Frequently Asked Questions on Child Anthropometric Failures in India

The National Family Health Survey is analysed to develop critical insights on child anthropometric failure in India. The analysis finds non-response of economic growth on nutritional well-being and greater burden among the poor as two fundamental concerns. This calls for strengthening developmental finance for socio-economic upliftment as well as enhanced programmatic support for nutritional interventions. The gaps in analytical inputs for programmatic purposes also deserves attention to unravel intricacies that otherwise remain obscured through customary enquiries. On the one hand, this may serve well to improve policy targeting, and on the other, this can help comprehend the nature and reasons of heterogeneities and inequities in nutritional outcomes across subgroups. Strengthening the analytical capacities of programme managers and health functionaries is recommended.

This study was supported through a grant from Tata Trusts to Institute of Economic Growth, New Delhi, India.

Interpretations made in this article do not reflect the views of the authors’ respective affiliated institutions.

Nutritional well-being is central for the achievement of several prominent national and international development goals (WHO 2016; NITI Aayog 2017). Given its intrinsic and instrumental relevance, the union and state governments in India have launched important nutrition-specific programmes starting from the Balwadi Nutrition Programme (BNP) in 1970, the massive Integrated Child Development Services (ICDS) in the late 1970s and the Mid-day Meal Scheme (MDMS) in 1995. However, despite considerable efforts, India is yet to witness meaningful reductions in the burden of child undernutrition. The recent wave of National Family Health Survey (NFHS 2015–16) confirms that every second child in India continues to suffer from some form of anthropometric failure (either stunting, or underweight, or wasting). Given the huge population base, the situation is rather grave, as over 60 million children in India (aged below five) are undernourished. The problem further intensifies because of an unexpected non-response of child nutritional improvements to economic growth (Joe et al 2016; Subramanyam et al 2011). The poor state of affairs is thus attributable to a range of social determinants, including policy targeting and coordination across nutrition-related developmental sectors (Smith and Haddad 2015).

The Prime Minister’s Overarching Scheme for Holistic Nourishment (POSHAN Abhiyaan) takes explicit cognisance of these concerns (NITI Aayog 2017). With a budget of ₹9,046 crore, the POSHAN Abhiyaan is designed to cover all the states/union territories and districts in three phases, that is, 315 districts in 2017–18, 235 districts in 2018–19 and remaining districts in 2019–20. While POSHAN Abhiyaan in itself has an earmarked three-year budget of ₹9,046.17 crore commencing from 2017–18, it really is an overarching framework that seeks to leverage funds, functionaries, technical resources and community awareness activities from existing programmes and schemes such as the ICDS, Pradhan Mantri Matru Vandana Yojana (PMMVY), National Heath Mission (NHM), Swacch Bharat Mission (SBM), National Rural Livelihood Mission (NRLM), Mahatma Gandhi National Rural Employment Guarantee Act (mgNREGA) and the public distribution system (PDS). The idea is to align the efforts of every stakeholder in a direction that could positively impact nutrition outcomes. The programme focuses on strengthening policy implementation (at central and state levels) to improve targeting (identification of high-burden districts), enhance multisectoral convergence, develop innovative service delivery models and rejuvenate counselling and community-based monitoring.