic so much so they are not in a position to provide service to the existing customer base. CCT or CTS has already been piloted for kerosene in parts of Rajasthan, as well as cooking gas in Karnataka and have been very impressive. Climate Change: The frequency, intensity and magnitude of droughts and floods are expected to increase as a result of climate change. The projected increase in temperatures and rainfall variability will negatively impact crop and livestock enterprises in most areas. Disease and pests associated with high temperatures are also likely to increase. Adaptation interventions that enhance farming communities resilience to climate change induced effects are critical for the realization of FNS

11

http://www.undp.org.in/content/cct/CCT_DP.pdf

Gender: A UNICEF study in India showed that women with higher autonomy (indicated by access to money and freedom to choose to go to the market) were significantly less likely to have a stunted child when compared with their peers who had less autonomy. 12 Vicious Cycle: According to the most recent estimates, child undernutrition contributes to more than one third of child deaths. Undernourished children who survive may enter the vicious cycle of recurring illness and faltering growth, with irreversible damage to their growth, cognitive development, school performance, and future productivity as adults. Malnourished children are much more likely to suffer from a serious infection and die from common childhood illnesses such as diarrhoea, measles, pneumonia and malaria, as well as HIV and AIDS. Low birth weight: The Human Development Report states, a staggering 21.5% percentage of babies in India are born with LBW, a problem that began inutero. A mean deficit of 1.4 to 1.6 kg in weight at one year worsens to a deficit of about 9 kg at 10 years and 1318 kg when adults. A similar trend is seen in the case of heights (where a deficit of 1cm at 1 year reaches 1213 cm when adult). It is therefore, not surprising that about half of children are under weight (moderate to severe under nutrition) or are stunted. There are no differences in the nutritional status between girls and boys; about 30% of all adults have BMI<18.5 (33% of women and 28% of men), which defines adult malnutrition. Maternal Literacy: The percentage of children who are severely underweight is almost five times higher among children whose mothers have no education than among children whose mothers have 12 or more years of schooling. Child Care: Children who are undernourished, not optimally breastfed or suffering from micronutrient deficiencies have substantially lower chances of survival than children who are well nourished Urban Vs Rural: Undernutrition is substantially higher in rural than in urban areas. Short birth intervals are associated with higher levels of undernutrition Caste: Children from scheduled tribes have the poorest nutritional status on almost every measure and the high prevalence of wasting in this group (28 per cent) is of particular concern.

12

http://www.unicef.org/india/nutrition.html

The mean heights and weights of children from SC/ST and other marginalized sections are below the national mean values13

Statement of the position

Many of the so-called poor countries produce more than enough food not only for their internal markets, but even for export, with hunger and malnutrition nonetheless persisting in the country. In a market economy, people who are too poor to exercise effective demand will not have food (unless they produce food for themselves, or receive food through transfers). Hunger and malnutrition today are not about availability of food, but are a matter of rights and entitlements. Right to food includes the right to be helped if one cannot take care of oneself, but it is, above all, the right to be able to feed oneself in dignity
5

There are immediate and underlying causes of food insecurity and undernutrition. This needs a multi-disciplinary approach covering diet diversification including micronutrients, womens empowerment, birth spacing, child care, education, health, safe drinking water, sanitation, and hygiene. According to the third National Family Health Survey (NFHS-3), in 20052006, nearly 56.2% of married women and 57.9% of pregnant women in the age group (1549) are anemic, Anemia among children in the age group 635 months also worsened from 19981999 to 20052006, from 74.2% to 78.9%. Access to health care and sanitation facilities is among the key determinants of nutrition security. Particularly womens access to clean drinking water, toilet facilities, and clean cooking fuel influences their health outcomes, which are critical to child health and nutrition. Womens health, nutrition, education and decision making through empowerment are important for nations nutrition security but remain neglected due to societal biases.14 It has been estimated that nutrition-specific interventions that tackle only the direct or immediate causes of undernutrition such as poor breast-feeding practices or vitamin and mineral deficiencies can only reduce global levels of chronic undernutrition by one-third and child mortality by one-quarter15. While these would be extremely significant actions, it is also clear

13 14

http://planningcommission.nic.in/plans/planrel/fiveyr/11th/11_v2/11v2_ch4.pdf http://www.insaindia.org/Nutrituion%20security%20position%20paper.pdf 15 http://www.dfid.gov.uk/Documents/publications1/scal-up-nutr-uk-pos-undernutr.pdf

that without efforts to address the indirect or underlying causes the global problem will not be resolved Decentralised Governance: It has been recognized that better governance is important for effective functioning of food-based programmes. Social mobilization, community participation and decentralized approach are necessary in this context16. The government should decentralize procurement; storage and distribution enhance efficiency and local trade. Transparency and social monitoring should be promoted and instituted at grass root level. Chhattisgarhs model suggest that removing PDS from private businessmen and giving to local community-owned bodies like forest co-operatives employing tribals and women self-help groups will go long way in delivery mechanism. Universal PDS: The performance of the PDS varies from state to state and it is observed that the states with sizable poor and vulnerable populations do not fare so well on the PDS or other safety net programmes, as the following graph suggests.

