A market solution to child malnutrition problem?

Poor households in big city slums invariably live in unbelievably cramped single room accommodation, with access to limited civic amenities like water supply and sanitation. Furthermore, both parents generally have to work to earn atleast food for the family.

In the circumstances - strapped for time, space, and resources - women make do with cooking simple, but unhealthy, carbohydrate heavy meals (say, rice/roti and curry), which are filling and keeps away hunger. The women do this despite being aware of the importance of nutritious food and what constitutes such foods. The higher cost of nutrient-rich foods is just another reason for this, though this is debatable.

Policy makers have long debated various strategies to improve the nutrition status of atleast the children living in slums. The Anganwadi centers are among the most visible of such interventions, and have had considerable successes in some areas. However, the overall nutrition of the family remains elusive. The large numbers of small eateries - women squatting on street margins, push carts, road encroachment stalls etc - in slums too provide much the same carbohydrate and fat heavy foods.

Faced with similar circumstances in the over-crowded slums of Jakarta, an NGO Mercy Corps started a healthy street food business for children called Kedai Balitaku, or My Child’s Café in April 2009. It started with a $120,000 donation, has since spun off into a for-profit company. The idea was that once people have access to healthy foods at very cheap prices (same as those of the unhealthy foods available elsewhere), they will prefer such foods over their traditional ones, atleast once a day. Creating a buzz around such foods, by careful marketing helps. An article by Tina Rosenberg in the Times describes KeBal,

"KeBal sells niche street food. Its clientele is children — and it focuses on those 5 years old and younger. The most popular meal is a chicken, rice and vegetable porridge, which costs the going rate of 20 cents. The leading snack is a 10 cent gelatin pop. Such pops are a common snack but they are almost always made with artificial fruit flavors; KeBal’s are made with real mango, strawberry, melon or other fruits. The menu also includes meatballs, macaroni and cheese and shu mai dumplings. The carts use food-grade materials and vendors get regular health inspections from KeBal’s management.

Nutritionists designed the menu, but just as important as what went into the food was convincing mothers to buy it and children to eat it. The advertising firm Saatchi & Saatchi donated the design of the visual brand and a marketing strategy aimed at children. The carts have bright colors and play music. Four dolls on the cart represent different food groups and are named for benefits of good nutrition — Strong, Smart, Lively and Taller. The cart also has built-in toys teaching shapes or colors that kids can play with while they wait. They display hand-washing messages and have jugs of water with soap so vendors can wash dishes and children can wash before they eat. The food is displayed at a child’s eye level. The Times column writes,

The food is prepared by KeBal employees in a cooking center, which starts work just after midnight to make food to sell to eight vendors, who begin their routes around 5 AM. The vendors take the risks and keep all the profit on the food they sell. KeBal is about to open a second cooking center, and is planning to have six by the end of the year, each providing food to at least eight vendors. Next year, as soon as Indonesian franchise law allows, KeBal will also start selling cooking center franchises. By 2013, the company hopes to own 21 cooking centers and have 10 more owned by franchisees. That will allow it to feed 6,000 children daily and take in projected revenue of at least $2 million a year."

An approach that mirrors KeBal, catalyzed with initial government or some non-government foundation support, and initiated in different cities across the country, has the potential to be a major intervention to improve nutrition levels in countries like India. The menus will have to be customized to meet local food requirements and locally available healthy foodstuffs.