Rice and sugar provide “limited benefit” in India’s food subsidy program

22 Jul 2020 --- The rice and sugar subsidized to low-income households via India’s Public Distribution System (PDS) may be of limited nutritional benefit. An international study revealed that children may be positively impacted by access to subsidized food through the PDS in the short-run, but the food they receive should not serve as a proxy for dietary diversity. Consequently, the study authors advocate for more diligent monitoring of the scheme’s impact on children’s nutritional outcomes, rather than a “drastic overhaul” of the PDS per se. Strikingly, the study points out that one-third of undernourished children worldwide live in India.

“Our findings suggest that the program could potentially accomplish more in terms of long-term outcomes by examining the nutritional quality of items on offer and considering alternative program specifications. A review on this basis is urgent – nutrition in childhood can have lasting consequences throughout our entire lives,” study co-author Dr. Jasmine Fledderjohann, Lecturer in Sociology at Lancaster University in the UK, tells NutritionInsight.

Rice generally has a substantially lower nutritional content in terms of iron, protein and fiber compared to other cereals, Dr. Fledderjohann details, and this is particularly the case with lower-quality rice. “Sugar, meanwhile, provides calories, but is again lacking in terms of micro- and macronutrient content. It has in fact been associated with a range of negative health outcomes.” However, many factors that ultimately determine the nutritional content of food exceeded the scope of the research, including considerations such as food preparation.

The pooled analytic sample comprises 5,279 observations from 2,944 children with 1,950 participants (66 percent) drawn from the young cohort aged 6 to 12 months and 994 (33 percent) taken from the older cohort, aged 8 years. Approximately 87 percent of households accessed at least one item through the PDS, with 86 percent accessing rice and 71 percent accessing sugar. In general, rice consumption was very high, equivalent to 55 to 65 percent of total caloric intake. A third (34 percent) of Indian children analyzed were stunted and just over a quarter (26 percent) had low Body Mass Index.Moreover, rice and sugar are not the only items on offer through the PDS. There has been variation both across time and in different states with respect to what’s offered, she says. These include wheat, cooking oil and pulses, such as lentils, which potentially fosters better nutritional outcomes.

The research team saw no evidence of nutritional improvements when children received subsidized rice and sugar.Subsidy improvement suggestions
A central point of tension is that the availability of less nutritious foods may encourage consumption due to its availability and limited choice of other foods. “If less nutritious food is what is available, then that is what will be consumed,” illustrates Dr. Fledderjohann.

The study detailed three main pieces of evidence that several adjustments to the PDS may improve its performance. First, the authors argue that bolstering the rice subsidy and dropping the sugar could improve gains, especially since they found no evidence of improvements in child height-for-age z-score (HAZ) via sugar consumption.

Next, social and behavior change campaigns – dependent on structural support – could address the importance of adequate nutrient intake and a balanced diet. Last, nutrient intake could be improved without changing existing consumption patterns through fortification of the food items provided as part of the PDS and the incorporation of more nutritious food items in the entitlement package.

Although there is “certainly some literature” supporting how food fortification could present a means of making nutritious food more accessible, Dr. Fledderjohann stresses that, in general, the literature on fortification is “mixed.”

Meanwhile, more nutritious food subsidies may “possibly” result in higher costs out of pocket for respective households, says Dr. Fledderjohann. “However, this would ultimately depend on the alternative specification of the program. The program could offer a different set of subsidized foods at a cost comparable to the current price points, but with the government, rather than the consumer, bearing the difference of cost. In practice, of course, this would depend strongly on budgetary constraints, among other considerations.”

The current study does not aim to “bash” the existing structure of the Indian PDS. “Particularly where children are not getting enough calories, items such as rice can at least help [them] meet their basic caloric needs. In fact, for some children, these calories likely have life-saving potential.”

“I think it’s really important to note that we cannot know the counterfactual here, that is, what would happen to children in the households that received PDS subsidies if the program were not available at all? This is speculation on my part, but I would guess that nutritional outcomes would be worse without the PDS,” she concludes.

Research has recently brought the importance of financially supporting countermeasures to malnutrition to the fore. A Chatham House report revealed the US$850 billion cost in productivity losses caused by malnutrition for businesses earlier this month. Meanwhile, UN data shows that the world is not on track to achieve its goal of combating hunger and malnutrition by 2030.

By Anni Schleicher

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