What we can expect from Naandi Foundation's landmark HUNGaMA survey

Back in August 2011, during a trip to Hyderabad to run my 6th marathon, I spent some quality time with Manoj Kumar, Naandi Foundation’s CEO, hearing about his journey (and Naandi’s journey) – rich fodder for a blog series on Naandi. The reason why the series has not yet seen the light of day must rank among the most absurd. In my quest for a deterministic cadence to this blog, I have deferred several newsworthy posts that have required follow-ups. Oh well! there’s my first confession for 2012. This post also marks the start of our series on Hyderabad-based Naandi Foundation which is making a significant social impact in three areas – childhood nutrition, early education, and safe drinking water.

During our August 2011 chat, Manoj was particularly excited about the upcoming release of India’s first ever comprehensive survey on childhood hunger and malnutrition (catchily dubbed “HUNGaMA”). On the eve of the release of the HUNGaMA survey by Prime Minister Manmohan Singh, I watched Manoj’s March 2011 TEDxDelhi video and some of the mainstream media coverage and gleaned the following insights.

According to UNICEF, 1 out of 3 malnourished children under the age of five are in India. It should then not surprise us that 1 out 2 Indian children are malnourished. What should shock us is that we’ve known about this since 2006. The 2005-06 National Family Health Survey showed that 20% of children under five years of age were wasted (aka “acutely malnourished”) and 48% were stunted (aka “chronically malnourished”).

In this current Indian climate where politicians are being branded as perhaps a notch above the “vermin” category, it should encourage us that a group of five parliamentarians got sufficiently riled up with the malnutrition data and formed a group called ‘Citizens Alliance Against Malnutrition’. Besides the five MPs (Sachin Pilot, Shahnawaz Hussain, Supriya Sule, Jay Panda, and Prema Cariappa), Naandi’s Manoj Kumar was the other prominent member of this group. In the TEDxDelhi talk, Manoj talks about the backdrop to this report, a counter-intuitive way in which they gathered data, and describes what we can expect from the survey.

If we knew, in real-time, where India’s malnourished children are, we might be able to design targeted interventions.

A total of 112 districts (which included 84,000 rural households and 100,000 mothers) were part of this survey, 100 of them were predominantly from the 6 biggest states with the most depressing child indices data and the remaining 12 were districts with the best child indices data — to understand what’s going right in those districts.

1.5 million person hours were spent in collecting this data but.. HUNGaMA has been less about collecting data and filling questionnaires as much as it has been about “listening to people, particularly mothers.”

Is there a relationship between the malnourishment data that we get and the background of the mothers?

Instead of collecting data, analyzing it and producing knowledge/insights from it, we did the reverse. Make the mothers talk, and from their knowledge, see if we can distill any information, and from that information, we throw you the data.

Four unexpected insights

1. Lack of awareness among mothers about what a malnourished child would look like. They know the difference between health vs. unhealthy, fat vs. thin but didn’t know symptoms of a malnourished child.
2. Colostrum (mother’s first milk) not being given to a newborn baby due to wide range of cultural reasons.
3. Maternity leave is taken for granted in the organized sector. In the unorganized sector, mother has to get back to work on the second or third day after the birth of her baby. Child is left in the care of a grandmother or some other caregiver. Clearly one of the root causes for malnourishment. One of the ideas being discussed: “is it possible to dovetail into the MNREGA scheme and guarantee 6 months of wages for a new mother”?
4. Village anganwadis are a beacon of hope for a very important reason that kids, for the most part, are well fed. Brainstorming ideas on cloud computing solutions to monitor kids real-time in anganwadis.

Sanitation practices were shocking. Soap apparently has become a gender symbol, associated and used only by men. Women don’t use it after any of their ablutions or before touching their young children.

Other questions that the survey would be looking to answer;

• Is there correlation between education level of mother and malnutrition?
• Is there correlation between age of mother when she got married to malnutrition
• Does the age gap between siblings influence malnutrition?