POSHAN ABHIYAAN MONITORING SURVEY QUALITATIVE SURVEY ON THR (AUG 2020) - October 2020 - gLOCAL ...
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1 POSHAN ABHIYAAN MONITORING SURVEY QUALITATIVE SURVEY ON THR (AUG 2020) October 2020
AGENDA 2
1. Results from qualitative study on Take Home Ration
i. Background
ii. Findings & Recommendations: Jharkhand
iii. Findings & Recommendations: RajasthanWE FOCUSED ON THR AS THE MAIN STUDY AREA 3
• Take Home Ration (THR), part of ICDS’s Supplemental Nutrition Program, is a key POSHAN Abhiyaan service1
• Important role in ensuring availability of nutritious, micronutrient-rich meals for pregnant women and young
children, especially in the context of COVID-19, which has disrupted food systems globally and within India.
• Both Rajasthan2 and Jharkhand3 implemented new THR production and distribution models in the last 12 months.
• There is little or no available studies on how these new systems are functioning.
• We found 5pp drop in THR access in Rajasthan and a 12pp drop in THR access in Jharkhand from Jan-May 2020
• Changes in access to THR varied significantly by district
1. Shankar, R. (2020). “Foreword.” Take Home Rations: A Compendium. Eds. Beesabathuni, K., Kumari, P., Bajoria, M. https://www.wcdsbp.org/publications/THR-Compendium_220720.pdf
2. (1st April 2020) Circular by WCD Rajasthan: About ensuring the availability of THR to the beneficiaries during COVID times when AWCs are closed. http://wcd.rajasthan.gov.in/docs/35592.pdf
3. (2019) MOU: agreements & memorandum of understanding mutually entered into between Department of Women, Child Development, and Social Security, Government of Jharkhand (DWCD &
SS) and the Jharkhand State Livelihood Promotion Society (JSLPS). Certificate No. IN-JH21501170238460R.TAKE HOME RATION CAN BE IMPROVED WITH ACTIONS IN 3 KEY
AREAS… 4
ADDRESS DELAYS IN PROVIDE ENHANCE TRUST &
FUNDING & PROCUREMENT COMMUNICATION
PAYMENTS
• Move to pre-paid system or
SUPPORT • Build transparency and trust within
JHARKHAND
JHARKHAND
JHARKHAND
expedite the reimbursement the beneficiaries by weighing THR
process. appropriately
• Plan a menu of alternatives to
• Set up e-payments system for ICDS • Design a strong communications
replace chronically missing items
and SHGs/JSLPS campaign with the message that
• Regularly update the price of THR THR should be consumed by
items based on market fluctuations pregnant women and children only.
• Establish single source of
RAJASTHAN
RAJASTHAN
RAJASTHAN
procurement; ensure that wheat • Strengthen communication on
• Reimburse Anganwadi workers for reaches PDS shops intra-household allocation
local purchasing • Provide logistical and • Add items to THR package which
• Set up e-payments system for ICDS transportation support to can only be consumed by intended
Anganwadi workers beneficiariesAGENDA 5
1. Results from qualitative study on Take Home Ration
i. Background
ii. Findings & Recommendations: Jharkhand
iii. Findings & Recommendations: RajasthanBACKGROUND: THR PRODUCTION MODELS 6
Centralized (public or private) Decentralized with production facilities Decentralized with self-help groups
Central production facility Local production facility Self-help groups
Anganwadi Centers Anganwadi Centers Anganwadi Centers
Beneficiaries Beneficiaries Beneficiaries
• Rajasthan • Madhya Pradesh • Kerala • Odisha • Jharkhand • Uttarakhand
• Telangana • Himachal Pradesh • Delhi • Tamil Nadu
• Bihar • Uttar Pradesh • Maharashtra • West Bengal
1. Beesabathuni, K., Kumari, P., Bajoria, M., eds. (2020). Take Home Rations: A Compendium. p. 28. https://www.wcdsbp.org/publications/THR-Compendium_220720.pdf
2. Flanagan, K. F., Soe-Lin, S., Hecht, R. M., & Schwarz, R.K. (2018). THR Production and Distribution Models- Challenges and Opportunities for Improvement. Policy Brief
4. Pharos Global Health Advisors. https://pharosglobalhealth.com/wp-content/uploads/2018/09/Policy-Brief-4.pdfRESEARCH QUESTIONS AND LEARNING GOALS 7
1. What are supply-side challenges of delivering THR given the changes in the supply model
along with COVID imposed barriers?
• What is the composition of THR being distributed?
• What is the process of procurement and production of the THR?
• How is the THR distributed to the beneficiaries?
• What are the preferences of the THR providers about its production and distribution model?
2. What are demand-side challenges in access and utilization of THR in the COVID scenario?
• What is the state of access to THR?
• How is the THR shared with the family?
• What is the composition of THR that beneficiaries receive, and what are the preferences of the beneficiaries
about the composition?
