Frontline nutrition workers foster disability inclusion

The Haryana government’s Department of Women and Child Development promotes disability inclusion through Mission Vatsalya and the Integrated Child Development Scheme. In this connection, it has introduced the Divyang Protocol at Anganwadi centres for the early detection and inclusion of children with disabilities. File photo: Special Arrangement

December 3 is International Day of Persons with Disabilities. It is a day dedicated to advocating the rights of people with disabilities by creating awareness and highlighting the inclusion and the needs of persons with disabilities who are among one of the most marginalised and under-represented communities in the world.

In recent years, there has been growing recognition, globally and nationally, of the significant connection between nutrition and disability. Various studies are increasingly underscoring this relationship. There are reports that illuminate the profound impact of nutritional status on overall health and well-being.

Nutrition, health and disability

Research indicates that countries with high levels of malnutrition tend to exhibit not only poorer health outcomes but also higher rates of disability among their populations. This correlation has far-reaching implications, suggesting that inadequate nutritional intake can lead to a range of health issues that contribute to disability. For instance, malnutrition may weaken the immune system, hinder physical development, and exacerbate chronic health conditions — all of which can significantly impair an individual’s ability to function effectively in daily life.

As governments and health organisations strive to improve public health, addressing malnutrition becomes increasingly critical. This is not only for enhancing individual quality of life but also for reducing disability rates on a broader scale. The link between nutrition and disability underscores the need for integrated health policies to improve dietary practices and ensure access to nutritious food for vulnerable populations.

Maternal malnutrition can lead to prenatal disability, malnutrition can contribute to developmental delays and disabilities at different points in the life cycle — for example, vitamin A deficiency can cause blindness), and some disabilities, such as cerebral palsy and Down syndrome, can put persons at risk of nutritional deficiency. There is a real need to make nutrition services, benefits, and information more accessible to persons with disabilities.

In 2023, the Ministry of Women and Child Development introduced the ‘Anganwadi Protocol for Divyang Children’, a national guideline for frontline community nutrition workers in India regarding disability inclusion. Anganwadi workers are crucial as community nutrition providers, executing and manifesting India’s most ambitious development programmes. They engage deeply with the communities, offering vital nutrition services and driving social and behavioural changes related to gender equality, social inclusion, nutrition, and early childhood development. The Protocol for Divyang Children equips them with comprehensive instructions for the early identification of disabilities, monitoring developmental milestones using the POSHAN Tracker, and ensuring referrals in partnership with Accredited Social Health Activist (ASHA) workers.

The experience in Haryana

The Haryana government’s Department of Women and Child Development is committed to promoting disability inclusion using Mission Vatsalya and the Integrated Child Development Scheme. It has introduced the Divyang Protocol and a unique podcast initiative, ‘Nanhe Farishtey’, to educate communities about disabilities and enhance awareness at Anganwadi centres for the early detection and inclusion of children with disabilities

The World Food Programme (WFP) has also partnered with the Department of Women and Child Development for a three-year intervention to transform norms around gender equality and social inclusion, including disability inclusion, by developing the capacity of Haryana’s network of 25,000 ‘Anganwadi’ workers.

As part of the collaborative programme, in a recent Needs Assessment Study for its intervention in Haryana, the WFP asked ‘Anganwadi workers’ across four districts about persons and children with disabilities in the local communities they serve. The study found that Anganwadi workers played an essential role in the early identification of children and referral for children and adults with disabilities. Nearly all the respondents had helped connect persons with disabilities to some form of medical and educational support, register for disability certificates, and help them avail themselves of government-provided benefits, including the National Disability Pension.

Early intervention, accessible medical therapy, and supportive services are crucial for aiding children with disabilities. Anganwadi workers play a vital role in this effort. Alongside building the capacity of Anganwadi workers on the Divyang Protocol, development actors must unite to create supportive services and infrastructure for these children. This includes establishing a group of trained specialist therapists for various disabilities, creating accessible schools and transportation, providing affordable assistive devices, and implementing information-communication systems to promote tailored nutritional well-being practices for individuals with disabilities. Community members and frontline workers can contribute by dispelling the disability stigma.

We all share the responsibility of ensuring that the nutrition and food security of persons with disabilities, particularly children, are at the centre of their rights, equal opportunity and well-being.

Elisabeth Faure is Country Director for the United Nations World Food Programme (WFP). Amneet P. Kumar, an IAS officer, is Commissioner and Secretary, Government of Haryana