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SOCIAL WELFARE AND NUTRITION

SOCIAL WELFARE

13.1 Programmes of social welfare as envisaged in the Plans are designed essentially to supplement the larger effort at human resource development. The objective is to improve the quality of life and to cater to the special needs of vulnerable sections like children, women and the handicapped through organised and sustained development activities.

Review

13.2 During the past three decades of planned development, social welfare as a Plan component has acquired great significance, as evidenced by its widening interface with Government and increasing participation by voluntary agencies. Upto the close of the Fourth Plan, most of the programmes were curative or ameliorative in nature. From the Fifth Plan onwards, emphasis has been on the promotion of preventive and developmental services. The Integrated Child Development Services (ICDS) scheme was one of the major programmes taken up in 1975-76 in the Central sector on an experimental basis. It was started in thirty three rural/tribal blocks and some urban slums, for providing children from poor families with the basic services of health, supplementary nutrition and non-formal pre-school education for a better start in life. On the basis of the positive results of these experimental projects, the pace of expansion of this programme was accelerated in the Sixth Plan. The programme has been evaluated through various studies, which revealed that some of the deficiencies noticed in the early stages had been looked into. The coverage of children below 3 years of age, which was found to be low, had started improving and there was an increase in the level of preventive health care and also greater utilisation of health services. An outstanding achievement in the implementation of the ICDS scheme has been the increase in the convergence of various mutually supportive services.

13.3 Grants continued to be given to voluntary organisations for providing creches for children of working/ ailing mothers in the unorganised sector. As per the recommendation of an expert group, constituted in 1981, the scheme "services for children in need of care and protection" was modified and the quantum of assistance to voluntary organisations enhanced. Training programmes for various functionaries connected with the implementation of the scheme were developed and launched in several States/Union Territories.

13.4 Programmes for promoting women's welfare received further fillip. These included socio-economic programmes, which gave employment opportunities to needy women and disabled persons to supplement their family incomes or to bring about their economic rehabilitation;condensed courses/vocational training courses which prepared women for certain recognised examinations thus enabling them to qualify for specific jobs and acquire various skills; and hostels for women, which helped in providing women from far-flung areas with staying and day-care facilities for their children. However, not all such programmes have progressed satisfactorily. The performance of the scheme "Functional Literacy for Adult Women" (FLAW) which was being implemented in 551 ICDS project areas was evaluated through independent organisations. The average attendance of women in FLAW classes was not found to be satisfactory, reportedly sixteen against the envisaged thirty. The scheme on "welfare of destitute women" also did not make much headway.

13.5 Greater attention was paid to the effective implementation of various education, training and rehabilitation programmes for physically handicapped persons. The rates of scholarships to the handicapped were revised upward with effect from 1982-83. A new scheme of "Assistance to disabled persons for purchase/fitting of aids and appliances" was introduced in 1981 on the occasion of the International Year of the Disabled for the economically weak disabled persons. In addition to the special employment exchanges for the handicapped, special cells were set up in the normal employment exchanges to facilitate proper placement of the handicapped.

13.6 The Central Social Welfare Board continued to function as the focal and apex agency in the voluntary sector. It made notable progress in its on-going programmes and initiated new activities during the Plan period. From its traditional role of a funding agency, the Board assumed the role of a catalyst of social change. In this process it assisted about 12,000 voluntary organisations all over the country in the field of welfare of children,women and the handicapped. It made efforts to extend its programmes to the uncovered areas to the extent possible, by encouraging new voluntary organisations. The Board brought out a directory of the social welfare organisations aided by it. The Voluntary Action Bureau, set up in 1982 to meet the challenge of crimes and atrocities against women and children, and to create an awakening among the masses towards their social responsibility, made good progress. Similar bureaux were set up in all the States/UTs except in Andaman and Nicobar Islands and Goa, Daman and Diu.

13.7 The Ministry of Social and Women's Welfare continued to give grants to universities/research institutions/professional bodies for (i) undertaking research studies and (ii) organising workshops/seminars which could help in identifying problem areas and research needs, discuss social problems and disseminate research findings. The National Institute of Social Defence (NISD) and the Natioal Institute of Public Cooperation and Child Development (NIPCCD) continued to undertake research studies and organise training courses/seminars/ workshops.

13.8 An Information and Mass Educational Cell was established with the aim of creating awareness of various social welfare schemes, to mobilise public opinion against social evils like atrocities against women, drinking, child marriage, etc., and to promote positive social attitudes. A plan of action was worked out and production of films and other software material was taken up.

13.9 During the Sixth Plan, several Central programmes had a number of achievements to their credit. These included the sanctioning of additional 869 ICDS projects bringing the total number of projects to 1019; institutional and non-institutional services to 32,000 children in need of care and protection; 4,785 condensed and vocational training courses benefiting 1,11,000 women; 3,589 socio-economic units covering 47,011 women and disabled persons; continuation of the national institutes for the handicpped, and assistance to 58 voluntary organisations for assisting about 25,000 disabled persons to acquire aids and appliances, besides providing various training and research programmes. In additional, 7,000 creche units covering 1,75,000 children and 344 working women's hostels with a total capacity of 22,150 inmates were functioning by the end of 1984-85. In addition to training functionaries for the ICDS scheme, the NIPCCD organised 364 workshops and seminars, brought out 175 publications and 60 other documents, and conducted 40 research studies.

