The book revisits the causes of persisting under nutrition in India, but moves away from the usual focus on women and children to a broader view of the entire population. It estimates the economic losses resulting from ignoring under nutrition in the adult working population and questions the current narrow focus of nutrition interventions, suggesting that a family-based approach may provide quicker results and long-term sustainability. It compares the best and worst performing states in the country to glean learnings from both successes and failures and emphasizes the need to hand over the ownership of nutrition outcomes from the state to the community and family for more sustainable results. The book is organized in three sections: Part 1 details the nutrition status of the population, regional variations in nutrition outcomes and government response in terms of interventions. Part 2 reviews issues and concerns like gender discrimination, poor child nutrition status, ineffective implementation of government programmes in the field and the possible impacts of emerging issues like climate change. Part 3 seeks solutions from both international and country experiences.

The persistence of undernutrition in the face of India’s impressive economic growth is of enormous concern. Less than 55 percent of mothers and children receive any essential health and nutrition inputs that are critical for improving maternal and child nutrition. We conducted a desk review (1) to document the extent to which national and civil society/NGO programs in India reflect current technical recommendations for nutrition and (2) assess the operational evidence base for implementing essential interventions for nutrition in the Indian context. We reviewed the design of the two major national programs, Integrated Child Development Services (ICDS) and the National Rural Health Mission (NRHM). Subsequently, we used Google Scholar to search the published literature from 2000 to 2012 for evidence of interventions addressing the inputs to improve child nutrition. Finally, we contacted 70 program stakeholders to identify the unpublished evidence on inputs in program models implemented by civil society/nongovernment organizations. We find that, by design, the two national programs (ICDS and NRHM) together appear to incorporate all the essential inputs and use evidence-based interventions. There is an expectation by design that the frontline workers of ICDS and NRHM coordinate and collaborate to deliver the interventions. A review of 22 program models shows that a majority focused on improving breastfeeding and timely initiation of complementary feeding. However, only a few addressed the full spectrum of complementary feeding, vitamin A deficiency, pediatric anemia, and severe acute malnutrition. None addressed how to reduce intestinal parasitic burdens or prevent malaria. There is limited published literature on the effectiveness of the recommended interventions to deliver the essential inputs. There are few efficacy studies and even fewer effectiveness studies or program evaluations on delivering essential nutrition interventions in the Indian context. The most commonly used delivery strategies across multiple essential inputs were home visits that involved individual or group counseling by community health workers or by self-help groups. Mass media and community events such as marriages and fairs were used as avenues to generate support for the interventions. Some programs used community mobilization to promote the interventions. Several of these programs worked to improve coordination and convergence between ICDS and NRHM and to strengthen these existing systems through training, improved monitoring, and supervision. Overall, a large gap persists in both the published and gray literature on how to promote interventions to address the essential inputs. Much more operational evidence is needed to ensure high-quality delivery of the evidence-based interventions that are already being implemented nationwide. Given the potential for the national programs to effectively deliver interventions to achieve maximum coverage and impact, and the government of India’s current interest in ICDS system strengthening, this is an opportune time to test some of the innovations using the ICDS and NRHM platforms.

Despite substantial economic growth, India has one of the highest undernutrition rates in the world; it is home to almost 40 per cent of the world’s stunted children. This volume assesses the status and causes of undernutrition in the country, and examines the effectiveness of policies designed to address undernutrition. The essays tackle wide-ranging themes and challenging issues including nutrition; water, sanitation and hygiene (WASH); maternal, neonatal and child health; Integrated Child Development Services (ICDS); Public Distribution System (PDS); crop procurement; and National Food Security Act 2013. With contributions from leading academic researchers, policymakers, as well as civil society representatives, this volume will be indispensable to scholars, teachers and students of public policy, development economics, development sociology, and Indian economy. It will also be useful to government institutions, think tanks and NGOs.

"The prevalence of child undernutrition in India is among the highest in the world, nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity and economic growth. Drawing on qualitative studies and quantitative evidence from large household surveys, this book explores the dimensions of child undernutrition in India and examines the effectiveness of the Integrated Child Development Services (ICDS)program, India's main early child development intervention, in addressing it. Although levels of undernutrition in India declined modestly during the 1990s, the reductions lagged behind those achieved by other countries with similar economic growth. Nutritional inequalities across different states and socioeconomic and demographic groups remain large. Although the ICDS program appears to be well-designed and well-placed to address the multi-dimensional causes of malnutrition in India, several problems exist that prevent it from reaching its potential. The book concludes with a discussion of a number of concrete actions that can be taken to bridge the gap between the policy intentions of ICDS and its actual implementation."

This book deals with issues related to undernutrition and anaemia in India. It establishes its interconnectedness with poverty, tribal living conditions, contraception usage, dietary diversity, and socioeconomic inequality. It addresses SDG 2, namely “end hunger, achieve food security and improved nutrition, and promote sustainable agriculture.” It puts forth the linkages between mother's economic empowerment and children's nutritional status, anaemia of women with particular reference to tribal women, and the issues associated with anaemia in India. It also delves into the relationship between contraceptive usage and anaemia level. It explores the proximate and intermediate determinants of undernutrition disaggregated at the state level in India. It elaborates the importance of ensuring food security and suggests policy measures to improve maternal and child health. The book is an asset for all researchers, academicians, clinicians and policy makers dealing with sociology, economics, public policy, social work, population study, gender issues, biostatistics, health, development, and nutrition.

Notwithstanding the sizeable economic and social gains made by India over the last two decades, the pernicious, often invisible, challenge of maternal and child undernutrition remains a national public health concern. This undermines the assumption that economic growth is in itself a sufficient condition for improvement in public health. India is home to over 40 million stunted and 17 million wasted children (under-five years) (Raykar et al., 2015). Despite a marked trend of improvement in a variety of anthropometric measures of nutrition (for example, rates of stunting, wasting in children under-five) over the last 10 years, child undernutrition rates in India persist as among the highest in the world. This inequality in access is accentuated by the stark state-level disparity in nutritional status. Malnutrition is also responsible for lowering individuals' immunity to infections and diseases; for instance, low body weight is responsible for 50 per cent of tuberculosis (TB) in India, and also leads to higher death rate (Swaminathan, 2016). Future growth will require significant investments into human resources of which health investments are critical.

This paper explores the dimensions of child undernutrition in India, and examines the effectiveness of the Integrated Child Development Services (ICDS) program in addressing it. The paper finds that although levels of undernutrition in India declined modestly during the 1990s, the reductions lagged far behind that achieved by other countries with similar economic growth rates. Nutritional inequalities across different states, socioeconomic and demographic groups are large - and, in general, are increasing. The study also finds that the ICDS program appears to be well-designed and well-placed to address the multidimensional causes of malnutrition in India. However, there are several mismatches between the program's design and its actual implementation that prevent it from reaching its potential. The paper concludes with a discussion of a number of concrete actions that can be taken to bridge the gap between the policy intentions of ICDS and its actual implementation.