The purpose of this Policy Note is to examine the trends in undernutrition in Karnataka and to document trends and geographic variability in the major determinants of nutrition and the coverage of key nutrition and health interventions. In doing this analysis, we aim to highlight key areas for actions to improve nutrition in Karnataka.

The IFPRI 2020 Conference on “Leveraging Agriculture for Improving Nutrition and Health” was held in New Delhi, India, February 10–12, 2011, and attracted more than 900 attendees. Conference activities included 12 plenary sessions, 15 parallel sessions, 14 side events, an ongoing knowledge fair with more than 25 exhibit booths and tables, six informal discussion groups, and roughly 30 “rapid fire” presentations during coffee breaks. Assessing the impact of this Conference is a task complicated by multiple issues such as assessment coverage and impact attribution. The assessment methods used here include surveys of conferees, Internet searches, website and literature searches, and extensive personal interviews. Distinctions are drawn between short-term and medium-term impacts, and also among impacts on individuals, on institutions, and on professional discourse. Impacts on individual conferees were measured through pre- and post-Conference surveys and telephone interviews. The impacts on the substantive views of those who attended the Conference were found to be small. Most conferees (75 percent) came to Delhi already convinced that a cross-sector approach to agriculture, nutrition, and health (ANH) was appropriate. At the individual level, the Conference impacted motivation and empowerment more than beliefs. The Conference gave those who attended new information, new networking opportunities, and various “positioning advantages” that made them more effective within their own institutions back home. Such advantages were primarily important in the short term. Regarding impacts on institutions, the 2020 Conference produced important but mixed results. Direct impacts on national governments were small, in part because ministerial structures and bureaucratic routines in governments are traditionally segregated by sector, and resistant to anything more than incremental change. Direct impacts from the 2020 Conference on private companies and NGOs were also modest, but for a different reason: these institutions are inherently comfortable working across sectors, so most of the private companies and NGOs participating in the Conference felt little need to change. The strongest institutional impacts from the Conference came within a category of organizations that wanted to integrate nutrition with agriculture, but were unsure of how, or how quickly, to move forward. These institutions included the CGIAR itself as it moved to create the CGIAR Research Program on Agriculture for Nutrition and Health (CRP4); the United Nations Food and Agriculture Organization (FAO) as it responded to an internal evaluation of its own work in nutrition; and a number of donor institutions including most prominently the UK’s Department for International Development (DFID), which used the materials and policy energy generated by the 2020 Conference to help guide and push a major expansion of bilateral funding into the ANH arena. These DFID responses alone were a large enough payoff to mark the Conference a success. A third significant impact from the Conference was on professional discourse. The 2020 Conference helped change the conversation about agriculture and food security by boosting the frequency of reference to cross-sector impacts on both nutrition and health. Impact measurement becomes difficult here, because the Conference was not the only initiative highlighting cross-sector linkages underway. Nonetheless, the average number of Google Internet hits per search for the phrase “linking agriculture, nutrition, and health” increased from 9,288 in the pre-Conference period to 13,508 in the immediate post-Conference period of March–May 2011. Searches of organization websites revealed that 18 of 21 of the sites had more links to agriculture, nutrition, and health issues immediately following the Conference compared to just before, and 20 of 21 had an even higher number of such links one year later in July 2012. The most obvious limitation on impact has been at the level of national government policy (excluding donor policies). Partly this reflects attendance. Only 19 percent of those who attended the 2020 Conference were government officials, compared to 41 percent who came from research institutes or universities. Yet, even where Conference impacts on governments might have seemed probable, they have proved (so far) to be mostly tentative or modest. The government of Malawi co-hosted its own version of the 2020 Conference in Lilongwe in September 2011. While this was an important step, the Conference was donor-suggested and donor-funded, and senior officials from the Ministry of Health were unable to attend.In Uganda, the 2020 Conference helped sustain an effort to mainstream nutrition within the Ministry of Agriculture. However, this effort was underway before the Conference, and parallel efforts from USAID, WFP, and FAO did as much to sustain it.In China, the leadership of the State Food and Nutrition Consultation Committee was briefed on 2020 Conference materials, which may have helped to establish a new (but already approved) food safety and nutrition development institute at the Chinese Academy of Agricultural Sciences (CAAS). Since Chinese leaders had been unable to attend the Conference itself, impacts in the country also depended heavily on a separate outreach effort by IFPRI leadership.In India, national officials and researchers—and IFPRI—made concerted efforts to use the Conference to shape language in the new 12th Five-Year Plan (2012–16). While some engaged in this effort claimed progress in that direction, nothing definitive has emerged and in India it appears that little has changed in the traditional separation between the agriculture ministry and the nutrition and health sectors. The Conference’s largest impacts within India were felt at the individual level, at the level of discourse, or within some state administrations, not within national governmental institutions. What can one reasonably expect when looking for impacts from a single international Conference? In the case of the 2020 Conference in Delhi, where the goal was to change the way individuals and institutions were thinking about ANH issues and considering them in professional discourse, measurable progress was made toward each of these goals in both the short term and the medium term. IFPRI took a risk by designing the Delhi Conference to challenge traditional paradigms. This assessment shows that, in both the short term and medium term, the risk has been rewarded.

