the mass of the people in
the State.
BOX 3.7
Iodisation of Salt
The availability of iodised salt to 90 per cent of households at an iodine level of 15 ppm (parts per million) or more is an indicator of success of the National Iodine Deficiency Disease Control Programme in the State. In Tripura, the NFHS-2 found that 70 per cent of households consumed salt with more than 15 ppm of iodine (see Table below). The village surveys found that all households consumed some iodised salt. While the overall availability of iodised salt is satisfactory, in the tribal village, 12 per cent of households consumed salt with lower iodine content than the recommended level of 15 ppm. This may be on account of a loss of iodine content due to poor storage and transport conditions, and calls for better distribution and management strategies. National data indicate that the use of adequately iodised salt improves with the standard of living. In Tripura, even among households in the low living standard category, only 10 per cent consumed non-iodised salt. The corresponding figure at the national level was 30 per cent.
Availability of iodised salt by iodine level, Tripura and village surveys (% households consuming)
State/Country/Area 0 ppm 7 ppm 15 ppm 30 ppm
Tripura 1998-99 (NFHS) 7.6 22.5 31.0 38.8
India 1998-99 (NFHS) 28.4 21.6 16.8 32.6
Non Tribal village 2005 0.0 2.9 5.9 91.2
Tribal village, 2005 0.0 12.2 12.2 75.6
In Tripura, fair price shops are used regularly to purchase rice. The quantity of rice purchased per person was 41 kg in West District, 50 kg in South District and 62 kg in North District and Dhalai, in 2005 (Table 3.19). The average purchase conceals differences across households. Pur- chases by BPL-card households were almost the same across all districts, and totalled more than 80 kg per per- son per year. This level of utilization is comparable to that of Kerala, the State with the best public distribution system prior to targeting.12 Purchases from the PDS thus contributed more than 60 per cent of the cereal require- ments of each individual in a BPL- card household.13
Even APL-card households pur- chased significant quantities from the ration shops, particularly in North District and Dhalai, indicating the dependence of all households on the PDS for purchase of food grain. The rise in prices of grain for APL house- holds (part of the policy of Targeted PDS) would have adversely affected access to food grain to such house- holds in these districts. Any weaken- ing of the public distribution system, be it through exclusion of households or through rise in prices, must be checked. In this context, the new guidelines from the Central Govern- ment on the number of households eligible for BPL cards must be exam- ined cautiously.
Our village surveys underline the role played by the public distribution system in ensuring basic food security. The PDS continues to be import- ant in Tripura as it is not a cereals- surplus State. Moreover, the State is isolated and dependent on supplies of grain from other parts of the coun- try, and many areas are particularly vulnerable during the monsoon
months when the transport of grain is not assured. Tripura must be given the support necessary to strengthen the public distribution system and prevent narrow targeting. Further, from a nutritional point of view, pul- ses and cooking oil need to be intro- duced as additional items in the pub- lic distribution system.
Other nutrition interventions
In addition to the PDS, the State has introduced and rapidly expanded the Midday Meal Scheme over the last five years. By March 2006, the school meal programme covered 97 per cent of all schools and 65 per cent of all children enrolled in schools. The
TABLE 3.18
Number and type of ration cards, Tripura, by district, 2005
Ration cards Number Cards Rationing of ration per population Total % APL % BPL % AAY shops shop per shop West District 347,966 68.3 24.4 7.3 684 478 2241
Dhalai 72,589 40.2 46.1 13.7 152 544 2025
North District 126,127 58.1 32.3 9.6 232 473 2547 South District 178,763 50.5 38.1 11.4 378 502 2030 Tripura 725,445 59.3 31.3 9.4 1446 509 2212 Notes: APL is above poverty line, BPL is below poverty line and AAY is Antyodaya
Anna Yojana card.
TABLE 3.19
Offtake of rice per person from the PDS, Tripura, by district, 2005 (in kg) Average offtake of rice Average offtake of rice
per person per card
APL BPL AAY All cards APL BPL AAY All cards North District 46.6 82.3 74.6 62.0 349.4 809.5 572.8 510.3 Dhalai 32.5 86.1 58.0 62.4 360.9 599.5 420.5 506.1 West District 19.5 88.9 63.7 41.3 107.4 469.7 327.2 223.5 South District 9.7 86.0 70.7 50.1 38.3 439.1 312.9 222.1 Notes: APL is above poverty line, BPL is below poverty line and AAY is Antyodaya
Anna Yojana card.
BOX 3.8
Public Distribution System
The village data confirm that there is good coverage of the public distribution system (PDS) in Tripura. The distribution of ration cards was near-universal in West Muhuripur (97 per cent of households) and Mainama (98 per cent of households). In Khakchang, the newly settled forest village, 15 per cent of households had applied for a transfer or a new card and were awaiting the new ration card.
