Tackling ‘hidden hunger’ in Andhra Pradesh

Ms Perda Leela, 25 years old, a resident of Chinnabarada village in Andhra Pradesh’s Vizianagaram district, was initially sceptical when she received fortified rice through the government-run public distribution system (PDS). Her neighbours warned her that it was “plastic rice”. However, after Tata Trusts officials explained to Ms Leela and others that fortified rice was perfectly safe and could help counter health risks like anaemia, her doubts and concerns were assuaged.

“Now I happily cook the fortified rice and feed it to my entire family. I am even noticing a change in my three-year old child, who is much more physically active than earlier,” she says.

Anecdotal evidence finds that Tata Trusts’ rice fortification programme has led to a substantial increase of health standards in Andhra Pradesh, including a reduction of anaemia among children and mothers, through the consumption of fortified rice. This fortified rice is nothing but rice made more nutritious by adding vitamins and minerals, which are often lost during the milling and polishing process. Implemented by the Trusts in collaboration with the government of Andhra Pradesh, the programme is also aligned with Andhra Pradesh’s State Nutrition Mission.

B Meena Kumari, a technical manager with the Andhra Pradesh State Civil Supplies Corporation Ltd. (APSCSCL), says, “Marginal and vulnerable communities are far from living a healthy lifestyle and their access to nutritious food is limited due to their socio-economic conditions. Rice fortification is a path-breaking initiative which provides the required daily recommended nutrients by adding micronutrients in staple food like rice, which helps in addressing ‘hidden hunger’ among those communities.”

Mission nutrition

Hidden hunger is defined by the Food and Agriculture Organisation (FAO) as a situation where ‘the quality of food that people eat does not meet their nutrient requirements’. This deficiency affects a person’s health, productivity, and psychological development.

Overall, over two billion people across the world suffer from hidden hunger-related illnesses. India’s record of malnutrition is particularly alarming. Over 67% of children under five years suffer from anaemia due to chronic undernutrition, while 35.5% are stunted. Similarly, anaemia among Indian women of reproductive age (15 – 49 years) stands at an abysmal 57.2%.

Andhra Pradesh is one state where a large number of people are afflicted with micronutrient deficiencies and related illnesses – particularly iron deficiency anaemia, whose prevalence is shockingly high. The Andhra Pradesh state government’s fact sheet (NFHS-4) reveals that 70% of children between the ages of six months and five years suffer from vitamin and mineral deficiency-related birth defects. In addition, 58% of pregnant women suffer from anaemia and micronutrient deficiencies.

These grim statistics underline an urgent need for scalable interventions that address the problem of micronutrient deficiency in the state.

A wide-ranging solution

Food fortification is one such cost-effective public health intervention to tackle micronutrient deficiencies. It is also part of the NITI Aayog-developed National Nutrition Strategy, which aims to tackle the high burden of malnutrition in India. The process entails the deliberate inclusion of essential minerals and vitamins in everyday foods to scale up nutrition levels on a mass scale.

In this context, fortification of rice, in particular, is the most cost-effective and sustainable manner in which micronutrients can be supplied to large populations by utilising existing public-funded interventions such as the Integrated Child Development Scheme (ICDS), Mid-Day Meals (MDM), and Public Distribution System (PDS) schemes.

Working through all the above channels, Tata Trusts’ rice fortification intervention in Andhra Pradesh involves the following aspects:

• Introducing fortified rice in the MDM and ICDS meal schemes through procurement and blending of fortified kernels in Krishna and West Godavari districts,
• Empanelling rice mills and setting up dosifiers (machines that add vital nutrients to rice) in rice mills with pre-defined protocols for quality, monitoring, logistics, and distribution to the MDM scheme and AWCs (anganwadi centres),
• Advocacy and technical support to the government of Andhra Pradesh for distributing fortified rice under PDS in Vizianagaram district, and scaling up the programme to the entire state under MDM and ICDS,
• Continuous support to APSCSCL for the pilot rice fortification programme under PDS throughout the state,
• Supporting the government for developing standardised QA and QC protocols to ensure the quality production of fortified rice, and envisaging strategies to build the capacities of APSCSCL functionaries and rice millers across the state.

A noticeable change

To date, the Trusts have helped APSCSCL produce 150,000 Metric tonnes(MT) of fortified rice. Among the beneficiaries are over 1.2 million schoolchildren, and pregnant and lactating women in the Krishna, West Godavari, and Vizianagaram districts. The programme is enabling the Trusts to showcase a cost-effective replicable model for scaling up rice fortification in other parts of Andhra Pradesh. Food fortification also helps the country progress upon three of the UN’s Sustainable Development Goals for 2030, viz., ‘No Poverty’, ‘Zero Hunger’ and ‘Good Health and Well-Being’.

“Due to the consumption of fortified rice, we have seen a significant reduction in the cases of children falling ill, as compared to the previous academic year. We have noticed that they are a lot more active in games and studies,” says Naga Malleswari, a medical supervisor at the Andhra Pradesh Social Welfare Residential Educational Institutions Society(APSWREIS), Adavithakellapadu, Guntur district.

Even better, the continuous blending technology model developed and adopted by Tata Trusts has led to a significant drop in the expenditure to produce fortified rice, consequently reducing the burden on the government exchequer.

By developing a culturally-appropriate, economically viable, sustainable, and scalable model to tackle hidden hunger in India, Tata Trusts’ rice fortification programme in Andhra Pradesh provides a blueprint for ridding the country of the scourge of malnutrition.