• What is the quality of the items delivered under THR and do beneficiaries like its taste?METHODOLOGY: CONDUCTED 114 QUALITATIVE
SURVEYS IN JUL-AUG 2020 8
• 120 PLWs from R2 quant
survey and via enrollment
• 90 AWWs via other IDinsight
data collection efforts. • 2 District Program
Managers of JSLPS in
• 13 SHGs through
• 542 AWWs Jharkhand
snowballing
26-29 July 26-31 July 2-12 Aug 7-14 Aug 18 Aug 28 Aug
ICDS OFFICERS /
SAMPLING PLW SURVEY1 AWW SURVEY3 SHG SURVEY JSLPS INTERVIEW
DSWOs INTERVIEW
• To understand THR • 542 PLWs • 6 members of SHGs in
context Jharkhand
• 15 pregnant women
• 3 ICDS officers from • 13 mother of child 0-
Rajasthan
6 months
• 3 DSWOs from • 26 mother of child 6-
Jharkhand
36 months
1 PLW survey was conducted in two phases. Phase 1 surveys were conducted between 2nd to 5th August and phase 2 surveys were conducted on 11th and 12th August.
2 Surveyed 27 PLWs and AWWs from Jharkhand and 27 from Rajasthan.
3 AWW surveys were conducted in two phases. Phase 1 surveys were conducted on 7 th and 8th August and phase 2 surveys were conducted on 13th and 14th August.METHODOLOGY: SAMPLING STRATEGY VARIED BY 9
RESPONDENT GROUP
Conducted 114 qualitative surveys
Demand-side actors Supply-side actors
Mother of Child Mother of Child Anganwadi SHG Members
Pregnant Women workers
0-6 months 6-36 months
49 102 979 90 13
• Re-enrollment survey of • Previous respondents • Previous respondents • Phone number collected • Phone number collected
Frame
1560 HHs to determine who delivered a child with children in this age by other IDinsight during AWW interviews
if any has pregnant between Jan and May group projects in the area
women 2020
301 302 603 90 13
Attempted
Randomly sampled, stratified on district performance on THR and personal history of access
to THR
Yield
15 13 26 54 6
1 District performance strata consisted of two categories: districts where the proportions of respondents receiving THR was higher than the state average were classified as high-performing districts and the rest were classified as
low-performing districts.
2 This THR receipt strata consisted of two categories: the respondents who had received THR in the last 30 days before May/July 2020 and the respondents who didn’t receive THR in the last 30 days before May/July 2020.
3 This THR receipt strata consisted of three groups instead of two while sampling mothers of children aged 6-36 months. Those three groups are: the respondents who reported receiving THR in the both rounds of the quantitative
survey (Jan/Mar’20 and May’20), the respondents who reported receiving THR in any one of the two rounds of the quantitative survey (Jan/Mar’20 and May’20), and the respondents who didn’t report receiving THR in any of the
two rounds of the quantitative survey (Jan/Mar’20 and May’20).METHODOLOGY: QUALITATIVE ANALYSIS IS A 10
MULTI-STEP PROCESS
Interviews Theme Coding Theme Analysis
• Phone calls to respondents • Turning narratives into • Frequency tabulation
This process was followed for the five • 30-45 minute interviews discrete units of information • Narrative summary
primary respondent groups:
Rajasthan Jharkhand
Transcription Paraphrasing
THR
• Hindi audio to Hindi text • Rephrasing for cohesive
beneficiaries
ideas and understanding
Anganwadi • Noticing emerging patterns
workers
Self-help group
members Translation Data Entry
• Hindi text to English text • Segmenting translated
transcripts by learning goalAGENDA 11
1. Results from qualitative study on Take Home Ration
i. Background
ii. Findings & Recommendations: Jharkhand
iii. Findings & Recommendations: RajasthanSNAPSHOT: THR PRODUCTION MODEL IN JHARKHAND
12
Current System (Decentralized) Old System (Centralized)
• November 2019 - present • June 2013 – October 2019
• Entitlement: Dry Ration (Per beneficiary, per
day)
Pregnant & Children
• Pregnant and Lactating women: Salty
lactating women 6-36 months
Pre mix
Rice 100 g 50 g
Lentils 30 g 30 g • Children (6-36 months) – Sweet Pre mix
Jaggery 40 g 30 g
Peanuts 25 g 30 g
Potato 125 g 100 g
320 g 240 g
• Self-help groups, run by JSLPS, procure, pack • Private agencies centrally produce the
and deliver items to AWCs premix and deliver to AWCs
• Distributed once a month by AWWs to PLWs • Distributed once a week by AWWs to PLWsJharkhand
SHG actions THR flow
Legend
THR PRODUCTION, FUNDING, AND
JSLPS actions
Payments flow
Gov’t actions
List of Beneficiaries flow 13
DISTRIBUTION MODEL IN JHARKHAND AWW actions
START HERE
JSLPS sends lists CDPO shares lists AWW sends list of
SHGs procures THR items
to SHGs with JSLPS beneficiaries to CDPO
Lentils, jaggery, peanuts,
potatoes are purchased locally Govt of India supplies 50%
State and central of SNP funding
Rice from FCI warehouse JSLPS distributes
governments fund Govt of Jharkhand supplies
funds to SHGs
JSLPS 50% of SNP funding
SHGs must
buy or SHGs weighs and
acquire
packs THR
packing
material
SHGs must SHG delivers THR
hire a vehicle to AWC Bill is shared
Bill is shared with
with JSLPS state- AWW distributes THR
WCD Jharkhand
level office to beneficiaries
At AWC once a month
SHGs fill out chalan
Bill is verified AWW takes photos and
to confirm delivery
and signed by beneficiaries sign register
and submit for
JSLPS DGM
reimbursementJharkhand
ACCESS TO THR IN JHARKHAND IS LOW SINCE THE 14
LOCKDOWN…
THR coverage • Decline in the THR coverage from 67% to 56% between February and May1.
