A woman cries after her grandson died after consuming meals at a school in eastern India.

The children, aged between 8 and 12, fell sick Tuesday after eating lunch at an elementary school in Gandaman, a village about 65 miles from Patna, the capital of Bihar, one of India’s poorest states.

The meal of rice, soybean and potato curry was provided under the central government’s “midday-meal” program, which aims to ensure children at government schools get at least one free cooked meal a day. India has more food-insecure people than any other country in the world.

“The oil used to cook the vegetables was foul-smelling. We suspect the poisoning was caused by insecticides such as organic phosphorous,” Amarjeet Sinha, Bihar’s education secretary, said Wednesday.

Shortly after eating lunch at around 12:30 p.m., several children started vomiting and some fainted, an official at Mr. Sinha’s office said.

A student getting her government-provided midday meal at a school on the outskirts of Jammu in February.

The headmistress of the school fled afterwards, according to Sujeet Kumar, district superintendent of police. “The food was stored in the house of the headmistress,” he said. “She has been missing since the deaths were reported. But this doesn’t establish her involvement in the tragedy.”

Police are searching for the headmistress, who Mr. Kumar named as Meena Kumari.

The children were initially taken to Sadar hospital in the nearby town of Chapra and later transferred to Patna Medical College and Hospital, added Chapra District Magistrate Abhijeet Sinha.

“The doctors tried their best to save them,” he said.

Bihar Chief Minister Nitish Kumar called an emergency meeting Wednesday and sent a team of forensic experts to the school to take samples of the contaminated food and assist local officials in an investigation.

P.K. Shahi, education minister in Bihar, said it was still unclear whether the poisoning was accidental. A female cook who consumed the food is in the hospital and her child was among the dead, said M.A. Khan, the head of Mashrak police station, which is investigating. Mashrak is roughly six miles from the school.

Doctors in Patna fear the death toll could rise, as many children are critically ill. Amarkant Jha Azad, medical superintendent at the Patna Medical College and Hospital, confirmed that food poisoning was to blame.

The Bihar government said Wednesday it would provide compensation of 200,000 rupees ($3,390) to families that lost children.

Under the midday-meal program, the central government each year distributes about 2.5 million metric tons of grain to about 600,000 schools, and provides grants for other ingredients such as vegetables and edible oil, as well as for equipment and staff.

But transport and storage is a problem, particularly in impoverished states like Bihar, so the food quality is often poor.

Because the government guarantees to purchase staples like wheat and rice from farmers, its warehouses are overflowing with far more grain than is needed to supply programs such as midday meals. As a result it’s often held in ramshackle storage conditions for up to three years.

“When food grain is stored for more than two years, the quality becomes a problem,” said N.C. Saxena, who was appointed by the Supreme Court in 2001 to oversee the midday meal program.

Despite the abundance, many states still struggle to provide meals under the program, said Mr. Saxena, who’s also a member of a national council that advises the prime minister on legislation. Only about half of Bihar’s government schools are able to provide free meals, he said.

“The system to collect food grains and deliver food grains from Food Corporation of India warehouses requires transport,” he said. “All that arrangement has not been made by many state governments.”

Cases of children being made sick by the food do happen, he said, though “they are by and large isolated.” It happened on June 27 to 23 schoolchildren in Goa, and earlier in the month to at least 15 in the central state of Madhya Pradesh—where local media reported that a lizard was found in one of the containers from which the meal was served.

“I am not saying the quality is very good,” Mr. Saxena added. “That is a concern, but when we cook the food, most bacteria and germs die.”

Srini Swaminathan, a former teacher at a school in Mumbai, said children he taught often refused the free lunch.

“They would say the food had lizards, bugs or cockroaches in it,” the 33-year-old said. “Day after day, they would eat junk instead of having proper food which nourishes their brain.”

“Even if you’re poor, you want dignity in the food you eat,” he added.

India is in the process of introducing one of the most ambitious food-aid programs ever attempted, with the aim of distributing cheap grain to about 70% of the country’s 1.2 billion people. The National Food Security Law is likely to be approved when Parliament reconvenes next month.

Critics say the legislation, which is expected to swell the annual food-subsidy bill to around $20 billion, is an attempt by the ruling Congress party to attract support ahead of next year’s national election, and that the money would be better spent on improving agricultural infrastructure.

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