The Operational Evidence Base for Delivering Direct Nutrition Interventions in India: A Desk Review

Abstract

The International Food Policy Research Institute (IFPRI), established in 1975, provides evidence-based policy solutions to sustainably end hunger and malnutrition and reduce poverty. The Institute conducts research, communicates results, optimizes partnerships, and builds capacity to ensure sustainable food production, promote healthy food systems, improve markets and trade, transform agriculture, build resilience, and strengthen institutions and governance. Gender is considered in all of the Institute's work. IFPRI collaborates with partners around the world, including development implementers, public institutions, the private sector, and farmers' organizations, to ensure that local, national, regional, and global food policies are based on evidence. IFPRI is a member of the CGIAR Consortium.

Reducing stunting in India: what investments are needed?

“…counselling for infant and young child feeding practices; guidelines are under development for paediatric iron folic acid supplementation). Two national programmes, implemented by separate ministries, Ministry of Women and Child Development and Ministry of Health and Family Welfare, operate across the country and are designed to together deliver all of the nutritionspecific interventions through their frontline workers (Avula et al, 2013). There are, however, gaps in the implementation of these interventions, arising from challenges such as operationalizing interministerial convergence, limited understanding of the frontline worker roles and responsibilities, inadequate training, limited mechanisms for supportive supervision, and the burden of multiple responsibilities for frontline workers and other health staff.…”

Undernutrition and Public Policy in India

“…As Menon et al (2013) note, sanitation and nutrition interact, so that breastfeeding and improving sanitation, for example, both do more to improve child height when working together. found that if 10 core nutritionspecific interventions were scaled up to 90 per cent, it would only reduce child stunting by about a fifth.…”

“…Action is needed on all the fronts. In India, there is now broad agreement on the package of direct nutrition interventions targeted to the first 1000 days of life (Avula et al 2013). Without a major shake-up in policy and an improvement in design of the ICDS as well as in the effectiveness of its implementation, the attainment of the goal of fast reduction in HUNGaMA looks unlikely.…”

“…1 Timely initiation of breastfeeding within one hour of birth 2 Exclusive breastfeeding during the first six months of life 3 Timely introduction of complementary foods at six months 4 Age-appropriate complementary feeding, adequate in terms of quality, quantity and frequency, for children ages 6-24 months 5 Prevention of anaemia 6 Safe handling of complementary foods and hygienic complementary feeding practices 7 Full immunisation 8 Reducing vitamin A deficiency 9 Reducing burden of intestinal parasites 10 Prevention and treatment of diarrhoea 11 Timely and quality therapeutic feeding and care for all children with severe acute malnutrition 12 Improved food and nutrition intake for adolescent girls, particularly to prevent anaemia 13 Improved food and nutrient intake for adult women, including during pregnancy and lactation 14 Prevention and treatment of malaria Source: Avula et al (2013). Interventions to reduce child undernutrition must be implemented at scale to achieve rapid reductions in undernutrition ), but less than 55 per cent of mothers and children receive any of the essential health and nutrition inputs in India (IIPS and Macro International 2007). The delivery of nutrition-specific interventions is spread across two prominent ministries, the Ministry of Women and Child Development (MOWCD) and the Ministry of Health and Family Welfare (MOHFW), and thus requires coordination between them.…”

“…Similarly, all three types of frontline workers are expected to coordinate their efforts to plan and provide services together during Village Health and Nutrition Days (Avula et al 2013). Depending on the intervention, the frontline workers in each programme complement or reinforce one another's roles.…”