has declined • Only a few beneficiaries reported receiving THR since April 2020.2
"I received THR only once during pregnancy. Had I received this
“Earlier, the Anganwadi worker used to tell us to come to
nutritious food regularly, I would have gotten more nutrition
the Center to get THR. Now they don’t call us for anything.
and strength. But we didn’t get it regularly and so I had to be
No one has called us in the last 3 – 4 months.”
operated during the delivery... because of physical weakness.”
– Mother of child 0-6 months in Pakur
– Mother of child 0-6 months in Hazaribagh
CLICK FOR
AUDIO QUOTE
1. These percentages are from our earlier quantitative surveys. In Round 1 (Jan/Feb), confidence intervals (CIs) are 61.5% to 68.5% and N=696. In Round 2 (May), CIs are 49.7% to 62.3%, and N=423.
2. In our recent qualitative survey, of the 24 beneficiaries of THR we interviewed, only 6 reported receiving THR since lockdown.Jharkhand
ACCESS TO THR IN JHARKHAND IS LOW SINCE THE 15
LOCKDOWN…
“When we call and ask people from ICDS department, they tell us that money has not been
disbursed from the top and we will get the THR [for distribution] when money comes from
there. Right now, it’s very difficult to run the program and make ends meet. Even if they do
not give us money, we still must distribute the ration to people. The government is killing us by
not sending the ration, and public are also pummeling us.”
- Anganwadi worker in Simdega district, Jharkhand
CLICK FOR
AUDIO QUOTE
THR distribution • Most Anganwadi workers (12) have not distributed THR since April or earlier.
has been • Only a few Anganwadi workers (4) said they had distributed THR in July or August, the
irregular months prior to data collection.Jharkhand
…MAINLY DUE TO SUPPLY SIDE CHALLENGES FACED 16
BY SHGS
Below are three most common challenges mentioned by self-help group members in Jharkhand.
N=6 SHGs
“The AWW thinks that we keep the THR items
Delayed or missing for ourselves, but the truth is that we don't
receive the money from the government on
reimbursements time. ... How can we distribute THR again if we
don't get our old money back?” CLICK FOR
AUDIO
– SHG member in Garhwa district, Jharkhand
Price increases in the THR “We face some problems when we must buy more expensive items
materials, and fixed for distribution. For example, if we are buying pulses for Rs.200 per
reimbursement rates. KG, then we will have no benefit from it. We will go in loss. If we
can buy items at the normal rate, then that will be help us.”
CLICK FOR
- SHG member in Simdega district, Jharkhand AUDIO
Delay in receiving list of “Sometimes there are some problems from AWW's end in providing us with
beneficiaries from the the updated number of beneficiaries in the area. Due to this sometime some
AWW people are not able to receive THR because we distribute the items according
to the old data about beneficiaries.” CLICK FOR
- SHG member in Garhwa district, Jharkhand AUDIOJharkhand
SHG actions THR flow
Legend
THR PRODUCTION, FUNDING, AND
JSLPS actions
Payments flow
Gov’t actions
List of Beneficiaries flow 17
DISTRIBUTION MODEL IN JHARKHAND AWW actions
START HERE
JSLPS sends lists CDPO shares lists AWW sends list of
SHGs procures THR items
to SHGs with JSLPS beneficiaries to CDPO
Lentils, jaggery, peanuts,
potatoes are purchased locally Govt of India supplies 50%
State and central of SNP funding
Rice from FCI warehouse JSLPS distributes
governments fund Govt of Jharkhand supplies
funds to SHGs
JSLPS 50% of SNP funding
SHGs must
buy or SHGs weighs and
acquire
packs THR
packing
material
SHGs must SHG delivers THR
hire a vehicle to AWC Bill is shared Bill is shared with
with JSLPS state- WCD Jharkhand by AWW distributes THR
level office DSWO to beneficiaries
At AWC once a month
SHGs fill out chalan
Bill is verified AWW takes photos and
to confirm delivery
and signed by beneficiaries sign register
and submit for
JSLPS DGM
reimbursementJharkhand
RECOMMENDATION 1: STREAMLINE FUND-FLOW AND
LEVERAGE TECHNOLOGY TO ALLOW FOR CONSISTENT
18
THR DELIVERY
Following are a few potential steps to implement the recommendation1:
Move from post-paid to pre-paid payment
• ICDS should provide funds to JSLPS in advance rather than reimbursing later to ease procurement by SHGs.