13.10 Social Welfare programmes received further momentum in the State sector as well. Taking advantage of the Central ICDS model, some State Governments initiated similar projects. By March, 1985, 117 projects had been sanctionad. The other programmes undei implementation were creches, balwadis, training-cum-production centres for women, institutional and non-institutional services for socially and physically handicapped etc. Children's Acts were enacted in all the States except Nagaland. However, their enforcement is yet to be extended to about one-third of the districts in the country, and services under this legislation were not uniformly available in the covered districts.

13.11 In spite of an outlay of Rs. 272 crore on Social Welfare in the Sixth Plan, there exist wide gaps in coverage and quality. Certain drawbacks have also been observed in the functioning of various schemes. The reach of services in ICDS was affected due to the considerable backlog in training and posting of personnel at various levels, particularly at the anganwadi and supervisory levels. Sustained efforts were made to improve the quality of services being provided in the projects, including health cover and immunisation, training of the anganwadi workers, and technical supervision. Coordination between health and welfare departments continued to improve. Referral services were, however, available only in very few projects. Community participation needed improvement. The quality of training at even a single level of social service was not uniform.

13.12 By and large, the concentration of institutional services for children, women and the aged had been in the urban areas, and there were regional imbalances. Institutional services lacked the minimum standard of services, including adequate trained man-power and supervision. Though the grant-in-aid programme had been in existence for a long time, voluntary effort in the North Eastern Region and backward States has yet to develop fully. There was an increasing tendency among voluntary organisations to depend wholly on aid from Government. A proper field counselling system was lacking.

13.13 Monitoring of physical performance is essential for gearing up the programmes to attain the envisaged objectives. Whereas the ICDS programme was systematically monitored such inbuilt arrangements to facilitate corrective action for other programmes were lacking.

13.14 In a few States, the Social Welfare programmes continued to be weak, and lacking in perspective. These need to be reoriented, keeping in view the emerging social problems and changed socio-cultural milieu of the region. In some States, the Social Welfare programmes continue to be administered by more than one department. The administrative machinery at the State level continues to be traditional and, in many States, it is not equipped to formulate proper schemes. Induction of professional competence and establishment of linkages with grassroot level workers were not given adequate attention. State-level organisations need to be reoriented with an interdisciplinary mix of personnel, taking into consideration programme specifications and objectives. This would make project formulation and implementation more effective, and responsive to local needs. Feedback from States/UTs, particularly on achievement in terms of physical targets under various programmes, continued to be inadequate, resulting in ineffective review.

The strategy for the Seventh Plan

13.15 Social Welfare services in their various facets are preventive, promotive, developmental and rehabilitative in nature. They are designed to enable the targeted sections of society to realise their full potential for growth. The programmes of the Social Welfare sector are only supplementary in nature, designed as they are to meet certain needs of the most deprived and vulnerable members of society.

13.16 The welfare of children, women and the disabled is linked with the development of the family, the basic social unit. Family welfare can best be promoted by providing to its members greater opportunities for employment to augment their incomes substantially; for the most part, these opportunities would be in rural development, agriculture, animal husbandry and other such sectors.

13.17 Preventive and developmental services of a domiciliary nature would be accorded priority over institutional care, as the latter tends to be expensive, and lacks a familial atmosphere which is necessary for healthy growth. Institutional services would be developed wherever necessary and machinery would be geared up to enforce minimum standards of services in the institutions. The existing facilities for institutional care and training of inmates would be reviewed and modified wherever necessary in order to make the programmes more effective. As massive efforts cannot be undertaken in all the fields of social welfare due to financial and organisational constraints, a selective approach has to be adopted for undertaking various programmes with a view to maximising the benefits to a larger number and minimising administrative costs. Spreading resources thin over a large number of schemes would be avoided, in order to make an impact on the intended target groups.

13.18 Child welfare would be given the highest priority. The basic minimum child care services would be extended to the most vulnerable group, i.e. 0-6 years of age, specially the age-group 0-3 years, in order to reduce the high incidence of child mortality, morbidity and malnutrition in the country. More emphasis would be laid on enhancing the capabilities of the mother to look after the health and nutritional needs of the children. Effective coordination would be sought in the provision of health inputs, nutrition education, water supply and other relevant services in order to maximise the returns from investments. Schemes for the welfare of women and also the handicapped will be given greater attention.

13.19 The emerging nuclear family is exposed to severe economic and social strains, as the traditional mechanism of social security and adjustment in time of crisis and conflict has almost been eroded. Hence stress would be on further strengthening the supportive services to the family.

13.20 In programmes for women, greater stress would be laid on the generation of both skilled and unskilled employment and promotion of opportunities for higher level skills through proper education and vocational training. Areas for the introduction of new technologies for reducing drudgery of household work would be explored;studies would be taken up in this area. The lacunae in legislation which hinder the availing of benefits and which also discriminate against women as compared to men would be reviewed in order to make the laws more equitable and practical.

13.21 Education and training play a vital role in the socio-economic rehabilitation of the physically handicapped. They would be encouraged to pursue education and vocational training through scholarships and other promotional aids in order to draw them closer to the normal stream of life. Prevention of disabilities through early detection and treatment of the physically handicapped would be given relatively high priority compared to purely curative services. Training institutions will be strengthened and expanded in order to make them perform the roles expected of them at the national level. Special attention would be given to the development of multi-disciplinary services, both in identification and treatment of the handicapped. Facilities for fitting of aids and appliances, particularly in the remote and backward areas, would be expanded in order to enable the beneficiaries to participate in economic and cultural activities to the fullest possible extent.

