How India can break the cycle of hunger: Insights from Sudarshan Suchi, CEO of Bal Raksha Bharat

Millions of women and children in India suffer from lack of nutrition and hunger in silence. Can this bold plan end malnutrition?

Malnutrition among women and children has been a persistent public health issue at the global, national and local levels and the recent UNICEF-WHO-World Bank Group Joint Malnutrition Estimates show that globally, 149.2 million children under five years were stunted in 2020, and 45.4 million suffered from wasting. Global leaders and agencies are responding to these urgent challenges while government and non-government organisations are implementing programmes and facilitating the uptake of nutritious food in vulnerable populations. However, the progress of nutrition outcomes is not in sync with our telling economic growth.

Breaking the cycle of hunger: How India’s bold new plan could end malnutrition for good (File Photo by AFP)

In an interview with HT Lifestyle, Sudarshan Suchi, Chief Executive Officer at Bal Raksha Bharat, shared ways to improve cross-sectoral convergence for nutrition in India and what role can civil society organisations play.

Why Are Millions Still Malnourished in India?

India’s improvement in nutritional indicators has been modest as seen from five panels of national family health surveys. There are of course states where the reduction has been impressive but, that gets elusive when we see the country average. There is a strong momentum building for improving nutritional outcomes and taking on the challenge of hunger and malnutrition. The government of India, its development partners and civil society organisations are committed to achieving the goals set under the national nutrition strategy. Launched in 2018, POSHAN Abhiyaan is the Government of India's flagship programme to improve nutritional outcomes for children, pregnant women and lactating mothers. Since then, the month of September has been celebrated as “Poshan Maah” for creating nutrition awareness, and this is the 5th Poshan Maah in its series.

Q. How is India's Poshan Abhiyaan tackling the crisis?

POSHAN Abhiyaan's approach is to anchor a multi-sectoral convergence to address nutritional issues through a framework of relevant interventions, indicators and targets for programmes implemented by different departments. The goal of achieving multi-sectoral convergence is to ensure that interventions from different sectors converge on households in the first 1,000 days. It is very well established now that cross-sectoral convergence is essential for considering this multidimensional nature of malnutrition. India is currently scaling up its nutrition movement by adopting a strategy of cross-sectoral convergence and promoting Jan Andolan. Although the overarching intent of convergence is clear, the operational guidance does not clarify how stakeholders could ensure that multiple programmes reach the same beneficiary in a given timeframe.

Q. How could cross-sector convergence change the game?

The Government of India’s Operational guideline for the Convergent Action Plan (CAP) seek to clarify the process of multi-sectoral engagement. The CAP framework has identified the activities and indicators based on the existing services that contribute to improved nutrition. The CAP requires program managers to set targets for the key indicators, identify bottlenecks, plan activities, and define monitoring mechanisms across the key thematic areas. However, studies show no clear operational guidelines for village-level convergence. According to the NITI Aayog monitoring report, Poshan Abhiyaan improved nutritional outcomes for children, pregnant women and lactating mothers. However, the coverage of Poshan Abhiyan remains low in most of the states. This report emphasised expanding coverage and improving the quality of essential health and nutrition interventions.

Devolution of financial power at the grassroots level has been a critical systemic barrier in our political space hence, convergence of line departments and their active role is essential to deliver services on time. Lack of accountability and administrative hierarchy is also a challenge in achieving convergence for nutrition. Insufficient data is a significant barrier to effective planning and driving interventions. Data of the target population at the village level, their need, availability of resources and a comprehensive plan for its mobilisation are essential for delivering nutritional outcomes.

Q. How could India’s new plan end malnutrition for good?

Ans. Thematic areas in nutritional discourse are mostly limited to nutritional food, food security, women empowerment, social safety nets, access to health and nutrition services and access to WASH (water, sanitation and hygiene). There is a need for a strategic response, including financial, business, scientific and political commitments, at each level of programme implementation.

• The government should lead this movement by enabling civil society organisations, agencies, businesses and the scientific community to play a crucial role in realising policy commitments, capacity strengthening and targeted financing. Convergence of all the stakeholders in their thinking and action is imperative for providing necessary support to this Jan Andolan.
• Diverse stakeholders can actively facilitate dialogue, evidence-building, learning and consensus building to move knowledge into practice for health, nutrition and wellbeing.
• Gram Panchayat is the perfect platform for strategic community-level convergence. It will bring women, social activists, health workers, anganwadi workers, resource persons, village level committee members, institutions and development partners on one page.
• Civil Society Organisation have a significant role to play in facilitating convergence activities at community level. These organisations can become partner of choice for identifying nutritional needs of the community, share ideas and implement projects in collaboration with the government. It will also help strategically identify tasks and implement them with agreed plans at the local level. Convergence can trigger a multiplier effect for breaking the vicious cycle of poverty and malnutrition. This network will help efficient implementation and real-time monitoring and evaluation of nutritional interventions.
• Poshan Panchayat and other village gatherings provide a better platform for increasing demand side interventions for nutrition and improving public participation.
• Jan Andolan will succeed when people at the grassroots level truly participate and act as per the policies and programmes.
• Experts suggest that households can be taken as points of convergence and village as the unit for each of the programmes.
• Annual and quarterly plans must ensure a cohesive nutrition-sensitive approach and monitoring of the outcomes. Poshan Panchayat is a breakthrough in improving convergence at the grassroots level.
• As a part of the convergence strategy, linkages between existing nutrition and sanitation programmes and income support efforts at community level are essential along with a robust behaviour change communication strategy. As we advance, convergence should bring efficiency in the system through coordinated efforts in nutrition data collection, communication, resource mobilisation, monitoring and evaluation. Convergence at local to national levels shall improve service delivery ensuring entitlements from all sectors reach the intended beneficiaries.