Human Development

Nutritional penalty of motherhood: Can midday meals for children also improve their mothers’ health outcomes?

  • Blog Post Date 26 May, 2023
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Nikita Sharma

Economics Editor, IGC

Midday meals provide a nutritional safety net for children and improve their learning outcomes and attendance. Nikita Sharma argues  that spillover benefits might also exist for mothers of the children who receive them. She highlights research findings which indicate that, in addition to addressing malnutrition among children, midday meals also ensure that mothers do not need to forgo their own consumption to feed their children in times of scarcity.

A mother and her child’s health are closely interlinked. Children are most dependent on their mothers for their nutritional needs, both as babies born to them and as children primarily cared for by them. In India, a mother’s height and educational attainment are strongly related to her children’s stunting levels (Kim et al. 2017). Yet, in the familial dynamics of Indian households, sociocultural expectations, conditionings, or norms push mothers to forgo their own consumption to help smoothen the effects of an economic shock. This was acutely heightened during the Covid-19 pandemic and the ensuant food insecurity (Kapoor 2022). 

The most recent National Family Health Survey (2019-2021) revealed that the incidence of anaemia among women aged 15-49 years increased to 57%, from 53.1% since the last survey (2015-16). As expected, this came in tandem with a rise in the prevalence of anaemia among children up to five years of age from 58.6% to 67.1%. Per this survey, 35.5% children under the age of five are stunted, 19.3% wasted, and 32.1% underweight.1 In May 2022, UNICEF alerted the fact that India has the most malnourished children in the world - 5,772,472 children under the age of five in India are severely wasted.

In 1995, following the rollout in select states, the midday meal scheme (now renamed as PM-Poshan) was officially launched in India. By 2001, a Supreme Court mandate had made it compulsory for government and government-aided schools to provide all children with a free cooked meal comprising at least 450 calories (kcal) and 12 grams of protein. An estimated 118 million children come under the ambit of this programme, which is the largest school feeding programme in the world. While this policy was chiefly geared towards addressing children’s malnutrition, decades of research have uncovered a multitude of spillover benefits.

School meals as a policy solution to address child nutrition

Research has shown a 49% increase in the daily nutritional intake of programme participants and reductions in children’s protein, calorie, and iron deficiency (Afridi 2010). When double-fortified salt was used in preparing the midday meals, it decreased anaemia among children (Krämer et al. 2018). There is evidence of catch-up growth and compensation for the malnourishment of a child’s early years (Singh et al. 2014), and increases in school attendance, especially among girls – overtime they improve math and reading learning outcomes (Afridi 2009, Chakraborty and Jayaraman 2019). From a policy perspective, midday meals not only provide a safety net to children by safeguarding their health and education, but also provide employment to women from underprivileged backgrounds and promote social cohesion by having communal eating at its heart (Singh et al. 2014). These benefits can be instrumental in bringing about lasting change, not just in the child’s life as they grow into adulthood, but also in the wider community.

Benefits passed down and spilt over to mothers

A recent study has even uncovered intergenerational benefits of the midday meal scheme – mothers who benefitted from the nutritional support of the midday meal scheme gave birth to children with greater height-for-age z-scores(Chakrabarti et al. 2021). They found that states which had greater coverage of the midday meal scheme in 2005 had fewer children who were stunted (up to five years of age) in 2016. The carry-over benefits of a mother’s exposure to the midday meal scheme as a child were stronger for families from lower socioeconomic backgrounds. Additionally, the researchers credited the midday meal scheme for a 13-32% gain in the average height-for-age z-score in India between 2006 and 2016. 