13.22 The Central Social Welfare Board and its counterparts in the States would be required to shoulder more responsibilty in promoting, strengthening and stimulating voluntary effort in different sub-sectors of social welfare and specifically in the areas of children's and women's welfare. The existing arrangements for coordination between the State Boards and State Departments of Social Welfare would be reviewed in order to avoid any duplication of effort. Voluntary agencies will be aided to take up activities in the backward, tribal and rural areas, rather than concentrating their efforts in the urban and metropolitan centres. Besides the programme support, grants-in-aid would be given for strengthening their administrative capabilities and expanding their programme coverage particularly in respect of children, women and the handicapped. The existing procedure for the release of grants would be reviewed with a view to make the grant-in-aid programme more simple and responsive to the needs of the voluntary agencies.

13.23 During the previous Plans, welfare services have expanded considerably, particularly in the areas of child and women's welfare. Besides, a variety of programmes for the economically weaker sections have been introduced by different Ministries at the Centre and also by the State Governments. The administrative machinery for project identification, formulation and implementation, particularly at the State level, would need to be strengthened, taking into account the programme content and coverage. Professionally trained technical manpower would have to be inducted at decision-making and supervisory levels. Functionaries engaged at different levels in the on-going schemes would have to be suitably trained to make them acquire the basic skills required for programme management.

13.24 Social Welfare programmes by their very nature will not succeed unless the local communities and beneficiaries participate fully and extend their cooperation in all stages of implementation. They would have to be involved in identification of local needs and prospective beneficiaries, delivery of services and programme supervision. Welfare Advisory Committees at different levels with representatives from local bodies and other community agencies would have to be constituted to deliver benefits to the intended target groups.

Seventh Plan Programmes

13.25 Child welfare: The major programme of ICDS seeks to lay a solid foundation for the development of the nation's human resource by providing an integrated package of early childhood services. These consist of (i) supplementary nutrition, (ii) immunisation, (iii) health check-up, (iv) referral services, (v) nutrition and health education and (vi) non-formal education to children below 6 years of age and pregnant and nursing mothers in most backward rural/tribal blocks and urban slums. While the programme would be expanded, emphasis will be on consolidation and improving the quality of services. The health component of the programme, viz., immunisation, health check-up, Vitamin 'A' prophylaxis, and iron and folic acid distribution, would be strengthened with stress on uninterrupted delivery of services. Necessary action would be initiated for maintaining the "cold chain" for the proper storage of vaccines. Efforts would be made to see that these services specially reach children below 3 years of age. Greater stress would be laid on the training of functionaries, as well as on their continued education through periodical refresher training courses. The mechanism for effective coordination between welfare and health departments at the block levels would be strengthened. Community support and participation would be elicited in running the programme. Further streamlining of the monitoring mechanism is envisaged for timely modifications and corrections in the programme, wherever necessary. Voluntary agencies and individual talent will be utilised in programme supervision, review and monitoring. They will be given financial and organisational support for this purpose.

13.26 The schemes for (i) services for children in need of care and protection and (ii) creches for the children of working/ailing mothers would be moderately expanded. It is proposed to ensure a minimum standards of services in the children's homes and creches through properly trained staff and adequate supervision. The training programme in the children's homes would be diversified and further vocationalised in order to provide larger employment opportunities to children once they have some degree of maturity. Setting up of separate institutions for these purposes would thereby be avoided. The services of institutions like ITIs and other training-cum-production centres, etc., would be availed of.

13.27 Women's welfare: The welfare programmes for women aim at providing those essential services for women which are not available to them under the general development programmes. The highest priority will be given to programmes extending opportunities to women for gainful employment. A new scheme, namely, Women's Development Corporations, would be taken up, through equity participation on a 50: 50 basis between the State and the Centre, for promoting employment-generating activities for women's groups and women from the weaker sections. The main functions of the Corporations would include identification of potential areas of employment, assistance to beneficiaries in project formulation, raising the requisite finances, arranging raw materials, providing consultancy services, creating an infrastructure for the marketing of products and other services which would promote economic development for women through gainful activity. The 'Socio-Economic Programme,' which aims at providing opportunity for 'work and wages' to needy women and disabled persons by setting up small units, e.g., ancillaries to large industries, handloom/handicrafts units, agro-based units, etc. would be continued and steps would be taken to make the schemes bankable in order to attract more institutional finance and for a large coverage of beneficiaries under employment. The scheme of 'Condensed Courses of Education and Vocational Training for Adult Women,' would be expanded to prepare the target group for public examinations upto matriculation/higher secondary level, and would impart training in vocations with a high employment potential. Measures would be taken to enhance the competence of the teaching staff/training institutions. Assistance for construction of 'Hostels for Working Women' to provide safe, suitable and healthy accommodation to women who migrate to urban areas for employment would be extended to more areas. Training courses of short duration would be organised for rehabilitation of destitute women in various vocations and trades of non-traditional nature. The implementing agencies would ensure their rehabilitation after the completion of training. Rural women would be encouraged to form themselves into a group/society to take up welfare activities in those areas where no such organisations exist, and bring about an awareness of social responsibility among the women of the region.

13.28 The Central Social Welfare Board, which is a Central organisation responsible for promoting and strengthening of voluntary effort, would pay attention to motivating more organisations to undertake welfare programmes for children, women and the handicapped. It would make efforts to identify voluntary organisations all over the country, and provide them with the required organisational and financial assistance. Necessary training for voluntary workers would be imparted at appropriate institutions. Field counselling services would be developed for offering technical assistance and guidance in order to improve the working efficiency of the voluntary organisations.

