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

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.

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.

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.

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.

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.

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

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.