Figure 4: Distribution of Poverty and Total (Public Distribution Systems, Targeted Public Distribution System, and Antyodaya Anna Yojana) Offtake by State, 20082009 (Provisional)iii

One of the most critical questions thus remains targeting and identifying the poor. In 2007 the planning commission acknowledged large scale exclusion of poor. The Indian Government

16

http://www.oxfamindia.org/sites/www.oxfamindia.org/files/working_paper_7.pdf

needs to learn its lessons from past and implement universal public distribution system like in Tamil Nadu. The proposed National Food Security Bill (NFSB) proposes supply of Rice, Wheat and Coarse grain through the TPDS. However it is essential to include pulses and cooking oil in the PDS so that needy have access to protein rich and energy dense food. If we consider some of the major sources of protein, pulses turn out to be one of the most economical for human consumption. Pulses are 1825 per cent protein. Currently, however, only 11 per cent of Indians' protein needs are met by pulses. Their remaining needs are either met through other sources or not at all. Source Milk Poultry meat Eggs Pulses Protein content (per/kg) 3.2% 18-20% 14% 18-25% Avg. price (Rs. per kg) 24 100 60 85 Avg. cost of protein (Rs. per 100/kg) 75 53 42 38

Source: Principles of Nutrition and Dietetics, primary research

Diversification: Production basket needs to be diversified toward high-value commodities, large postharvest losses (20% to 30% for fruits and vegetables) and poor value addition continues to pose challenges. Most of the existing marketing systems for high-value commodities, particularly fruits and vegetables, are quite fragmented and the supply chains are not adequate for handling perishable commoditiesiv Promoting Nutri-Cereals (Coarse): Incentivize cropping nutritious traditional and low water use crops such as millets. Millets can be grown in arid and rainfed region with rainfall as low as 350 mm. The government also should increase the minimum support price for coarse grains & pulses Purchase Power: To eradicate all forms of malnutrition, increasing the purchasing power of the poor and strengthening the public distribution system are indispensable. Providing for an adequate minimum nutrition of all household members year-round simply takes more, because the percentage of total income being spent on food is lower due to competing needs. Large absolute increase in poor households' incomes are necessary along with synergistic public

expenditures in health, water, sanitation, nutrition and women's and children's care in order to root out poverty-linked malnutrition in the world. Poverty still is the major determinant of protein-energy malnutrition in the world as conventional wisdom has indicated us17. Development Indicator: Nutrition should be clearly stated as an important input and output parameter for judging development and should not be treated as trickle down beneficiary of economic and industrial development Direct Marketing (Supply Chain): A World Bank study on the value chains of mangoes, lychees, and potatoes in Bihar shows that a significant amount of the consumer price is lost in transport and wastage; for mangoes, the farmers receive 34%, for lychees 42% and for potatoes 16% of the consumer price (World Bank 2007). For instance, a farmer selling in the Azadpur market in Delhi has to pay a 6% fee to the commission agent, while a farmer in the Vashi market in Mumbai has to pay 8.5%, in addition to a market fee of 1%. These are the official rates (quite high for the services delivered by the commission agents); unofficially, the fees go up to 12%16%. Hence, efforts to promote direct farm market linkages and strengthen supply chains would help enhance rural farmers profit margin. The government need improve rural infrastructure manifolds in terms of rural accessibility and food storage facilities. Gaps Way Forward/ Suggestion Availability Low productivity under small and sustenance farming Storage, Transportation & Marketing Financial Services Improve water management rural lift irrigation where water table is high (e.g N. Bihar) Technology & extension Improve rural road Improve rural warehousing & cold storage Improve access to credit Lower interest rate agricultural loans (small farmers ? )

17

http://www.humaninfo.org/aviva/ch31.htm

Climate change mitigation

Improved awareness Promote local traditional adaptation techniques Promote innovation Accessibility