13.29 Welfare of the handicapped: The main thrust in the programme for welfare of the handicapped will be on prevention of disabilities and development of functional skills among the handicapped. A- larger number of disabilities are preventable, if timely measures are taken in the areas of health and nutrition and accident prevention. Besides strengthening the activities of immunisation/ prophylaxis against diphtheria, whooping cough and tetanus, nutritional anaemia and blindness due to Vitamin 'A' deficiency, vaccination against polio and typhoid and the provision of nutritional supplements, education in health and nutrition will be given priority. Suitable measures to prevent and control disabilities caused by accidents will be taken. A programme of mass education for early identification of disabilities and the symptoms causing them will be intensified.

13.30 Simple, durable and inexpensive aids and appliances would be made available to handicapped persons so that they can become functional and useful citizens. The National Institute for Rehabilitation, Training and Research (NIRTR), earlier known as National Institute of Prosthetic and Orthotic Training (NIPOT), will continue to conduct training courses for prosthetic and orthotic technicians, multi-rehabilitation assistance, doctors and other professionals. When awarding scholarships to handicapped persons, stress would be laid on vocational training, which has better employment potential. Training schemes would be so devised as to impart adequate vocational skills leading to employment in the open market or to self-employment. Sheltered workshops for the severely handicapped will seek to supplement those efforts. Suitable arrangements are envisaged for organising supply of raw materials and for marketing their products. Employment officers specialising in placement of handicapped persons are proposed to be added in all employment exchanges with registration of 150 or more handicapped persons. Incentives would continue to encourage disabled workers to improve their standard of performance to persuade employers to accept physically handicapped persons. The scheme of District Rehabilitation Centres (DRC), which aims at providing comprehensive and integrated care services to the handicapped individual from early childhood till he is rehabilitated in the community, is being taken up at present on a pilot basis. Further expansion would be taken up after the programme is evaluated. Grants-in-aid will continue to be given to voluntary organisations for purchase of equipment and improvement of standards of services for the handicapped.

13.31 The activities of the four national institutes for the handicapped, i.e., one each for the visually handicapped, orthopaedically handicapped, hearing handicapped and mentally handicapped, working in the field of training, research, vocational guidance and development of suitable service models for the disabled, would be strengthened, based on the latest research and developments taking place, both inside and outside the country. These institutes would continuously evaluate the existing technology and explore new methodologies for promoting the optimum utilisation of the capabilities of the handicapped, so that their occupational options are widened, with resultant improvement in their social independence.

13.32 Social defence: In order to raise the quality of social defence services on the basis of certain well-defined norms and to keep abreast of newly emerging forms and trends of criminality a comprehensive approach towards preventive treatment and rehabilitative services is envisaged. Greater stress would be laid on the creation of public awareness regarding social legislation enacted to safeguard the rights and interest of children, women and other categories of socially handicapped persons. Efforts would be made to provide services under the Children's Act in a judicious manner to all the areas of the country. Keeping in view the growing menace of juvenile maladjustment and delinquency, a new scheme, viz., Prevention and Control of Juvenile Maladjustment with optimum use of community based services will be taken up through the States and Union Territories as a Centrally Sponsored Scheme on a pilot basis in few selected urban areas. This would include a variety of programmes such as counselling and guidance, family life education, organised recreation, etc. Similarly another scheme, 'Welfare of Prisoners,' would be taken up to strengthen the correctional content of prison programme through the provision of educational and vocational training, after-care services and training of personnel. These two new schemes are aimed at evolving appropriate models for the prevention and treatment of delinquency and crime in keeping with the realities of the socio-cultural and economic life of the people. Besides, an added thrust would be given to the protection of women in moral and social danger, and the scheme of Short Stay Homes would be expanded moderately to cover helpless victims.

13.33 In dealing with the various social defence programmes, National Institute of Social Defence (NISD) will lay stress on the areas of research and evaluation, training of functionaries and consultancy for official and non-official implementing agencies.

13.34 Prohibition: Recent studies indicate that the consumption of narcotics, alcoholic drinks and addictive drugs which are deleterious to physical and mental health is on the increase, particularly among the younger age-groups. The intemperate use of these addictives has brought in its wake a variety of undesirable consequences, and even economic ruin to many poor families. These would have to be discouraged with sustained propaganda and community education through the mass media, particularly television and films. Local bodies, voluntary agencies and communities would be encouraged to undertake educational work on a wider scale for the promotion of temperance and avoidance of consumption of alcoholic beverages. Intensive efforts would be initiated for preventing the brewing and drinking of illicit liquor by the vulnerable sections of the population.

13.35 Mass education: Social problems are closely associated with traditional attitudes, beliefs and ignorance prevailing among the people. Some of these have worked as major constraints on proper implementation of different development and welfare schemes. The Information and Mass Education Cell functioning at the national level would continue to accelerate its efforts for creating community awareness and public opinion against social evils. It would identify the relevant material and prepare inputs for various media like television and radio in addition to undertaking printed publicity work. It would maintain a regular liaison with the media units.

13.36 Social welfare in the State Sector: In the State sector, the social welfare programmes are variegated, depending upon the nature and magnitude of the prevailing social problems in the different regions. In all these programmes, utmost importance would be given to education, training and rehabilitation services so as to enable the concerned target group to become self-reliant. Institutional care will be provided only where it is necessary. Child welfare will continue to receive high priority. The States and Union Territories would be encouraged to undertake additional ICDS projects on the Central pattern to cover more children, pregnant women and nursing mothers with a package of nutrition and health services. Efforts would be continued to provide creches/ day care services for children of working women, with increased emphasis on improvement in health and nutrition linkages. In income-generating activities such as craft training, training-cum-production centres etc., meant for needy women and handicapped persons, stress would be laid on diversification and introduction of new trades/ vocations keeping in view the availability of local raw material and market needs. The Women's Finance and Development Corporations in certain States have proved very useful in helping women to take up bankable projects, and thereby raising their income status. The feasibility of similar programmes in other States/UTs would be explored.