• If not possible operationally, then fast-track the fund disbursement to JSLPS to ensure enough financial capital with SHGs
Regularly update the price per THR item
ICDS should update the reimbursement price per THR item at least quarterly to address the price fluctuations in the market
Leverage technology
• Transition all state ICDS payments to e-payment systems to allow for seamless money transfer
• Beneficiary lists should be provided to SHGs through AWWs in real time by utilizing existing technologies (eg: CAS)
1. These recommendations are in line with earlier recommendations from the World Food Programme (WFP) and Tata Trust. (a) WFP. (2019). Review of Take-Home Rations under the Integrated Child Development Services in
India. https://docs.wfp.org/api/documents/WFP-0000111827/download/ . (b) Schwarz, R. K., Flanagan, K. F., Soe-Lin, S., & Hecht, R. M. (2018). Opportunities & Challenges in the Integrated Child Development Services’ Take-Home
Rations program. Policy Brief 1. Pharos Global Health Advisors, Tata Trust.
2. E-payments systems are associated with reductions in payment delays. Beesabathuni, K., Kumari, P., Bajoria, M., eds. (2020). Take Home Rations: A Compendium. p. 32. https://www.wcdsbp.org/publications/THR-
Compendium_220720.pdfJHARKHAND: BENEFICIARIES ARE NOT RECEIVING ALL
ITEMS UNDER THR 19
Distribution of peanuts has been irregular.
Reason: fluctuation in its price during the
Rice lockdown
Delivery of potatoes stopped since Dec 2019.
Lentils
Distributed only once in Nov 2019.
Reasons: potatoes rot easily, quality
Jaggery complaints from beneficiaries
Peanuts
“Earlier we used to get rice, jaggery, pulses, and peanuts,
but now it is only pulses and jaggery... Both rice and pulses
Potato should be provided – how can we eat only pulses?”
- Mother of Child 6-36 months in Garhwa district,
Jharkhand
"We have to hear all the bad words. People accuse of taking
the rice and peanuts from their THR packets. We only give AWWs also receive complaints from the beneficiaries
them as we get.” who accuse them of stealing from their entitled amount.
- AWW in Pakur district, JharkhandJHARKHAND: BENEFICIARIES PREFER THE NEW
THR ITEMS…
20
Taste and “Now, the ration that we get is better. People used to feed the
Quality premix to animals, goats, lambs. But people don’t give rice,
jaggery, chana to animals -- they eat it themselves.” CLICK FOR
- Mother of Child 0-6 months in Hazaribagh district, Jharkhand AUDIO
Regularity
Taste
Prefer Old
preferring the new system
System
Stated reasons for
“I like the present ration because I can cook it and make
N=6 something the child likes to eat. I can make rice and dal but in the
earlier one I can only make halwa. This has added choice in taste
Prefer New now. The ration is satisfactory, but it is a bit less in quantity.“ CLICK FOR
AUDIO
Nutrition Nutritional - Mother of child 0-6 months in Hazaribagh district, Jharkhand
System
Value
N=13
“I like the dry ration. In dry ration we get three to four things like
Variety
rice, dal, peanuts, and jaggery. We get protein from dal and rice.
Eating jaggery is also good.” CLICK FOR
AUDIO
Ease of Use - Mother of child 6-36 months in Garhwa district, Jharkhand
Note: Anganwadi worker preferences were far more mixed, and often reflected the Anganwadi worker’s perception of beneficiary preferences.Jharkhand
…BUT CALL FOR CONSISTENT DELIVERY AND GREATER 21
QUANTITIES
The two most common pieces of feedback from beneficiaries were…
1. Deliver THR regularly and on time. Why is delivery irregular?
10 out of 23 THR beneficiaries gave feedback that • Upstream supply-side challenges, including
the most important improvement to be made in the payment delays in the new model
THR program is increase consistency of delivery. • Covid-19 pandemic
Why do beneficiaries feel quantity is
2. Increase the quantity provided
insufficient?
11 out of 23 THR beneficiaries gave feedback that
• Families are sharing THR items
the quantity of THR currently being provided is
insufficient. Many beneficiaries (8) mentioned that • Raw grains more easily incorporated
the new THR lasts them less than 3 days. into family meals
• Increased food insecurity
“We only get 2 Kg in two months. You tell me then how long
should it last! It lasts for only two days.”
- Mother of Child 6-36 months in Garhwa district, Jharkhand
CLICK FOR AUDIOJharkhand
RECOMMENDATION 2: ENSURE ADEQUATE QUANTITIES 22
OF THR REACHES INTENDED BENEFICIARIES
Following are a few potential steps to implement the recommendation:
Replace chronically missing items
Decide on a menu of acceptable, energy-dense and nutrient-rich THR items to replace items that have chronically been
missing, like potatoes and peanuts.
Build transparency and trust1,2,3
• Train SHGs to label packages with the weight of the contents on the outside
• Provide AWCs with weighing machines and encourage AWWs to re-weigh contents in a visible way to the beneficiaries.
Address quantity and allocation issues
• Direct resources towards a strong and creative communications campaign, with the message that THR should be
consumed by pregnant women and children only such as posters, wall paintings, counselling, THR packaging etc.
• Ensure that the increased allocation of PDS under PMGKAY is implemented successfully on field and there is sufficient
awareness around the same.
