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Fighting anaemia with ‘paushtic’ rice

  • Villagers in Maharashtra’s Gadchiroli district were initially suspicious of rice mixed with Fortified Rice Kernels An awareness programme has changed that
  • This is a collaboration between the Maharashtra government and Tata Trusts

To dispel doubts, women were requested to cook and serve the ‘paushtic’ rice at awareness workshops.
To dispel doubts, women were requested to cook and serve the ‘paushtic’ rice at awareness workshops. (Photo: Simit Bhagat)

When Raju Padalwar received his monthly supply of rice in January, he saw a few grains in the batch that shone unlike the rest of the kernels. He had heard of the government’s plan to supply paushtic (nutritious) rice in his village Nargunda, in the Bhamragad tehsil of Gadchiroli district, but he had little idea that the suspicious-looking grains were actually Fortified Rice Kernels (FRK). The scepticism of Padalwar and others from the area lead to paushtic rice temporarily earning infamy as “plastic rice".

Padalwar’s reservations were perhaps justified given the lack of awareness at the time. Today, that has changed and the rice has been introduced as a collaborative project between the Maharashtra government and Tata Trusts to address the problem of anaemia in the region. One of the major reasons for it is the low level of nutrition and lack of diversity in diets among tribal communities.

“Anaemia is an issue in most rural regions of India and the biggest reason for low birth rates. In Gadchiroli, it becomes even more acute because the tribal populations live in remote places with a difficult terrain, and, at times, no road network. So it’s a combination of factors that leads to anaemia, especially in pregnant mothers and adolescents. Then, there is also a leftist movement prevalent in the region, which can make things difficult," says Shekhar Singh, district collector, Gadchiroli.

According to Singh, the state government is executing programmes such as Weekly Iron and Folic Acid Supplementation under which, as the name suggests, they administer an iron and folic acid tablet every week to adolescent girls and keep a check on the health of anaemic mothers.

The problem with such tablets, says Anagha Amte, a gynaecologist from Lok Biradari Prakalp (a social initiative that works on health, education and wildlife in Gadchiroli), is that most don’t have them. There is also a misconception within the tribal community that consumption of iron tablets leads to an increase in the weight of a baby, which can lead to complications during delivery.

“Rice fortification is a different approach. Rather than giving something over the top such as an iron folic acid tablet, we are including these nutrients as part of the diet. This is exactly how iodine was introduced in the diet through salt. Fortification can be a good and effective tool but at the same time it cannot solve everything," Singh says.

The idea was to introduce FRKs as part of the rice supply. The kernels are made with rice powder and mixed with micronutrients such as vitamins B1 and B12, besides folic acid and iron in certain proportions. They are then shaped in the form of rice and mixed with the main supply at the miller in a ratio of 1:100, in accordance with Food Safety and Standards Authority of India (FSSAI) standards.

Rice, though, wasn’t part of the original plan. In 2017, as part of its nutrition programme, Tata Trusts started out with wheat fortification during a six-month project. The fortified wheat was supplied to a slum in Turbhe in Navi Mumbai.

“We evaluated the project to understand the scalability. What we realized was that Maharashtra was not primarily a wheat-eating state—it was a combination of rice, jowar (sorghum), bajra (pearl millet) and ragi (finger millet). However, rice was the staple in most places, since it is grown in this region. We had to understand where local millers were accessible to process it," says Sonal D’Souza, project manager (food fortification), Tata Trusts.

Over the next few months, Tata Trusts evaluated the places where rice was grown and produced. It found the Konkan belt and Vidarbha region suitable for the project.

“The process is a value-chain model where we are procuring the rice locally, milling and fortifying it at the local miller to make it economically feasible. The rice millers are also major stakeholders in this project, so we had to keep in mind their considerations as well," says D’Souza.

A baseline study was conducted in March 2018 in three blocks of Gadchiroli—Bhamragad, Etapalli and Kurkheda—to assess the status of anaemia among women (15-45 years) and children under five years, and understand the level of interest among fair-price shop owners in fortified rice, since they would be responsible for the distribution. The baseline survey found mild anaemia in 30% of adolescent girls in Kurkheda and Bhamragad, and 43% in Etapalli. There were high ratios of sickle cell anaemia among pregnant and lactating mothers in all three blocks . Over 60% of adolescent girls were nutritionally weak, according to their Body Mass Index (BMI) status.

The study then picked out the Kurkheda and Bhamragad blocks for the programme. There were preliminary assessments of four rice plants to understand if these were capable of conducting the blending process to produce 65,851.92 quintals for the two blocks, to benefit a population of 189,972.

“The state food and civil supplies department too wanted to evaluate the complete pilot project to understand the point of efficacy in reducing anaemia. It was of paramount importance for us that hygiene is maintained, quality standards are high and there is continuous testing being done at various levels," D’Souza says.

“Fortified rice is a tried and tested formula. In 2012, the first project was undertaken in the Dhenkanal district in Odisha as part of the midday meal scheme. That is also a tribal block, and, after 18-24 months, they found there was a reduction of anaemia by 0.4%. It is now a published case study in the World Food Programme. We simply wanted to extend it through the public distribution system so that the beneficiaries were extended to an entire household rather than just children," D’Souza adds.

When the rice was introduced in the Kurkheda and Bhamragad blocks in January, its appearance led to resistance. Some tried to burn the FRKs; others put them in water to see if they would dissolve.

“Though we did involve all the stakeholders, which includes our staff, rice millers, shopkeepers and the beneficiaries, there were still issues about the colour; a few complained about the taste after cooking as well," says Mahesh Pathak, principal secretary, food and civil supplies and consumer protection, Maharashtra government.

As a result, they had to put up banners to create awareness about the project and then ask journalists and self-help groups to conduct workshops and camps for locals. The rice was even cooked and served in the form of masala rice and kheer. Over time, confidence built up.

“We had doubts over the quality of rice initially, but after learning about it at the workshops, we are more clear on the intention of the programme," says Ranju Naita, a resident of Fari village in Kurkheda.

The project was evaluated by the government’s policy think tank, NITI Aayog, and published as a successful health innovation pilot in March.

A scale-up plan for all 12 blocks in Gadchiroli will be executed by the state government, Tata Trusts and Bharat Petroleum Corporation Ltd. It’s also being introduced in other states.

“We made a presentation to NITI Aayog in the conference of the secretaries of food and civil supplies in January. It is now being scaled up to 15 districts across 15 states. All the misgivings were removed after realizing the speed at which it can be done and the cost-effective implementation," Pathak says.

They are also now undertaking a survey to understand the impact of the programme on health and better understand attitudes towards the use of fortified rice.

“Community mobilization was an important aspect of the pilot. At the end of it, we have to keep in mind that we are doing this for the beneficiaries," D’Souza says.

Shail Desai is a Mumbai-based writer.

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