13.37 The schemes of orthotic and prosthetic aids to physically handicapped persons would be expanded further with adequate facilities of fitting centres. Educational incentives like scholarships/stipends, book grants, uniforms etc., are envisaged to improve the enrolement ratio of physically handicapped children at the primary and middle levels. This would help them to avail of higher level educational facilities and related job opportunities.

13.38 The services envisaged under various legislations such as juvenile courts, children's homes, remand/ observation homes, certified schools, rescue homes, beggar homes would require to be strengthened, keeping in view the increasing problems of juvenile delinquency, trafficking in women and girls and beggary in the country. The States and UTs would be requested to adopt the progessive features of the Central Children's Act. Financial assistance would continue to be provided to voluntary organisations for undertaking institutional and non-institutional services for the affected groups. It would be impressed upon the States and UTs that they should develop suitable technical competence at different levels, so as to identify and assess the emerging social problems in particular areas, and suggest and devise ways to overcome such problems.

13.39 ffesearc/p.-For ensuring better results from the programmes under implementation, research and evaluation studies would be sponsored/taken up, and statistical data collected in the priority areas, keeping in view the Plan policies and social problems. Problems related to child development would be studied in the context of the social-cultural milieu to the regions, and required changes or modifications brought about in the child welfare services. Studies would be taken up to identify problems in the area of child labour, particularly in the unorganised sector, and also those engaged in hazardous occupations. Problems of displacement of women due to the introduction of new technologies in identifiable areas, and causes for the decline of employment of women in certain sectors would have to be investigated. The problems of mortality and morbidity among female babies and the impact of malnutrition among pregnant women and on the health of the babies and mothers also need to be analysed. The needs of continuing education with a view to promoting formation of skills and employment would have to be studied and areas of vocationalisation suitable specifically for women identified. The gaps and the needs under various training and rehabilitation programmes for the handicapped would need to be assessed by initiating microlevel studies. The grants-in-aid programme would be reviewed for further simplification and avoidance of delays in the sanctioning and disbursement of assistance.

13.40 Research studies relating to the spread of the usage of drugs and aloholic drinks among students, industrial workers and other vulnerable sections will be supported on a wider scale. The efficacy of the Children's Acts in terms of level of services provided would be studied. Various pieces of social legislation concerning dowry, prohibition, equal renumeration, excise policy in tribal areas etc. have been in force for quite some time. The impact of such legislations on the intended target groups and the adequacy/inadequacy of various provisions thereunder in the light of experience would be analysed.

13.41 The role of people's participation and their awareness of various legislations would also have to be assessed in order to make social legislations more effective. Most of the State Govts. have enacted legislation for the prevention of beggary and have taken up a number of schemes for training and rehabilitation of beggars. The cost effectiveness of these programmes and thier successful implementation would also have to be studied in order to formulate the training and the rehabilitation programmes based on the needs of the inmates in the beggar homes.

13.42 The linkages and mechanism for effective application of science and technology would be established with a view to tackle the problems of physical disabilities, drudgery in women's work, preservation of polio vaccines etc. Studies would be taken up on the development of modification/selection of aids and appliances for disabled persons, household equipment and gadgets for women, portable containers for storage of vaccine and other similar aspects.

13.43 Administration and monitoring: The Administrative machinery, both at the Central and State levels, will be strengthened. In the States, emphasis would be on bringing the administration of social welfare programmes under the department wherever this arrangement does not exist. Alternatively, an attempt would be made to take steps for effective coordination to achieve a unified approach and direction in planning and implementation. Induction of professional staff and expansion of in-service training, will be given due attention for improving the technical skills needed for project identification, formulation, implementation and monitoring.

13.44 Monitoring of various Plan programmes would be given more importance, as this is a prerequisite for taking up any modifications/corrections in the schemes. This aspect would also be given attention at the district and other lower levels. Provision has also been made for setting up a 'Women's Development, Planning and Monitioring Cell' at the national level to monitor the Central and State programmes being implemented under various sectors for women's development.

Outlays

13.45 The outlay for Central and Centrally sponsored schemes in the Social Welfare sector is Rs. 799.97 crores vide details in Annexure 13.1. The Plan outlay for the States and Union Territories is Rs. 191.87 crores and Rs. 20.52 crores respectively, vide details in Annexure 13.2.

NUTRITION

13.46 The problem of under-nutrition and malnutrition widely afflict certain sections of the population. Protein-Energy Malnutrition (PEM) long has been identified as the major nutritional problem in India. Various studies on dietary intakes reveal that the nutritional gap in children is primarily due to inadeqate nutritious food and not the protein quality. Pregnant women and nursing mothers and childern belonging to the younger age-groups have poor reserves of Vitamin 'A' which leads to xerophthalmia. Infants with low birth weight generally have poor stores of Vitamin 'A'. Severe forms of PEM have caused two clinical forms of disorders, i.e., Kwashiorkor and Marasmus among the childern belonging to the poorer families. Iron deficiency anaemia among women of all age-groups, and particularly those in the reproductive age-group, is also a major problem. Besides, goiter which is widespread among the hill regions of the country due to iodine deficiency, is also being noticed in other parts of the country. Populations inhabiting certain ecological tracts are affected by fluorosis, caused by water with high fluoride content, while lathyrims is noticed among people who consume kesari dal.

