Nutrition in India: Policy initiatives, investments, and outcome
India has managed to bring together a unique and compelling combination of policy efforts, investments, and on-ground impact to wage war on what has been one of its legacy challenges – child nutrition. It is an area where the Government of India, taking cognisance of the inter-linkages with human capital, economic development, and overall well-being, has made tremendous efforts. After all, today’s hungry children simply cannot be expected to be tomorrow’s achievers and demographic dividend. The Government has deployed a wide of innovative policies and interventions that address various facets of child nutrition and ensured sustained efforts.
Yet, we cannot look at nutritional programmes in India today without factoring in the historical role and impact of decades-old efforts and policy support. For example, the Government of India’s Integrated Child Development Services (ICDS) scheme that was launched in 1975 was India’s first initiative to bring together a wide range of nutrition-related services, including supplementary nutrition, immunization, and health and nutrition programmes.
Then, of course, came the Mid-Day Meal Scheme, which is world-renowned for the scale, reach, and impact it has achieved in bringing nutritious, hot and fresh meals to children. The scheme not only serves as a nutritional programme in India but has created a pathway to incentivise the trifecta of school enrolment, attendance and retention; it has, therefore, managed to simultaneously address the distinct developmental priorities of education and nutrition. In addition, the National Food Security Act (NFSA) of 2013 has established the Right to Food as a legal entitlement.
Therefore, there is a meaningful context to the nutritional programmes in India that are in motion today, especially because they offer learnings, insights, and replicable models of outreach and nutrition delivery. Their assessment also allows the scope to learn from mistakes and build upon best practices. At the same time, India has evolved considerably since these schemes and programmes were launched, and it is crucial to update them to reflect upon advances in urban modernisation and the changes that have been seen in rural India and their impact on nutrition.
For example, the POSHAN Abhiyaan (National Nutrition Mission) of 2018, which reflects the government’s prioritization of addressing child malnutrition, brings together many effective initiatives and interventions in the realm of child health and nutrition. It also includes an emphasis on nutritional outcomes for children, pregnant women, and lactating mothers, and is being implemented nationwide.
When we consider the impact of nutrition awareness and access efforts, we must also laud that there has a been significant improvement in citizen awareness. As a result, improvements have been seen in several key indicators – from stunting to According to data from the National Family Health Survey (NFHS), the prevalence of stunting under five years of age to the prevalence of underweight children.
Due emphasis must also be paid to the understanding that malnutrition, as a problem, cannot be siloed off from other developmental challenges. From lack of education to lack of dietary diversity, every factor contributes, in ways small and large, to malnutrition. Even access to sanitation and hygiene, and child health and nutrition services makes a significant difference.
In response, the Government of India has emphasised greater convergence between the efforts of various ministries. In particular, the Ministries of Women and Child Development, Health and Family Welfare, and Human Resource Development, all have a key role to play. Through a concerted effort, an enabling environment for better nutritional outcomes is swiftly emerging across the country.
Whatever success has been seen has been due to strong and visible political commitment, adequate resource allocation, and effective implementation. We must laud the governmental bodies, as well as NGOs like Bal Raksha Bharat (Save the Children), who have been implementing initiatives on the ground, taking into cognisance sociological and community factors that decide nutrition access at the household level. These have led to visible behaviour change and other benefits and are helping ensure that interventions reach the most vulnerable populations.
Bal Raksha Bharat, also known as Save the Children, is actively working to combat malnutrition in India through its Health and Nutrition Programmes. In 2022, their programmes benefited 3.43 lakh children. They collaborate with government agencies, local administration, and academic institutions such as the Indian Council for Medical Research – National Institute of Nutrition (ICMR NIN) and International Institute for Population Sciences (IIPS) to strengthen health & nutrition programmes in hard-to-reach areas. They provide technical assistance and facilitate health system strengthening with a focus on service delivery, health workforce empowerment, information dissemination, medical products, vaccination, financing, leadership, and governance. They promote community-level behaviour change to drive the adoption of healthy behaviours.
Being a multi-thematic organisation, they use integrated approaches to address the many underlying causes of malnutrition and employ evidence-based strategies to improve access to safe and nutritious food through nutrition-sensitive agriculture, water, sanitation and hygiene (WASH), social protection, education, livelihoods, and school health and nutrition interventions.