1. Beesabathuni, K., Kumari, P., Bajoria, M., eds. (2020). “Governance and Accountability: Experience of Odisha”. Take Home Rations: A Compendium. p. 32. https://www.wcdsbp.org/publications/THR-Compendium_220720.pdf
2. Schwarz, R. K., Flanagan, K. F., Soe-Lin, S., & Hecht, R. M. (2018). ICDS programmatic governance, accountability and performance management, and quality assessment – Challenges, and Opportunities for Improvement. Policy Brief
3. Pharos Global Health Advisors.
3. WFP. (2019). Review of Take-Home Rations under the Integrated Child Development Services in India. https://docs.wfp.org/api/documents/WFP-0000111827/download/AGENDA 23
1. Results from qualitative study on Take Home Ration
i. Background
ii. Findings & Recommendations: Jharkhand
iii. Findings & Recommendations: RajasthanSNAPSHOT: THR PRODUCTION MODEL IN RAJASTHAN
24
Current System (Centralized) Old System (Decentralized)
• April 2020 - present • March 2013 – March 2020
• Entitlement: Per beneficiary, per month
• Nutrition pre-mix
Pregnant women & Children
• Made by pounding soyabean, wheat,
lactating mothers 6-36 months
sugar, dal
Wheat/
3kg 2-2.5kg
Rice
Lentils 1-3kg 1-3kg
This THR package is adopted under COVID and plans to
include black sesame seeds, groundnuts, oil, milk powder
and sugar soon.
• AWWs procure THR materials from PDS • SHGs, organized by ICDS, procured grains,
shops or local markets roasted, mixed, and packed to create a
nutrition premix
• Distributed once a month by AWWs to PLWs
• Distributed once a week by AWWs to PLWsTHR PRODUCTION, FUNDING AND
AWW actions THR flow
Legend
ICDS actions
Payments flow
DISTRIBUTION MODEL IN RAJASTHAN
Gov’t actions
List of Beneficiaries flow 25
PDS. actions
Food supplier. actions
ICDS sends list of AWW sends list of
beneficiaries to PDS shops beneficiaries to ICDS
Govt of Rajasthan PDS shops store THR
If wheat is not available at PDS
allocates funds to NAFED packets, until AWWs shop, or given by schools
and FCI collect them
AWW purchases wheat in AWW collects THR items
local market from PDS shop
Funding Start AWW arranges for vehicle AWW arranges for vehicle
THR start
and/or help conveying materials and/or help conveying materials
Govt of Rajasthan NAFED and FCI provide
budgets for SNP wheat and lentils to PDS
shop AWW packages wheat.
Govt of India supplies 50% of AWW purchases packaging
SNP funding (Lentils have been pre-
material
Govt of Rajasthan supplies packaged since July)
50% of SNP funding
Govt of Rajasthan AWW distributes THR to
ICDS reviews and releases AWW submit bills for
distributes funds to beneficiaries
reimbursements reimbursement
ICDS
At AWC once a monthRajasthan
NEW THR DISTRIBUTION MODEL IN RAJASTHAN HAS 26
HELPED IN DELIVERY DURING LOCKDOWN
THR access is still • Decline in the THR coverage from 31% to 26% between Jan and May.1
low • Only half of the interviewed beneficiaries (12 out of 23) received the ration during lockdown
• Majority of AWWs reported regularly distributing THR during the lockdown, occasionally
with only partial items.
THR distribution • Some AWWs (8 of 25) reported missing at least 1 month of THR distribution since
improving lockdown.
• Distribution has mainly happened through AWCs even during the lockdown
• A couple AWWs (3 of 25) distributed THR at homes as well.
“In the last four months, the AWW has delivered THR to us in our home
four times. The first two times they delivered THR, they delivered 3kg
packets of wheat only. The last two times, they delivered 3kg packets
gram pulses only.”
– Currently pregnant woman in Baran district, Rajasthan
1. This finding comes from our earlier quantitative surveys. In Round 1 (January), confidence intervals (Cis) 30.4% to 37.5% and N=893. In Round 2 (May), CIs 22.5% to 29.6% with N=647.Rajasthan
HOWEVER, SOME CHALLENGES STILL REMAIN 27
• A few AWWs complained receiving less quantity than required from
Insufficient THR available at the
PDS shops.
PDS shops and other suppliers • 3 out 7 beneficiaries report THR wasn’t available at the AWC CLICK FOR
AUDIO QUOTE
• Some AWWs reported that bringing big 50-100 kg sacks of wheat on
their own from the PDS shop is logistically difficult
Transportation hurdles
• Hiring vehicles has become more expensive, and reimbursements for CLICK FOR
AUDIO QUOTE
transport are not always disbursed
• A few AWWs reported that ICDS has not reimbursed amount for the
THR procured from their own money.
Reimbursement delays • Some AWWs reported that ICDS has reimbursed less amount and many CLICK FOR
AUDIO QUOTE
reported that there has been delay in the reimbursement.
• State ICDS has issued at least 12 orders since April’20 for THR
Multiple sources of THR procurement
procurement • Source of procurement has been shifting between PDS shops, schools,
market etc. adding to confusion and logistical challenges
MORE VOICES FROM
ANGANWWADI WORKERSRAJASTHAN
PROCUREMENT OF WHEAT HAS BEEN PARTICULARLY 28
CHALLENGING
Availability and procurement patterns over the last 5 months
APR MAY JUN JUL AUG
More than half of AWWs say that wheat is not
Locally purchased
consistently available for distribution.