13.47 The prevailing high mortality rate among infants and toddlers, and also the morbidity patterns, have a link with malnutrition and intestinal infiection. It has been well established that the main causes that aggravate the prevailing mortality and morbidity rates are under/malnutrition, lack of health facilities, absence of safe drinking water, environmental hygiene and bad sanitation. Besides, socio-economic imbalances, unemployment and inadeqate purchasing power and inability to utilise health services and other infrastructure aggravate this problem.

13.48 The worst victims of this problem are childern in the age-group 0-6 years, pregnant women and nursing mothers, and particularly those belonging to these population groups in drought-prone areas and remote tribal areas and among landless agricultural labourers, rural artisans and certain strata living in urban slums. Dietary surveys by the National Nutrition Monitoring Bureau reveal that nearly 50 per cent of the households surveyed in different States of the country consume food which is quite inadequate to meet their requirements of either calories or proteins, or even both. An assessment of malnutrition among childern below 6 years of age reveals that less than 15 per cent of them could be considered as having a normal status of nutrition; the rest suffer from varying degrees of under-nutrition.

13.49 The nutritional deficiency disorders are closely associated with poverty, unemployment, illiteracy, lack of environmmental sanitation and hygiene, large family size, birth order, non-observance of spacing between childern and lack of safe drinking water.

13.50 The problem of malnutrition has been recognised since the inception of the Plans, and number of schemes were introduced for combating it. However, during the first three Plans nutrition was not singled out as such for specific Plan programmes but formed one of the components of the health sector. It was only in the Forth Plan that an Integrated Nutrition Programme was introduced. It was recognised that production of more food was needed to solve the problems of malnutrition and to improve the nutritional status of the population. Thus, stress was laid on agriculture and its allied activities as an effort in this direction. The Applied Nutrition Programme which was introduced in 1960 was extended to all the States and Union Territories by 1973. It aimed at spreading the concept of balanced diets, production and consumption of protective foods and proper techniques of cooking. The Mid-Day Meal Programme (MDM) for providing supplementary food to school childern, which was introduced in 1962-63, became a part of the Minimum Needs Programme in the Fifth Plan under the State sector.

13.51 The Special Nutrition Programme (SNP) for pre-school childern and pregnant women and nursing mothers was introduced in 1970-71. It was originally launched as a Central Programme and was transferred to the State sector in the Fifth Five Year Plan as a part of the Minimum Needs Programme. The Integrated Child Development Services (ICDS) Programme was started in 1975-76. The Special Nutrition Programme is in operation since then in the Integrated Child Development Services Projects, although there are feeding centres outside the project areas also.

Sixth Plan Review

13.52 The anticipated coverage under SNP by the end of the Sixth Plan was 11 million beneficiaries, including a coverage of 5 million beneficiaries outside the ICDS. Under the Mid-Day Meal Programme (MDM), the coverage increased to 20 million beneficiaries by the end of the Sixth Plan.

13.53 Among the Central sector programmes, the thirty-one Mobile Extension Units (MEU) continued to work for popularising local low cost foods, promoting suitable dietary habits and propagating nutrition education. These units conducted 86,000 demonstrations, covering approximately 30.20 lakh beneficiaries during the Sixth Plan. Besides, a number of folders, pamphlets, booklets, and wall posters of various types were published for countrywide distribution under the scheme of "Mass-media Communication Extension" for disseminating information and creating awareness on food preservation and nutrition among the masses.

13.54 There were two plants working at Bangalore and Hyderabad for the production of Miltone at the beginning of the Sixth Plan. Three plants were added during the Sixth Plan period at Ranchi, Calcutta and Kanpur. By the end of the Plan period, five plants were producing around 30,000 litres of Miltone aday.againstthe installed capacity of 38,000 litres/day.

13.55 Three energy food plants at Belgaum, Chitradur-ga and Raichur and five Ready-To-Eat (RTE) extruded food plants at Hyderabad, Delhi, Dhar, Jaipur and Gangtok were set up during the Sixth Plan period. These had an average production capacity of 69 metric tonnes per day. The food produced was used in the supplementary feeding programme for pre-school and school children in the supplementary nutrition programme.

13.56 Fortification of milk with Vitamin 'A' to curb nutritional blindness, was started at the Mother Dairy at Delhi in 1980. Fortification was also started at two other dairies, viz., the Delhi Milk Scheme, Delhi and the Mother Dairy, Calcutta. The total quantity of milk fortified by these three dairies was about 11.2 lakh litres per day by the end of the Sixth Plan period.

13.57 For combating the problem of anaemia due to iron deficiency, the effects of consuming iron fortified salt were field-tested. Taking the results of the trials into consideration, a project for the commercial production of iron fortified salt in collaboration with the Government of Tamil Nadu is being contemplated. A capacity of 15,000 metric tonnes per annum is projected.

13.58 Diet and nutrition surveys were carried out in the States and Union Territories of West Bengal, Meghalaya, Pondicherry, Kerala, Bihar, Tripura, Sikkim, Andaman and Nicobar Islands and Goa, Daman and Diu, to collect information on food consumption, dietary patterns, attitudes and beliefs about various foods consumed. On the basis of the data obtained, the Government of India suggested low-cost balanced diets for different age-groups and areas.

13.59 The two supplementary feeding programmes have been evaluated, and several studies conducted, in different parts of the country to determine their cost effectiveness and impact on the beneficiaries. Only a few studies with small sample sizes have confirmed improvement in areas where the programmes have been executed effectively. Various drawbacks that have been pointed out include improper selection of beneficiaries;lack of continuity in food supplies; poor community support; sharing of food by non-beneficiary members of the family; pilferage in the channels of distribution;non-adherence to the minimum number of feeding days;and lack of proper infrastructure for supervision, implementation and monitoring at the field level.

