Feeding Five People on Two Hundred Rupees a Day
The Verma family in a semi-urban mohalla has five members: the father (38, a daily-wage mason), the mother (32, seven months pregnant with her third child), a daughter (9), a son (5) and the father's mother (65). The family's food budget is about Rs 200 a day. At the ANM's check-up the mother's haemoglobin was 8.4 g/dL. The 5-year-old passes hard stools every third day and refuses vegetables. The grandmother has lost most of her teeth and says dal gives her gas. The local kirana sells wheat flour, rice, arhar and chana dal, groundnuts, jaggery, mustard oil, seasonal green leafy vegetables, bottle gourd, tomato, onion, potato, milk at Rs 60 a litre, eggs at Rs 7 each, and bananas. The daughter has started refusing milk. The family already spends about Rs 40 a day on biscuits, chips and a cold drink for the two children.
1. Identify the nutritional problems in this family and trace each one to its likely cause.
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Mother, Hb 8.4 g/dL at seven months: this is moderate anaemia. Causes in this setting are low iron intake and low absorption, repeated closely spaced pregnancies, and a diet whose iron is largely plant phytate. Pregnancy raises iron demand sharply, so intake must rise, not stay at the family's usual level.
Son, hard stool every third day: too little dietary fibre and water, and a vegetable-refusing child who fills up on biscuits and chips. Constipation here is a diet problem, not a disease needing tonics.
Grandmother, no teeth and 'gas from dal': she cannot chew, so she eats soft refined food, and she may eat dal late or in large amounts. The gas complaint usually means large portions, too much oil or eating too fast, not that dal is harmful.
Daughter refusing milk: normal in this age group if milk is forced; calcium can come from curd, chana, green leafy vegetables and groundnuts.
Common thread: Rs 40 a day, one-fifth of the food budget, buys almost no nutrients but displaces milk, eggs and dal. Fixing the household depends more on reallocation than on adding money.
2. Plan one day's meals within Rs 200 that addresses at least three of these problems, and justify your choices in terms of cost and nutrients.
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Plan (approximate prices)
- Early morning: 200 ml milk for the mother and grandmother (Rs 12).
- Breakfast: rotis from 500 g atta (Rs 20), groundnut-jaggery chutney, 100 g groundnut (Rs 12) + 30 g jaggery (Rs 3), 2 bananas (Rs 10).
- Lunch: rice 300 g (Rs 15), arhar dal 150 g (Rs 16), green leafy vegetable 250 g cooked in 30 g mustard oil (Rs 10 + Rs 6).
- Evening: 2 boiled eggs for the children (Rs 14), roasted chana 100 g (Rs 10).
- Dinner: rotis from 400 g atta (Rs 16), bottle gourd sabzi with tomato-onion (Rs 12), chana dal (Rs 8).
- Extras: spices, lemon, salt (Rs 10). Total about Rs 174, leaving Rs 26 for fruit or a second vegetable.
Justification
- Green leafy vegetables, jaggery and groundnut give iron; a squeeze of lemon or amla gives vitamin C, which raises absorption of plant iron. Tea or coffee with meals must be avoided, as tannins block iron.
- Egg and dal supply protein for the pregnant mother and growing children.
- Whole atta, dal, vegetables and the banana supply fibre; add 6-8 glasses of water for the constipated child.
- The grandmother gets dal in small amounts, well cooked and mashed with rice, not a large oily helping.
3. The family insists it cannot give up the Rs 40 spent on biscuits, chips and cold drinks. How would you counsel them without lecturing, and what would you ask them to change first?
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Start from what they already believe: they buy these foods because the children demand them and because they look like a treat that a poor family can afford. Do not attack that feeling; redirect it.
Ask, don't tell: ask what the children eat at 5 p.m. and whether they finish dinner afterwards. Most families see for themselves that the cold drink kills appetite and the biscuits replace dal.
One change at a time: first swap the cold drink for lemon water with a pinch of salt and sugar, or buttermilk, which costs a fraction and adds fluid. Second, move Rs 20 of the Rs 40 to eggs and roasted chana, so the children still get a 'special' snack. Third, keep the remaining Rs 20 for fruit.
Show the arithmetic: Rs 40 a day is about Rs 1,200 a month, enough for roughly 170 eggs or 20 litres of milk. Written on paper, this is more convincing than a warning about junk food.
Use the label: show the child the sugar listed on a biscuit pack and let the daughter read it, which turns the lesson into a home-science activity. Follow up at the next ANM visit and praise the change rather than repeating the advice.