Pulses
There has been poor communication on what to
Available from PDS do when wheat is not available.
Wheat shops
AWWs have to take the flak from beneficiaries if
Provided by complete quantities are not delivered
schools (MDM)
“We don’t have to pay at PDS shop, but if the items are not enough, then we have to purchase it from our own money. We
inform our supervisors how much THR we got for free and how much we had to purchase. But now, reimbursements on local
purchase have been denied. Now our supervisors have instructed us to distribute three kilos each for 150 women. It totals to
450 kilos. But we get only 350 kilos in supplies. If I do not give THR to 33 women then they will call me a thief, and then they will
make complaints to my supervisors. Howsoever you work here, it is a thankless job.”
- AWW in Jodhpur district, RajasthanTHR SUPPLY CHAIN IN RAJASTHAN 29
BROKE AT THREE MAIN POINTS
ICDS sends list of AWW sends list of
beneficiaries to PDS shops beneficiaries to ICDS
Govt of Rajasthan PDS shops store THR
If wheat is not available at PDS
allocates funds to NAFED packets, until AWWs shop, or given by schools
and FCI collect them
AWW purchases wheat in AWW collects THR items
local market from PDS shop
Funding Start AWW arranges for vehicle AWW arranges for vehicle
THR start
and/or help conveying materials and/or help conveying materials
Govt of Rajasthan NAFED and FCI provide
budgets for SNP daal and wheat to PDS
shop AWW packages wheat.
Govt of India supplies 50% of AWW purchases packaging
SNP funding (Dal has been pre-
material
Govt of Rajasthan supplies packaged since July)
50% of SNP funding
Govt of Rajasthan AWW distributes THR to
ICDS reviews and releases AWW submit bills for
distributes funds to beneficiaries
reimbursements reimbursement
ICDS
At AWC once a monthRajasthan
RECOMMENDATION 3: STREAMLINE THR SUPPLY 30
THROUGH EFFICIENT PROCUREMENT, LOGISTICS AND
REIMBURSEMENT
Following are a few potential steps to implement the recommendation:
Streamline the THR procurement process
• Ensure one central source of procurement of THR and ensure its effective implementation on ground.
• Ensure availability of sufficient amount of wheat and lentils at PDS shops on time.
Provide logistical support to AWWs
• Arrange transport for AWWs to collect THR or ensure PDS shops deliver directly to the AWCs.
• Provide AWCs packaging materials to package wheat
Reimburse AWWs on time
• Reimburse AWWs on their actual costs if they are procuring THR items from local market.
• Adopt e-payment mechanism for all the payments within ICDS to allow for seamless money transfer
1. Beesabathuni, K., Kumari, P., Bajoria, M., eds. (2020). Take Home Rations: A Compendium. https://www.wcdsbp.org/publications/THR-Compendium_220720.pdf
2. Schwarz, R. K., Flanagan, K. F., Soe-Lin, S., & Hecht, R. M. (2018). Opportunities & Challenges in the Integrated Child Development Services’ Take-Home Rations program . Policy Brief 1. Pharos Global Health Advisors. Tata Trust.
3. WFP. (2019). Review of Take-Home Rations under the Integrated Child Development Services in India. https://docs.wfp.org/api/documents/WFP-0000111827/download/Rajasthan
BENEFICIARIES PREFER THE NEW THR SYSTEM 31
A LOT MORE…
“I like the pulses and wheat that are provided as THR right now. Children
Taste and also like it, and eat the food we prepare with this. I like the pulses
Quality because I can cook daal with it at home.”
Ease of - Mother of Child 0-6 months in Baran district, Rajasthan
Regularity
cooking
preferring the new system
Usefulness Prefer new “Children like the taste of food items cooked with the wheat and they
Stated reasons for
N=1 eat it also. When I was getting Panjri, even I didn't like the taste of it
system then how can children like it! I prefer the grains over Panjri because the
N=15
Liked by food cooked with the grains are salty and children like it.”
Nutrition children - Mother of child 6-36 months in Ajmer district, Rajasthan
Taste
“I didn’t like the taste of Panjri but I like the taste of food cooked with
Quality the wheat and pulse. “
- Currently pregnant women in Tonk district, Rajasthan
Variety
Note: Anganwadi worker preferences were far more mixed, and often reflected the Anganwadi worker’s perception of beneficiary preferences. 4 out of 25
AWWs suggested an alternative to either system: provide cash instead of grains. CIFF and IPE global are working with GoR to pilot cash transfers to improve
nutritional status of mothers and children. More info here. This program is not being piloted in any of the districts in which IDinsight conducted interviews.Rajasthan
…BUT CALL FOR GREATER QUANTITY, FREQUENT 32
DISTRIBUTION, AND ADDITIONAL ITEMS IN THR.
The three most common pieces of beneficiary feedback: Why do beneficiaries feel quantity is insufficient?