13.60 The feeding programmes were taken up without proper integration with programmes of employment, health, drinking water, hygiene and sanitation. In the absence of such linkages, not much impact on the improvement of the nutritional and health status of the community was observed.

13.61 The evaluation of the extension programme through MEUs reveals that the visit frequencies of these units in rural areas were very low and their activities were mostly concentrated in the cities. The MEUs could visit a village not more than once a year, the staff members were mostly urban oriented, both in education and temperament, and as a result it was difficult for them to establish rapport with rural communities.

The Objectives of the Nutrition Policy

13.62 The long-term nutrition policy has to aim at increasing the functional efficiency of the labour force and other segments of the population by promoting the concept of balanced intake of nutrition with locally available food commodities. The policy would have to be focussed so as to improve the nutritional status of a child during the pre-school years, as this would determine to a considerable extent the work-capacity and endurance during adult life. The nutrition policy should also achieve reduction in infant and maternal mortality rates and bring about changes for the better in the prevailing patterns of morbidity. Besides, considerable importance should be given to the reduction of nutritional deficiencies among the vulnerable sections of the population, particularly children and nursing mothers.

Strategy for the Seventh Plan and beyond

13.63 Long term sfrategy.-Foremost among the elements of the long-term strategy to combat malnutrition and under-nourishment is the expansion of employment opportunities and stabilisation of income, especially among the vulnerable population groups. Besides the main income earning activity, subsidiary occupation to augment family income would have to be encouraged through imparting suitable skills, which would promote diversified subsidiary occupation and income generating assests under the various anti-poverty programmes. Simultaneously, effort would have to be made for an extended public distribution system, which would cover ultimately the entire country, but in the medium term it would be extended to provide the essentials of a balanced diet at reasonable price in the endemic poverty stricken, malnourished/undernourished parts of the country. The agricultural policy would have to include pointed support for such an extended public distribution network so that cereals, legumes and pulses and edible oils in sufficient quantities are made available. Post-harvest technologies, low-cost transportation and effective delivery systems would have to be devised. Besides processing with local technologies to the extent feasible, local population and communities would be fully involved in the preparation and distribution of food and other commodities required for a balanced diet. A massive nutrition education programme, as part of the total package of health and nutrition services has to be mounted through the mass media for generating awareness and knowledge among rural families and especially women, of the importance of nutritional requirements for a healthy life.

13.64 Efforts would have to be made to further expand the programme of immunisation of children and pregnant women. Children in the age-group 0-3 years would require total immunisation in order to withstand the commonly prevalent diseases.

13.65 Lessons on nutrition, health, welfare and population control will have to be given to the target beneficiaries through formal and non-formal channels. For this, the educational content would need to focus on the relationships between health, nutrition, birth rate, immunisation and environmental and other parasitic infestation. Functionaries at various levels like Auxiliary Nurse Mid-wives, Grams Sevikas, Anganwadi workers, teachers and personnel engaged in voluntary welfare work would have to be trained to deliver the message of the relevance and importance of nutrition and health education through suitable in service training programmes.

13.66 It is well recognised that lack of protected water supply in rural and urban areas causes diarrhoea, gastroenteritis, dysentery and hepatitis. These diseases account for a large proportion of infant and child mortality. The provision of safe drinking water, along with drainage facilities, would have to be given greater attention for effecting improvements in community health. Incentives would have to be given to communities, local bodies and families in order to promote adoption of low-cost sanitation methods like those which have been adopted with success in many parts of the country. This would remove one of the most frequent causes of infection and disease in rural as well as many urban areas. Besides, adulteration of foodstuffs would have to be checked effectively in order to minimise the deleterious effect on the health of the population.

13.67 Universities, research organisations and other voluntary agencies would be assisted and stimulated for assuming larger roles in the formulation and evaluation of various schemes.

13.68 Youth clubs, Mahila Mandals and voluntary organisations would have to play an important role is stimulating voluntary effort and in ensuring that services reach the intended target groups.

13.69 Thus, for improving the overall nutritional status on the long-term basis, a coordinated effort would have to be made in the areas of (i) employment generation; (ii) equitable distribution through expansion of public distribution system; (iii) provision of safe drinking water supply;(iv) immunisation on a wider scale; (v) expansion of health care system; (vi) creation of awareness about personal hygiene; and (vii) control of communicable diseases and intestinal infestations.

13.70 Immediate measures: However, as a short-term strategy, special attention would need to be given to the vulnerable sections like childern, pregnant women and nursing mothers, under the direct nutrition intervention schemes like Supplementary Nutrition Programme (SNP) and Mid-Day Meals Programme (MDM). These programmes would have to be continued with a selective approach to benefit childern and mothers living in the most backward rural and/or tribal area and in drought-prone areas and urban slums. Efforts would be made to restructure the on-going programmes by adding related inputs so as to make them more effective. Supplementary Nutrition Programme would be confined to the ICDS scheme/blocks to the maximum extent possible. Wherever it is operating outside the ICDS, provisions would bemade for bringing in other inputs, particularly health. The nutrition components of Primary Health Care need to be identified and incorporated in service delivery systems. Maternal care is crucial for child health. Wholesome child-feeding and weaning practices hold the clue to child health and these need to be inculcated through education. All educational programmes must support breast- feeding. The energy drain on women fetching water and fuel over long distances has to be alleviated by ensuring easy access to these essentials. Improvement of nutritional status of vulnerable sections continues to present a challenge; an effective response is needed.