A notable approach to addressing maternal undernutrition during pregnancy in India in recent years has been the integration of hot-cooked meals (HCM) for pregnant and lactating women together with the provision of other health/nutrition services. Called the One Full Meal (OFM) program, these efforts aim to improve maternal nutrition and health across India by bundling center-based HCM with other nutrition services and behavior change communication implemented through the Integrated Child Development Services (ICDS) scheme. The program is offered at anganwadi centers (AWCs) and has been implemented in eight states in India, including Andhra Pradesh, Chhattisgarh, Gujarat, Karnataka, Maharashtra, Telangana, Madhya Pradesh, and Uttar Pradesh. Although the OFM program has been implemented since 2013, there is limited consolidated insight on its effectiveness or on broader lessons for implementation. The objectives of this evidence review of the OFM program are, therefore, to (1) compare the different state OFM program models on their objectives, implementation elements, cost norms and monitoring mechanisms; (2) develop program impact pathways on the potential ways in which the program could influence intended outcomes; and (3) examine the availability of evidence underpinning the program’s intended pathways to impact.

Agriculture's vast potential to improve nutrition is just beginning to be tapped. New ideas, research, and initiatives developed over the past decade have created an opportunity for reimagining and redesigning agricultural and food systems for the benefit of nutrition. To support this transformation, the book reviews the latest findings, results from on-the-ground programs and interventions, and recent policy experiences from countries around the world that are bringing the agriculture and nutrition sectors closer together. Drawing on IFPRI's own work and that of the growing agriculture-nutrition community, this book strengthens the evidence base for, and expands our vision of, how agriculture can contribute to nutrition. Chapters cover an array of issues that link agriculture and nutrition, including food value chains, nutrition-sensitive programs and policies, government policies, and private sector investments. By highlighting both achievements and setbacks, Agriculture for Improved Nutrition seeks to inspire those who want to scale up successes that can transform food systems and improve the nutrition of billions of people.

Improving Water and Nutrient Use Efficiency in Food Production Systems provides professionals, students, and policy makers with an in-depth view of various aspects of water and nutrient us in crop production. The book covers topics related to global economic, political, and social issues related to food production and distribution, describes various strategies and mechanisms that increase water and nutrient use efficiency, and review te curren situation and potential improvements in major food-producing systems on each continent. The book also deals with problems experienced by developed countries separtaely from problems facing developing countries. Improving Water and Nutrient Use Efficiency emphasizes judicious water and nutrient management which is aimed at maximising water and nutrient utilisation in the agricultural landscape, and minimising undesirable nutrient losses to the environment.

This open access book examines the interactions between India’s economic development, agricultural production, and nutrition through the lens of a “Food Systems Approach (FSA).” The Indian growth story is a paradoxical one. Despite economic progress over the past two decades, regional inequality, food insecurity and malnutrition problems persist. Simultaneously, recent trends in obesity along with micro-nutrient deficiency portend to a future public health crisis. This book explores various challenges and opportunities to achieve a nutrition-secure future through diversified production systems, improved health and hygiene environment and greater individual capability to access a balanced diet contributing to an increase in overall productivity. The authors bring together the latest data and scientific evidence from the country to map out the current state of food systems and nutrition outcomes. They place India within the context of other developing country experiences and highlight India’s status as an outlier in terms of the persistence of high levels of stunting while following global trends in obesity. This book discusses the policy and institutional interventions needed for promoting a nutrition-sensitive food system and the multi-sectoral strategies needed for simultaneously addressing the triple burden of malnutrition in India.

This paper attempts a disaggregated analysis of existing data sets pertaining to nutrition in India and identifies the priority geographical areas, social and age groups for possible nutrition interventions. Also analyzed is the effectiveness of public responses to the nutrition problem as reflected in distribution of expenditures, and the impact of direct and indirect nutrition intervention. The outstanding nutritional issues are also discussed. Overall, the paper argues the need for striking a proper balance between needs, potential demand and available resources.