India's Undernourished Children: A Call for Reform and Action

May 18, 2006


Executive Summary:
India’s Integrated Child Development Services (ICDS) needs to undergo significant changes to address the current malnutrition crisis in India, according to a World Bank report. The prevalence of underweight children in India is among the highest in the world, and is nearly double that of Sub-Saharan Africa, the report says. It also observes that malnutrition in India is a concentrated phenomenon. A relatively small number of states, districts, and villages account for a large share of the burden – 5 states and 50 percent of villages account for about 80 percent of the malnutrition cases.

Chapter 1: Dimensions of the Undernutrition Problem in India
The consequences of child undernutrition for morbidity and mortality are enormous – and there is, in addition, an appreciable impact of undernutrition on productivity so that a failure to invest in combating nutrition reduces potential economic growth. In India, with one of the highest percentages of undernourished children in the world, the situation is dire. Moreover, inequalities in undernutrition between demographic, socioeconomic and geographic groups increased during the 1990s. More, and better, investments are needed if India is to reach the nutrition MDGs. Economic growth will not be enough.

Chapter 2: Integrated Child Development System: Results Meeting Expectations?
India's primary policy response to child malnutrition, the Integrated Child Development Services (ICDS) program, is well-conceived and well-placed to address the major causes of child undernutrition in India. However, more attention has been given to increasing the coverage than to improving the quality of service delivery and to distributing food rather than changing family-based feeding and caring behavior. This has resulted in limited impact.

Chapter 3: How to enhance the impact of ICDS?
Urgent changes are needed to bridge the gap between the policy intentions of ICDS and its actual implementation. This is probably the single biggest challenge in international nutrition, with large fiscal and institutional implications and a huge potential long-term impact on human development and economic growth.