Service Delivery of Food Schemes

Universalise PDS Decentralize purchase for PDS, ICDS & MDM Include Nutri cereals, pulses and oil in PDS Institute Social Monitoring Avoid private business men, involve women SHG, Cooperatives SC & ST SHG & cooperatives need to be given priority in running PDS and MDM schemes

Caste Divide

Cultural practices

Improved awareness with regards to good and bad practices Government need to focus on investing in rural India Provide rural amenities at par with urban Adsorption

Rural Vs Urban Divide

Diversification

Promote millet/ coarse grain farming by incentivizing and promote consumption through awareness generation

Clean drinking water and sanitation facilities

Increased awareness Maintenance of Watsan facilities Increased awareness Improve coverage and delivery Adult education Improve coverage, quality and functioning of schools Improves awareness Incentivise women participation in workforce

Health services

Education

Gender

 Background information
Emmanuel Hospital Association (EHA) is a fellowship of institutions (including 20 hospitals and 30 Projects) and individuals that exists to transform communities through caring, with primary focus on the poor and marginalized. EHA was founded in 1970 as an indigenous Christian health and development agency serving the people of North India. Its primary focus is the poor, largely in rural areas. With a catchment population of nearly seven million, EHA treats more than 500,000 patients each year in some of India's most needy areas. EHA derives it vision and values from life of Lord Jesus Christ. Bible says He (God) defends the cause of the fatherless and the widow, and loves the alien, giving him food and clothing. (Deut. 10:18) Jesus did it when he was on the earth. Moses law commands people to keep the sabbatical (seventh) and Jubilee (fiftieth) year. The sabbatical year is kept so that poor can get food (Exodus 23:11) and Jubilee year so that the property of the poor can be restored (Leviticus 25:10). Jesus refers to the Year of Jubilee in his manifesto (Luke 4: 16-19). When explaining Gods Kingdom he says those who fed the hungry, quenched the thirsty did it to Him. (Matt 25:33-35) This is the driving force behind EHA in standing up for the marginalized and making their voice heard. The position paper tries to represent its experience and learning from over 29 Community health & development projects that are found in 27 blocks / municipalities of which 22 are rural and are located in some of the most backward regions of our country.

Conclusion
The World Health Organization cites malnutrition as the greatest single threat to the world's public health but the answer to Food Security and Malnutrition is not easy. The issue is complex and multi sectoral and so the response should be.

How we will work

The objective of EHA FNS programme will be to mainstream FNS in the project interventions. This will involve sensitising project team to see the linkages, identify best practices and scaling it up. Project will include undernutrition as a indicator in measuring development outputs. EHA will focus on high impact low cost nutrition interventions which will be accessible to our CHDP target communities or EHA units catchment areas.

The focus will be to break the vicious cycle of malnutrition in by targeting more adolescent girls, pregnant women and young children Improve communities knowledge, behaviour, usage and monitoring of health and nutrition services by mobilising womens groups, child care givers, strengthening village health committees and initiating communication campaigns aimed at changing behaviour in the long term

Test new approaches and share the lessons to wider audience for example promoting agriculture based social enterprises in the communities

What we expect to deliver by 2015 Mainstream Food Security & Nutrition Security intervention in at least 12 CHDP Promote right nutrition & care among 12,000 pregnant women and their child during 1,000 day window (pregnancy to childs 2nd birthday) through linkages thus impact on a childs ability to grow, learn, and rise out of poverty Reach 12,000 malnourished U5 with Hearth/ Nutrition Education and Rehabilitation Session (NERS) /advocating for new ICDS centres Help 600 farmers adopt improved technology like SRI, SWI and sustainable agriculture

i ii iii

http://www.sccommissioners.org/Starvation/starvation.html http://pib.nic.in/newsite/erelease.aspx?relid=80834
Source: http://fcamin.nic.in/dfpd_html/index.asp

iv

ADB Sustainable Development Working Paper Series No. 16

http://www.adb.org/sites/default/files/pub/2010/ADB-WP16-Food-and-Nutrition-Security-StatusIndia.pdf http://www.unhcr.org/4885998c2.html http://globalfoodchainpartnerships.org/india/Papers/Posters/ChilukuriMaheshwar.pdf http://www.downtoearth.org.in/content/letters-april-15-2012 http://devinder-sharma.blogspot.in/2009/03/coarse-cereals-should-be-called-nutri.html www.milletindia.org http://www.indg.in/agriculture/msp/MSP-English.pdf/ http://foodgrainsbank.ca/uploads/fjrf_biblical.pdf