Children in India are more likely to be malnourished than in many other countries. Approximately 60 million children are underweight in India. Malnutrition decreases educational achievement, labor productivity, and economic growth, especially among the poor and the vulnerable, where malnutrition is highest. The progress in reducing the proportion of undernourished children in India over the past decade has been modest and slower than what has been achieved in other countries. The picture is further exacerbated by significant inequalities across states and socioeconomic groups - girls, rural areas, the poorest and scheduled tribes and castes are the worst affected - and these inequalities appear to be increasing.
India's primary policy response to child malnutrition, the Integrated Child Development Scheme (ICDS) is well-conceived and well-placed to address the major causes of child under-nutrition in India. However, it has not yet succeeded in making a significant dent in child malnutrition. This is mostly due to the priority that the program has placed on food supplementation rather than on nutrition and health education, and because of the fact that the program targets children mostly after the age of three when malnutrition has already set in.
DFID support in Orissa, West Bengal, Madhya Pradesh, Bihar, and Andhra Pradesh, through technical assistance support teams, or TASTs, focuses on working with state governments to develop nutrition strategies that include health and nutrition services. These services include reducing micronutrient deficiencies, particularly in women and children, ensuring nutrition services through the Integrated Child Development Scheme, and supporting collaborative efforts of different government departments towards such issues as food security, access to health care, and women's empowerment.
The TASTs have made significant strides in their work with state governments to ensure that nutrition is an integral part of state health plans. Some initiatives include -
West Bengal
- Targeting vulnerable groups - a baseline survey was conducted to identify measures to improve service delivery with community participation
- Master trainers and the state and district levels were trained in a step towards improving the Integrated Child Development Scheme
- TAST played an active role in bringing about inter-departmental collaboration and empowering communities and families to adopt sound nutritional practices
- Strengthened monitoring and evaluation to ensure that the programme remains on track
- Developed a state Behaviour Change Communication (BCC) plan to promote community participation
- Set up a State Nutrition Management Support Unit to improve BCC and management information systems
Orissa
- Decentralized planning identifying block priorities
- Ensuring community participation in planning, implementation, and monitoring
- Strengthening service delivery for nutrition
- Early childhood education
- Inter-department collaboration
- Behaviour Change Communication
Madhya Pradesh
- Including nutrition in health plans; encouraging inter-sectoral collaboration (Departments of Food and Civil Supplies, Agriculture, Rural Development and Panchayati Raj, Education, State Planning Commission, etc)
- Capturing real-time data through digi tracking for important indicators like child health, maternal deaths, and severely malnourished children
- TAST has worked with the Department of Health and Family Welfare to develop an M&E Framework and improve reporting mechanisms by web-enabled MIS systems to ensure availability and quality of data
- Working with several departments to integrate their work towards a nutrition-rich Madhya Pradesh