A synthesis of evidence on take home rations

According to the National Family Health Survey (NFHS-4) in 2015-16, 38.4 percent of children in India under the age of five are stunted, i.e., have impaired growth and development. This rises to 41.2 percent in rural areas, ranking India 134th out of 151 countries. Devoting public resources to reducing micronutrient deficiencies in children is essential for improved health and is associated with large economic returns in the long run through better productivity, lower health costs, and intergenerational transmission of these benefits.

The Government of India has a long history of interventions focused on maternal and child health. A key component of the former has been the provision of food rations under the Integrated Child Development Services (ICDS) scheme’s Supplementary Nutrition Program (SNP), established in 1975. Currently, as part of the SNP, pregnant women and mothers of children aged 6 months to 3 years receive monthly Take Home Rations (THR), and children aged 3-6 years receive a daily hot meal at the anganwadi (or crèche). Apart from this nationwide in-kind support, the central government also administers cash transfer programmes for pregnant women and lactating mothers. The Janani Suraksha Yojana (JSY) programme delivers cash conditional on an institutional birth.

This paper synthesizes evidence on Indian programs targeting maternal and child nutrition. Much has been written on the comparisons between cash and in-kind transfers internationally and this paper does not profess to add evidence to that body of works. Nor does it seek to discuss the issue of cash versus in-kind in general terms. This paper focuses on the Indian experience of THR and cash transfers, diverse as this context is, targeted at pregnant/lactating women and young children below three years of age. The paper draws on recent research over the past two decades and covers mainly but not exclusively peer-reviewed published research.