Deaths due to severe acute malnutrition (SAM) in India could be about a tenth of what was earlier believed, which implies that instead of taking emergency measures such as providing Ready To Use Therapeutic Food (RUTF), there needs to be a focus on non-food interventions such as sanitation, health, clean drinking water along with an emphasis on nutrition.

Ready To Use Therapeutic Food (RUTF)

• According to WHO, RUTF is a thick Peanut Paste,
  vegetable oil, sugar, and milk powder and a complex of
  vitamins and minerals. It is also referred to as ‘Energy
  Dense Nutritious Food – EDNF’ due to its high
  calorific value.
• It is a medical intervention to improve the nutrition intake of children suffering from Severe Acute Malnutrition (SAM).
• It contains 520-550 kilocalories of energy per 100g.
• Usually, it is given to children aged between six months and six years, after a doctor’s prescription.
• A child can be given three packets daily for a month and each packet which costs around Rs 25 and has a shelf life of two years.

Where is it being predominantly used?

• RUTF use is common in Africa, where the incidence of malnutrition among children is high.
• In India, the global collaborative ‘Scaling Up Nutrition’ movement has tied up with Maharashtra, Uttar Pradesh and Jharkhand to promote therapeutic food.
• Pilot projects to treat severely malnourished children with RUTF have been undertaken in all three states and in

What is the Indian government’s take?

• The government maintains that enough evidence is not available to substantiate the benefits of RUTF vis-à-vis other interventions.

Benefits of RUTF?

• The United Nations Children’s Fund (UNICEF) supports community-based management along with RUTF.
• UNICEF notes that RUTF is safe, cost-effective and has saved the lives of hundreds of thousands of children.
• India is one of 16 countries where local manufacturers of RUTF are being given UNICEF accreditation.

Opposing views

• Debates, in essence, revolve around concerns over whether RUTF would be effective in India, considering its varying food habits.
• There are concerns that RUTF may replace nutritional best practices and family foods that children would normally be eating.
• Also, this might encourage discontinuing breastfeeding in children older than six months.
• Temporary Solution – A slip back to malnutrition, once RUTF was stopped, was also noticed in a considerable number of cases.
• While there is no large scale study of post-RUTF treated children in India so far, health activists say it cannot be a permanent solution
• Financial Burden – RUTF is a medical intervention, and at Rs 25 per packet, a single child’s treatment will cost Rs 2,250 a month.

How else can the problem be addressed?

• The Health Ministry is working to develop guidelines and a toolkit for early childhood development.
• This is to better equip frontline workers for counseling families on nutrition and feeding practices.
• The family-centric approach instead of a food-centric approach for handling malnutrition is being mooted.
• Hand Holding of target families is essential for optimal childcare practices, along with adequate hygiene and sanitation.
• Counseling on family planning to ensure low birth weight babies aren’t born is another measure.
• Ensuring regular meals for children through properly streamlining anganwadis will also significantly reduce malnourishment.