Turning to the type of card, in Khakchang, in many ways the poorest village, 73 per cent of households had either a BPL (below-poverty-line) card or AAY (Antyodaya Anna Yojana) card (see Table 1 below). In Mainama, which is a tribal-majority village, 55 per cent of households had BPL cards and another 10 per cent had AAY cards. West Muhuripur is a multi-caste village with no tribal population; here 42 per cent of ration cards were classified as BPL and another 5 per cent as AAY cards.
The pattern of utilization of the PDS is very closely tied to the type of ration card held by a family (Table 2). A very high proportion of BPL and AAY card-holders purchased rice regularly from the fair-price shops. These households also turned to the fair-price shop regularly for other items including sugar, kerosene and salt. Among BPL card- holders, the few who did not purchase from the fair-price shop regularly reported ‘poverty’ or lack of purchasing power as the main reason for not doing so.
The pattern of purchase was different among those with APL cards: these households purchased sugar and kerosene more frequently than rice from ration shops (not surprising, since the price of rice is close to the market price for APL households). Unlike other parts of India where APL card-holders have almost fully withdrawn from the use of fair price shops for cereal purchase, in all three survey villages, APL card-holders did utilize the fair price shop for rice purchases. In Khakchang, 32 per cent of APL card-holders purchased rice from the ration shop. In a remote location such as Khakchang village, the ration shop is the most accessible location for purchasing basic necessities. It is important to ensure that all households in such remote locations are provided with BPL ration cards.
Table 2
Percentage of card-holders by items purchased and type of card
Type of card Mainama Khakchang West Muhuripur
Kerosene Rice Sugar Salt Others Kerosene Rice Sugar Salt Others Kerosene Rice Sugar Salt Others APL 61.2 10.2 61.2 16.3 16.3 78.9 31.6 26.3 10.5 0.0 76.9 23.1 78.8 23.1 13.5 BPL 68.0 87.0 55.0 20.0 14.0 79.2 87.5 43.8 18.8 2.1 83.3 83.3 81.0 28.6 9.5 Antyodaya 89.5 94.7 78.9 26.3 10.5 87.5 87.5 56.3 31.3 12.5 100.0 100.0 80.0 20.0 20.0 All 68.2 65.3 58.8 19.4 14.1 62.4 56.5 30.6 12.9 1.2 80.8 52.5 79.8 25.3 12.1 Source: Foundation for Agrarian Studies (2006).
Table 1
Number and percentage of households possessing ration card by type of card Mainama Khakchang West Muhuripur Type of card Number Per cent Number Per cent Number Per cent
APL 47 28.3 17 20.7 52 52.5 BPL 96 57.8 45 54.9 42 42.4 Antyodaya 17 10.2 15 18.3 5 5.1 APL and BPL 2 1.2 2 2.4 BPL and Antyodaya 2 1.2 1 1.2 Unspecified 2 1.2 2 2.4 Total 166 100.0 82 100.0 99 100.0
annual utilization of food grain for the Scheme was over 91,000 quintals (or 17.5 kg per child).
The Integrated Child Development Services (ICDS) scheme has been in place since 1975. In March 2006, there were 3,902 Anganwadi centres in the State, covering all forty blocks and all urban areas. In April 2006, the Government announced a pro- gramme of universalization of ICDS with the aim of reaching every child and every nursing or pregnant mother. Consequently, there was massive expansion; with the opening of 2,220 new centres, in 2007, the State had 6,122 operational Angan- wadi centres. The ICDS provides many services, including immuni- zation, health check-ups, nutrition education, and supplementary nutri- tion to pregnant women, mothers and malnourished children. In 2006– 07, supplementary nutrition was provided to 2,33,427 children in the age group 6 months to 6 years – 76 per cent of total coverage – and 38,545 women.
3.4 Housing, Sanitation and Drinking Water
Housing
Housing is of central importance to the quality of life. Living in proper shelters minimizes disease and injury,
and contributes to physical, mental and social well-being. In addition to providing basic shelter, housing and the home environment provide pro- tection against health hazards arising from the physical and social environ- ment. Lack of access to piped water or an alternative nearby source of safe water, and lack of sanitary facilities are often considered key indicators of unhealthy housing, leading to high disease burdens in both rural and urban areas. Factors such as poor indoor air quality, inadequate solid waste disposal facilities, poor food storage, overcrowding, poor ventila- tion, insufficient lighting, inappro- priate construction material, building defects and pests, all influence the health of rural communities.
In Tripura, a large proportion of all families (85 per cent) reside in kachha or temporary houses. Only 8 per cent of families have pucca or per- manent houses, and 6 per cent have kachha roofs with a pucca super- structure (Table 3.20). While the housing data indicate that housing conditions are poorer in Tripura than the national average (where 32.5 per cent of families live in kachha houses), the predominance of temp- orary structures in Tripura is partly explained by the traditional use of bamboo and cane in house construc-