Seventh Plan Programme

13.71 The Special Nutrition Programme will continue to be the major intervention feeding programme attempting to provide 300 calories and 8-12 grams of protein per beneficiary in the age group 0-6 years, and 500 calories and 25 grams of protein for pregnant women and nursing mothers for 300 days in a year. Besides continuance of nutrition support to 11 million beneficiaries in the 1136 on-going ICDS projects, i.e., 1019 projects in the Central sector and 117 projects in the State sector, and SNP centres outside ICDS areas, the programme would be expanded to cover all the additional ICDS projects during the Seventh Plan. Measures would be taken up to bring SNP centres either within the ambit of the ICDS programme or upgrading them by linking them with other inputs like health, sanitation, hygiene, water supply and education. Attempts would be made to ensure uninterrupted supply of required nutrition material for specified days in all the anganwadis/SNP centres. The unit costs would be revised to ensure required nutrients etc. to the beneficiaries.

13.72 The Programme of Mid-Day Meals (MDM) for school going children in the age group 6-11 years, provides 300 calories and 8-12grams of protein per child per day for 200 days in a year. About 20 million beneficiaries were getting such nutrition support at the end of the Sixth Plan. The scheme did not contribute adequately to the improvement of the nutritional status of the child. Hence, stress would be laid on the consolidation of the programme by linking it with other inputs of health, potable water, improvement in sanitation etc. rather than on its quantitative expansion.

13.73 Education and extension: The programme of Nutrition Education would be long-term measure in dealing with the problem of malnutrition and its causative effects. An integrated scheme for imparting education on nutrition and other related aspects like health, environmental and personal hygienne, child welfare, etc., would be taken up through the mass media and inter-personal communication, so as to extend coverage in terms of both beneficiaries and content. Relevant audio-visual messages would be developed as a communication units. It is also proposed to train field level staff especially functionaries such as ANMs, CHVs, AWWs, VLWs, village teachers and Mahila Mandal workers in coordination with training organisations working in this area. Besides, for disseminating knowledge and creating awareness on food preservation and processing updated resource material in the form of booklets, pamphlets and newsletters and audio-visual aid such as slides, photographs and posters would be brought out on a bigger scale.

13.74 Production and processing schemes: Miltone, a beverage based on a blend of milk and vegetable protein, is at present being processed in five plants with an installed capacity of 38,000 litres/day. Besides, five plants manufacturing Ready-To-Eat (RTE) and three energy food plants are in operation, each with a production capacity of two or more tonnes per day. It is proposed to set up three additional miltone plants, each with an installed capacity of 10,000 litres a day and three additional RTE food plants, each with one-tonne-a-day capacity. These Plants would be working in close collaboration with the feeding programme.

13.75 Fortified food: At present 12.5 lakh litres of milk per day are being fortified with Vitamin 'A'. It is proposed to expand production to achieve a target fortification of 45 lakh litres/day by the end of the Seventh Plan.

13.76 With the development of process technology for fortification of salt with iron, it is now considered feasible to combat the widespread problem of iron deficiency anaemia. The project for the fortification of salt with iron already initiated in the Sixth Plan would be further expanded by commissioning three new plants with a total production capacity of 45,000 metric tonnes of iron-fortified salt every year.

13.77 Survey, research and evaluation: The scheme of Diet and Nutrition Surveys would be continued to find out the nutritional status of the population, including the incidence of deficiency diseases. Stress would be placed on the utilisation of the research findings by various governmental agencies and the improvement of the quality of data collection.

13.78 Research and development activities are of utmost importance in the area of low cost nutritious foods using locally available materials. Work on special types of diets and processed foods would be initiated with the help of the Central Food Training and Research Institute (CFTRI), National Institute of Nutrition (NIN) and similar institutions. Universities and research organisations would be encouraged to undertake investigations with a common research design, on the dietary habits of different people and identification of subtle socio-cultural and customary beliefs and practices affecting their nutritional status. Impact of on-going nutrition and education programmes by different media and ICDS shceme on the reduction of mortality, morbidity rates and incidence of malnutrition would need to be assessed and necessary changes/modifications brought about in the respective programmes. It would be necessary to undertake researches to develop reliable and simple indicators/ instruments for indentification and measurement of nut rition deficiencies for field application.

Outlays

13.79 An outlay of Rs. 7.32 crores is provided for nutrition programmes under the Central sector vide details in Annexure 13.3. The Plan outlay for the States is Rs. 1693.86 crores while that for the Union Territories is Rs. 39.00 crores, Annexure 13.4.

ANNEXURE—13.1 Seventh Plan Outlays—Social Welfare, Central and Centrally Sponsored Schemes
(Rs. crores)

S Provision made under Rural Development sector. 306; @ Provision was made on year to year basis.; * Originally the outlay was for Artificial Limbs Manufacturing Corporation/National Institute for Prosthetic and Orthotic Training.; £ Included under Item V-2

ANNEXURE—13.2 Seventh Plan Outlays—Social WelfareStates/UTs.
(Rs.lakhs)

* Includes Rs. 1800 lakhs for Special Employment Schemes.; £ Includes Rs. 303 lakhs for 'Social Inputs'.; $ Includes Rs. 70 lakhs for 'Ex-servicemen's Corporation'.; = Includes Rs. 191 lakhs for 'Legal Aid to Poor' and 'Sanjay Gandhi Institute for Youth Leadership'.; + Includes Rs. 10 lakhs for 'Legal Aid and Advice'.; @ Includes Rs. 25 lakhs for welfare of ex-servicemen.

ANNEXURE—13.3 Seventh Plan Outlays—Nutrition: Central Sector
(Rs. crores)