• Families are sharing THR items
Increase the quantity provided • Raw grains more easily incorporated into
Most of the THR beneficiaries gave feedback that the
family meals
quantity of THR currently being provided is
insufficient. Many beneficiaries said that quantity of • Increased food insecurity
THR should be more than 5 KG.
Deliver THR more frequently. Why do beneficiaries request greater frequency?
Many THR beneficiaries gave feedback that THR • Before March 2020, THR distribution was once
should be delivered 2-3 times per month and a few a week
beneficiaries also said that it should be delivered • May be an implicit ask for greater quantity
regularly and on time.
Add other items to the THR.
A lot of THR beneficiaries gave feedback that Why do beneficiaries call for additional items?
additional items should be provided under THR. • Only 2 items (wheat and pulse) don’t meet the
Additional items suggested by the beneficiaries are: nutritional requirements.
Rice, Moong daal, Oil.
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AUDIORajasthan
RECOMMENDATION 4: CONTINUE THE CURRENT THR 33
MODEL BUT ENSURE COMPLETE NUTRITION
Following are a few potential steps to implement the recommendation:
Address quantity and allocation issues
• Direct resources towards a strong and creative communications campaign, with the message that THR should be
consumed by pregnant women and children only such as posters, wall paintings, counselling, THR packaging etc. 1,2,3
• Add items in THR package which can be easily set aside for the intended beneficiaries and reduce intra-household
consumption.
• Ensure that the increased allocation of PDS under PMGKAY is implemented successfully on field and there is sufficient
awareness around the same.
Build transparency and trust3,4,5
• Package THR items uniformly, with clear labels on THR entitlements for different beneficiaries.
• Provide AWCs with weighing machines and encourage AWWs to re-weigh contents in a visible way to the beneficiaries.
1. S. John & S. Prakashi. (16 Sept 2020).“When Walls Talk”. Outlook POSHAN. https://poshan.outlookindia.com/story/poshan-news-when-walls-talk/360390
2. Alive & Thrive. Rapid improvements in infant and young child feeding practices resulting from a large-scale program in Bangladesh. https://www.aliveandthrive.org/wp-content/uploads/2018/07/Country-brief-Bangladesh.pdf
3. WFP. (2019). Review of Take-Home Rations under the ICDS in India. https://docs.wfp.org/api/documents/WFP-0000111827/download/]
4. Beesabathuni, K., Kumari, P., Bajoria, M., eds. (2020). “Governance and Accountability: Experience of Odisha”. Take Home Rations: A Compendium. p. 32. https://www.wcdsbp.org/publications/THR-Compendium_220720.pdf
5. Schwarz, R. K., Flanagan, K. F., Soe-Lin, S., & Hecht, R. M. (2018). ICDS programmatic governance, accountability and performance management, and quality assessment – Challenges, and Opportunities for Improvement. Policy
Brief 3. Pharos Global Health Advisors.TAKE HOME RATION CAN BE IMPROVED WITH ACTIONS IN 3 KEY
AREAS… 34
ADDRESS DELAYS IN PROVIDE ENHANCE TRUST &
FUNDING & PROCUREMENT COMMUNICATION
PAYMENTS
• Move to pre-paid system or
SUPPORT • Build transparency and trust within
JHARKHAND
JHARKHAND
JHARKHAND
expedite the reimbursement the beneficiaries by weighing THR
process. appropriately
• Plan a menu of alternatives to
• Set up e-payments system for ICDS • Design a strong communications
replace chronically missing items
and SHGs/JSLPS campaign with the message that
• Regularly update the price of THR THR should be consumed by
items based on market fluctuations pregnant women and children only.
• Establish single source of
RAJASTHAN
RAJASTHAN
RAJASTHAN
procurement; ensure that wheat • Strengthen communication on
• Reimburse Anganwadi workers for reaches PDS shops intra-household allocation
local purchasing • Provide logistical and • Add items to THR package which
• Set up e-payments system for ICDS transportation support to can only be consumed by intended
Anganwadi workers beneficiaries35 APPENDIX
BACK
METHODOLOGY: DEMAND-SIDE SAMPLE WAS STRATIFIED ON 36
DISTRICT PERFORMANCE AND HISTORY AS A THR BENEFICIARY
Lives in above Lives in above Districts above state average on access to THR1
average district average district
& & • Rajasthan (26%) • Jharkhand (55%)
o Tonk (42.4%) o Pakur (57.0%)
Did not receive Received THR in
THR previously previous rounds o Bhilwara (36.1%) o Khunti (69.1%)
o Baran (44.0%) o Simdega (69.7%)
o Jhalawar (52.3%)
Lives in below Lives in below Districts below state average on access to THR1
average district average district
& & • Rajasthan (26%) • Jharkhand (55%)
Did not receive Received THR in o Bikaner (18.5%) o Garhwa (54.4%)
THR previously previous rounds o Jodhpur (12.6%) o Hazaribagh
o Ajmer (13.0%) (39.5%)
1. These estimates come from IDinsight’s Round 2 quantitative data collection in May 2020. Access to THR is defined as having collected THR in the last 30 days”.ANALYSIS METHODS: DATA ENTRY & PARAPHRASING
Back 37ANALYSIS METHODS: THEME CODING
38
BackBACK
JHARKHAND: ANGANWADI WORKERS HAVE MIXED
PREFERENCES FOR THR SYSTEM
39
Stated reasons
behind preference
Beneficiaries like it
Nutritional value
Ambivalent / Prefer Old No quantity issues
Stated reasons no preference System
n=3 Delivered on time
behind preference
n=3
Beneficiaries like it
Prefer New
System
Nutritional value n=4
More women
come to AWC
MORE VOICES FROM
ANGANWWADI WORKERSBACK
RAJASTHAN: ANGANWADI WORKERS DIFFER ON
PREFERRED THR SYSTEM 40
