A Newly Introduced Millet-based Take Home Ration: Utilization, Strength & Challenges in Ahmedabad Municipal Corporation, Gujarat

Abstract

Introduction: The Government of India is promoting millet-based nutrition through Integrated Child Development Services (ICDS) and POSHAN Abhiyaan. In December 2023, two ICDS blocks of Ahmedabad Municipal Corporation (AMC) implemented a pilot project to provide a millet-based Take Home Ration (THR). Objectives: To evaluate the utilization and barriers in utilization of a millet-based Take Home Ration compared to the standard Take Home Ration among beneficiaries and to identify strength and challenges in effective implementation of millet-based Take Home Ration. Methods: A cross-sectional analytical study was conducted across 60 Anganwadi Centres (AWCs), with 30 each from millet-based THR and standard THR blocks. Using WHO cluster sampling and Probability Proportional to Size methodology, a total of 1,627 beneficiaries were surveyed—comprising children aged 6 months to 3 years (n₁=1178), pregnant women (n₂=220), and lactating mothers (n₃=229). Data were collected in April 2024, four months post-implementation, using a structured, pilot-tested questionnaire. Results: Utilization of millet-based THR was lower (n=749, 92%) compared to standard THR (n=773, 95%), with a significant gap among children (91.8% vs. 95.9%, p=0.003). However, the frequency of consumption per week (3.4±2.05 vs. 2.3±1.33 times, p<0.001) and monthly packet usage (5.05±1.9 vs. 4.5±2 packet, p<0.001) were significantly higher in the millet-based group. Barriers to utilization included disliking the taste (53%) and appearance (47%). Awareness of the change in THR composition was limited (53%), and recipe demonstrations were not conducted. Conclusion: Millet-based THR was well tolerated with no adverse effects. However, effective implementation requires improved taste, community sensitization and training of Anganwadi workers.