1. Despite India's substantial progress in human development since its
independence in 1947, more that half of its children under four years
of age are
moderately or severely malnourished, 30 percent of newborns are
significantly underweight, and 60 percent of Indian women are anemic.
An initiative by
Team Liaison
Sneha Pande
Saurabh Tomar
Nitin Chamoli
Anurag Amar
Shubham Naithani
Graphic Era University
Dehradun
Uttarakhand

2. India no longer faces the famine and epidemics that made
life expectancy barely more than 30 years at the time of its
independence. Despite progress in food production, disease
control, and economic and social development, India accounts for
40 percent of the world's malnourished children while containing
less than 20 percent of the global child population.
Malnutrition varies widely across regions, states, age,
gender, and social groups, being worst in children under two, in
the large northern states, and among women, tribal populations,
and scheduled castes. Fortunately, the most severe form of
malnutrition has declined by one-half in the past 25 years.

3. Malnutrition among young children and
pregnant women-the most
vulnerable groups-has three main causes:
inadequate food intakes;
disease, including common diarrhea; and
deleterious caring practices, such
as delayed complementary feeding.
Poverty and gender inequity are among
the most important factors responsible
for the high level of undernourishment.

4. If India is to succeed in dealing with
malnutrition, the first essential
requirement is a higher level of sustained
political commitment. This will require a
policy and implementation structure that will
actively lead, monitor, and sustain national,
state, and local action in many sectors,
including agriculture, industry, and water and
sanitation.

5. Program-driven nutrition studies, i.e., operational research
that emanates directly from constraints to program
effectiveness, for example, in
reducing low birth weight and anemia
* Analysis of nutritional needs at the local level and means by
which programs (TPDS, ICDS, health, water and sanitation,
etc.) can be designed to
meet these needs
* Nutrition status measurement and determinants analyses,
including
surveys and qualitative studies
* Scientific and technological research, especially on major
problems such
as anemia and nutrition-infection relationships
* Studies on the nutrition consequences of new economic,
including agriculture, and social policies and programs
* Economic studies, such as cost-benefit and cost-effectiveness
analyses,
of nutrition interventions.

6. Nutrition Monitoring.
India needs to establish a broad-based, efficient system to collect and
analyze nutrition data for use in decision-making and
advocacy. The emphasis must be on collecting relevant and manageable
amounts of high-quality information, not on large quantities liable to
remain unused. Nutrition status data must be collected and made
available
at regular intervals, at least annually. The National Nutrition Monitoring
Bureau (NNMB) was an excellent idea in this regard, but it has not been
as
active and rigorous as desirable. A carefully targeted and reliable
system
is urgently needed, using the best data collection, computerization,
and
analysis methods.

7. The changes need to achieve at least the
following four objectives:
* Improved targeting, especially to reach those
children under two and
pregnant women who are most at risk of
malnutrition
* Greatly enhanced quality of services and
impact, particularly on behavioral change
* A reliable monitoring and evaluation system
as soon as possible
* Community ownership and management of
the program

8. To reduce malnutrition in India, the most critical resource is not
financial but political commitment. Malnutrition fails to receive the
priority it deserves in India, as in many countries, because it is
largely invisible, program efforts do not extend across many sectors
and levels, and, above all, sustained political commitment is
lacking for the
long and difficult task of prevention. Inadequate commitment to
deal with the problem effectively also manifests itself in the
pervasive corruption
within the programs, which results in few resources reaching the
poor. It is urgently necessary to address this problem. Political
commitment to improved nutrition should be demonstrated by
sustained allocation and proper direction of the necessary financial
and human resources.
Thank you for the opportunity.