Stated reasons
behind preference
Beneficiaries
use this more
Ambivalent /
No preference
Less work for
N=5 Prefer New AWW
System
Stated reasons Nutritional value
N=8
behind preference Monthly distribution
Nutritional
value Prefer Old
System
Less work for
N=9
AWW
Quality
Weekly distribution
Eaten by intended beneficiary
4 out of 25 AWWs suggested an alternative to either system: provide cash instead of grains.1
1 CIFF and IPE global are working with GoR to pilot cash transfers to improve nutritional status of mothers and children. More info here. This program is not being piloted in any of the districts in which
IDinsight conducted interviews.JHARKHAND: VOICES FROM ANGANWADI WORKERS BACK
41
"We, the AWWs, need to reduce malnutrition in children. If we stop the things “Everything supplied to us gets finished. In my area,
that are making the children and pregnant women malnourished by providing people are quite educated now. Every beneficiary
the right nutritious foods at the right times, we can control malnutrition. comes and collect THR. Nothing remains as leftover.
Otherwise, we can't do it. Since we haven't gotten any THR to distribute in the People are very aware in my area about their rights
last 4-5 months, how can we fight malnourishment? We have the will to end and government schemes. Moreover, we also make
malnutrition, and we can work on it also. For that, we should be free from them aware. We just send them information whenever
government pressure, and we can pursue this matter aggressively so that no the ration is supplied, and they come and collect it. It
children become malnourished. If children already are malnourished, then we is coming for them what we will do if we keep it. We
can make them better. We cannot do this right now. Right now, we can work are aware of the coronavirus too. For that, we have to
hard, but the problem is not with us. If we don't have the right tool to fight maintain discipline and distribute while maintaining
malnutrition, then we cannot win this fight. The government already knows proper distance between them and taking care of
what they are doing for us and not doing for us. The only thing we can do is sanitization also.”
gather in small groups and and raise our voice in rallies, but then we sit idle - Anganwadi worker in Garhwa district, Jharkhand
because nothing is heard. What we need to do is our work. We know how we
work, and how to make it better. They say they will give us our salary, but then
they don't give it. Then they ask us to work overtime. Our workload is too much.
We cannot think about our own problems or our family problems. Why bother
though when no one will listen to what we are saying.” “If the foundation is not good, building will not stand for
-- Anganwadi worker in Simdega district, Jharkhand long. Nutritional requirements are not met by just
eating rice, pulses and jaggery. It should also include
fruits, milk and eggs. You get strength by eating fruits.
“Both systems are the same for us. We just have to take the packets and Nothing much will happen by eating rice, pulses and
give them to people. How do we know which among these is better? jaggery."
People are saying that the current system is better where they have been - Anganwadi worker in Garhwa district, Jharkhand
given rice, pulses and jaggery.”
– Anganwadi worker in Garhwa district, JharkhandRAJASTHAN: VOICES FROM ANGANWADI WORKERS BACK
42
We do face a lot of difficulties while distributing the Wheat has not been supplied. Only pulses are provided, and in this case, we do not
complete nutrition because the women create a large get enough pulses for all our beneficiaries. Last time we had 135 aspirants and they
crowd by when they hear that it is being distributed. supplied just 100 kilos of pulses. This creates problems. It becomes very difficult to
Many women who are not registered with us also come face the public. If we supply THR by purchasing on our own, the bills submitted for
to collect and start shouting that they also want the take reimbursement are not approved. Now we have been given clear instructions not
home ration. to purchase by our own… We are trapped from both sides. The public complains of
- Anganwadi worker in Ajmer district, Rajasthan short distribution, and government does not reimburse the purchase bills.
- Anganwadi worker in Jodhpur district, Rajasthan
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They reimburse us at the rate of ₹ 56 for pulses, but we are
paying for pulses at rate of ₹ 65-65 rupees” The Anganwadi center building is broken. Many times snakes and scorpions come
- Anganwadi worker in Baran district, Rajasthan out. One day, a snake fell on our helper Didi. There are difficulties. When some
officer comes and we tell them snake had come, they don’t believe us"
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- Anganwadi worker in Jhalawar district, Rajasthan
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We get tired carrying loads for far distances. We end up My ASHA co-worker, Anganwadi helper and I went home to home and delivered THR.
getting dirty from the mud on the way. In some areas, One person cannot do it all alone. The distribution, getting the register signed, and
there is a threat of dogs. Some houses have pet dogs taking photos requires more than one person.
that disturb us as well. - Anganwadi worker in Jhalawar district, Rajasthan
- Anganwadi worker in Ajmer district, Rajasthan
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