Another benefit of midday meals is revealed through its absence. By virtue of how a family operates amidst food shortages and financial constraints, and mothers being left with little choice but to be the primary caregivers of their children (and other dependent members of the household), there exists a nutritional penalty of motherhood. In times of scarcity, mothers, regardless of their health status or nutritional need, are likely to be the first to give up consumption. Therefore, by providing children with food, the state might be ensuring that more food is left at home for the mothers. While no known study on India’s midday meals investigates this, it has been studied in the context of the American Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The researchers find that when children cease to be eligible for the benefits of WIC, their nutritional intake doesn’t change, but instead is buffered by their mothers who consume less as a result (Bitler et al. 2022). They compare their result for symmetry with the evaluation of another programme that granted eligible families with children in the United States a $60 voucher to buy groceries. As expected, the voucher led to a reduction in the adult food insecurity by 18.5% (Bitler et al. 2022). The spillover benefits and gains of such food assistance programmes, therefore, extend to other members of the family, and might be saving mothers from falling into a nutritional decline.

Household implications of providing midday meals

The enrolment of children in government schools has been increasing, yet this hasn’t been met with a commensurate rise in budget allocation for the midday meals. Despite plentiful research evidence on the many spillover benefits and need for the provision of midday meals in schools, the government slashed the budget for midday meals from Rs. 128 billion in FY2022-23 to Rs. 116 billion in FY2023-24. Rising prices will further render this allocation insufficient. This raises obvious quantity and quality trade-offs for the schools providing midday meals at a time when the country cannot afford to have any child go hungry or be fed poorly.

However, as schools navigate these challenges, its consequences will reverberate to the homes of the children. Parents who are still recovering from the onslaught of the pandemic will have to fill this gap and provide more for their children, likely from their own plates. Mothers will be first to shield the impact of food insecurity for their children. As the caloric and nutritional intake of mothers deplete, incidence of anaemia and other deficiencies will rise, invariably passing on to their to-be-born children, and the cycle will repeat, entrapping the country in poor health and nutrition. 

This article first appeared on the IGC blog.


  1. Malnutrition among children can result in low weight-for-height (wasting), low height-for-age (stunting) and low weight-for-age (underweight).
  2. The z-score expresses the anthropometric values such as height or weight as a number of standard deviations below or above median value of the reference population. (Standard deviation is a measure that is used to quantify the amount of variation or dispersion of a set of values from the average of that set). 

Further Reading

  • Afridi, Farzana (2009), “The Impact of School Meals on School Participation: Evidence from Rural India”, The Journal of Development Studies, 47(11): 1636-1656.
  • Afridi, Farzana (2010), “Child welfare programs and child nutrition: Evidence from a mandated school meal program in India”, Journal of Development Economics, 92(2): 152-165.
  • Bitler, M, J Currie, HW Hoynes, KJ Ruffini, L Schulkind and B Willage (2022), ‘Mothers as Insurance: Family Spillovers in WIC’, NBER Working Paper 30112.
  • Chakrabarti, Suman, Samuel P Scott, Harold Alderman, Purnima Menon and Daniel O Gilligan (2021), “Intergenerational nutrition benefits of India’s national school feeding program”, Nature Communications, 12: 4248. This paper has been abridged for Ideas for India here.
  • Chakraborty, Tanika and Rajshri Jayaraman (2019), “School feeding and learning achievement: Evidence from India’s midday meal program”, Journal of Development Economics, 139: 249-265.
  • Kapoor, C (2022), ‘How deepening Covid-19 distress has left Indian women malnourished’,, 22 November.
  • Kim, Rockli, IvánMejía-Guevara, Daniel J CorsiVíctor M Aguayo and SV Subramanian (2017), “Relative importance of 13 correlates of child stunting in South Asia: Insights from nationally representative data from Afghanistan, Bangladesh, India, Nepal, and Pakistan”, Social Science & Medicine, 187: 144-154.
  • Krämer, M, S Kumar and S Vollmer (2018), ‘Improving Children Health and Cognition: Evidence from School-Based Nutrition Intervention in India’, Discussion Papers No. 247, Georg-August-Universität Göttingen, Courant Research Centre - Poverty, Equity and Growth.
  • Singh, Abhijeet, Albert Park and Stefan Dercon (2014), “School Meals as a Safety Net: An Evaluation of the Midday Meal Scheme in India”, Economic Development and Cultural Change, 62(2): 275-306. A version of this paper is available here.
  • UNICEF (2022), ‘Severe wasting: An overlooked child survival emergency’, UNICEF Child Alert Report.

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