Gujarat's Poshan 2.0 conundrum: Central funding up, beneficiaries down

Gujarat, India's fourth richest state with a projected Gross State Domestic Product (GSDP) of ₹27.9 lakh-crore, is strangely grappling with malnutrition in children, anaemia in pregnant women and sickle cell anemia among women of all ages.

Here is something stranger — it is not for want of funds.

Gujarat, the home state of Prime Minister Narendra Modi, has been allotted Rs 2879.3 crore under the PM Mission Poshan Abhiyaan 2.0 over the past three years. The scheme, popularly known as Poshan 2.0, is an integrated nutrition support programme that aims to address malnutrition in children, adolescent girls, pregnant women, and lactating mothers.

Also read: Gujarat's paradox: High per capita income, but poor health, nutrition levels

Since 2021, the Centre has been consistently increasing fund allocation under the scheme to Gujarat. In the financial year 2021-22 (FY22), Rs 839.86 crore was allocated to Gujarat under Poshan 2.0. The amount was Rs 912.64 crore in FY23, and Rs 1,126.8 crore in FY24.

This data was revealed when the Union Ministry of Women and Child Development submitted a detailed report outlining the increase in funding allocated under Poshan 2.0 to Gujarat in response to a question raised by Rajya Sabha MP V Shivadasan earlier this month.

Steady decline in beneficiaries

However, state health department data and the ‘Poshan Tracker’ — the ICT (Information and Communication Technology) application for monitoring service delivery under Poshan 2.0 — reveal that despite the increasing financial support to the state, the number of beneficiaries under the scheme has been declining steadily over the past three years.

Per Poshan Tracker data, in FY22, there were 4.287 million beneficiaries of the scheme. In FY23, the number fell to 4.047 million. By March 2024, the scheme had only 3.782 million beneficiaries in Gujarat.

The data also reveal that only Rs 1,310.23 crore have been utilised so far out of the total Rs 2,879.3 crore allocated to the state in the last three years.

Kids with stunted growth

Data from the NFHS-5 reveal that Gujarat ranked fourth in terms of stunted children three years in a row since 2021. The state ranks second in terms of wasted and underweight children and women with anaemia, with 39 per cent of children in the state being underweight for their age and 65 per cent of women aged 15-49 suffering from anaemia.

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As per the data, from 2021 to August 2024, 41,632 children suffering from severe acute malnutrition have been admitted to Nutrition Rehabilitation Centre (NRC) in Gujarat, the second highest in the country after Tripura.

Moreover, the number of children with severe and acute malnutrition have increased in the state since 2021 with 9,606 children admitted in NRC in 2020-21, 13,048 in 2021-22, 18,978 in 2022-23.

Increase in crib deaths recorded

Adding to that, the number of ‘crib deaths’, the death of newborns due to malnutrition, has also increased in Gujarat in the past three years.

“Over the years, the top priority in Gujarat has been given to industries and urbanisation. However, when it comes to the social sectors, the state has never accorded the same priority,” said Prof Dilip Mavlankar, former Director of Indian Institute of Public Health, Gandhinagar.

The analysis put forth by the NFHS-5 report on the situation prevalent in Gujarat suggests that 23 determinants directly or indirectly impact nutritional indicators. Among them is education, age of marriage of women and school dropout rate, where the state lags behind other big states.

“Regarding underlying determinants of nutrition, the literacy rate among women in Gujarat stands at 76.5 per cent, which is marginally better than the national average. Among these determinants, women with 10 or more years of schooling is also a factor where the number is 33.8 per cent for Gujarat as compared to 41 per cent national average. In terms of early marriage before the age of 18 years, Gujarat stands at 21.8 per cent compared to 23.3 per cent national average. These factors have a substantial impact on nutritional indicators,” states the report. Also read: Gujarat PMJAY fraud | Paediatrician falsely 'treats' 116 healthy infants

Trying hard: Minister

“I accept that we are lagging behind in certain health parameters. However, the government is sincerely attempting to combat the issues. In the 2024 state budget, we have set aside Rs 5,500 crore to tackle malnutrition as against the Rs 3,200 crore allocated in the last financial year,” Gujarat Health Minister Rushikesh Patel told The Federal.

“Gujarat annually spends at least Rs 1,000 crore on child welfare alone. The state government is running various programs for child welfare like the Chiranjeevi Yojana, Bal Bhog Yojana, Vitamin Yukt Poshan Aahar Yojana, Kanya Kelavani Yojana, Nutrition Rehabilitation Centre, Bal Sakha Centre, Bal Amrutam, Kasturba Poshan Sahay Yojana, Mission Balam Sukham, and Mamta Ghar. There is no dearth of efforts by the state government,” said Patel when asked why almost 50 per cent of the Mission Poshan fund remained unused.