Indian schoolchildren at Jahangirpura Shala Number 2 eat their midday meal. (Sam Panthaky/AFP/Getty Images)

India's cooked midday meal (CMDM) program is the largest school lunch program in the world and a vaunted achievement of the Indian state. Its roots go back to a 1925 meal program in the city of Chennai, then known as Madras. It was launched more widely in the 1960s, expanded in the 1980s and '90s and, in 2001, established nationwide by a Supreme Court ruling that a midday meal was the right of all Indian schoolchildren. A recent United Nations report found that it had reduced child hunger and increased school enrollment, particularly among less privileged social classes. The program serves kids at 600,000 schools and delivers 2.5 million metric tons of grain every year.

But India's school lunch program is being viewed more critically this week, after meals tainted by pesticides killed 23 students and sickened many others at a school in Bihar state. This was not the first such incident – there were reports of three others just this week – but it is the most severe. In the backlash, some are pointing to a 2010 Indian government report on the program that, while generally positive, identified serious issues in the CMDM program, particularly with regards to hygiene and food quality.

The 2010 Planning Commission report on the CMDM program, commissioned by the Indian government, praised the program for curbing hunger but warned that food quality and food preparation conditions remained problematic in some areas – especially Bihar, where the 23 students died this week.

The investigation found a "large proportion of children" in Bihar reported that the food was "of bad quality." A troubling 72 percent of Bihar children said the food was "poor quality" – by far the worst score out of 17 regions surveyed, the second-worst of which had only 14 percent saying the food was poor quality. Most districts reported about 1 percent. Similarly, 78 percent of Bihar children said they were not satisfied with the meals, also the highest proportion in India. Almost as many parents in Bihar, 69 percent, said the meals were poor quality.

There is no reason to believe that children or parents in Bihar, one of India's poorest regions, would have unusually high standards. Nor, though, is it necessarily clear that meal quality is a direct function of wealth; two surveyed regions where families are much poorer than those in Bihar, Andhra Pradesh and Arunachal Pradesh, both reported significantly higher scores for food quality and meal satisfaction.

Schools in Bihar, as in a number of other regions, often lack proper cooking facilities, according to the report, which warned that this can lead to food safety and hygiene problems. In many cases, it explains, "cooking was done outside the kitchen under the shade of trees due to improper condition of [cooking] sheds, making it difficult for the organiser to enforce safety and hygiene in cooking." The report continues:

Adequate and appropriate infrastructure is crucial to ensure hygiene. Most of the sample schools in all the surveyed states reported inadequate infrastructure like lack of kitchen sheds, absence of separate space for cooking and serving meals, no storage facilities and no clean source of water. Even where kitchens were available, they were not in good condition and had poor ventilation. In many sample schools, cooking was done in open space or under shade of trees.

Fewer than half of Bihar schools have proper kitchens or cooking sheds, according to the report: 42 percent. Of those, fully 50 percent are described as "poor" quality and only 72 percent are even described as "functional." Still, this problem is far from exclusive to Bihar; most surveyed regions were even less likely to have proper cooking facilities. In Arunachal Pradesh and Himachal Pradesh, for example, only 12 percent and 5 percent of schools have kitchens, respectively. In Punjab, zero surveyed schools had kitchens.

Only half of Bihar schools have food storerooms – as with the lack kitchens, a problem that appears rampant across Indian schools – and 16 percent of them are described as "poor" quality. The report explains that this can contribute to food hygiene problems: "Lack of proper planning and absence of proper coordination between Bihar State Food Corporation and district level officers has resulted in erratic supply of funds and foodgrain," it explains. "Schools generally do not receive [their] quota of foodgrain in a planned manner on a monthly basis, as a result of which a few schools were overstocked resulting in breeding of insects." While it's not clear precisely how the food in this week's incident was tainted, insecticide appears to have been involved.

Alarmingly, the report notes that in some schools in Bihar, lacking proper water for cooking, meals were prepared "using water from ponds." But a lack of proper drinking water, which as the report notes may lead to health problems, is a problem in many surveyed regions.

Bihar's school lunch program was the most rapidly growing in India from 2000 to 2006, adding several thousand children every year. It was also, by the time this survey was released in 2010, the least likely to serve each child an adequately size meal: 22 percent of the program's beneficiaries said they were not getting enough food. It's not clear whether these strains on the program in Bihar exacerbated the health issues there or merely coincided with them. But it's clear from the Indian government report that, despite the program's broader successes in feeding hundreds of thousands of children, many of whom might have otherwise gone hungry, feeding them in a way that is hygienic and safe remains a challenge – one not exclusive to Bihar state.