Scaling?up ICDS: Can Universalisation Address Persistent Malnutrition?

A countrywide initiative, the ICDS programme is India's primary response to addressing child malnutrition, but has had mixed success on the state of malnutrition in India. This article reviews the ICDS from the perspective of a scaling?up management framework and analyses aspects of design, advocacy, implementation and monitoring in the scaling?up of ICDS. Universalisation of ICDS with quality is well within the means of government and recent advocacy has resulted in increased funding; the scaling?up of ICDS is challenging. Successful scaling?up of ICDS requires the implementation of a multicomponent model, demanding a high level of quality and performance, coordination and convergence in the face of varying and limited management and technical capacity, poor governance environments, and little experience of engaging communities. Success in addressing these constraints is possible but attention to detail is critical and lessons should be adapted to suit local context

Biological, Programmatic and Sociopolitical Dimensions of Child Undernutrition in Three States in India

The recently developed India State Hunger Index 2008 highlights the continuing sorry state of hunger in India, and shows that children underweight makes the largest contribution to hunger index scores for most of India. In this article, we apply an assessment framework developed by the Mainstreaming Nutrition Initiative to understand three dimensions of child undernutrition in India: (1) the biological/epidemiological aspects of the nutrition situation, (2) the programmatic interventions and environment and (3) the sociopolitical environment for nutrition. We conduct this assessment for three states in India, each of which offers a distinct typology: (a) Bihar, an extremely poor northern state with high levels of undernutrition; (b) Karnataka, a southern state with high economic growth, but high child undernutrition rates; (c) Tamil Nadu, a southern state portrayed as an example of successful health and nutrition programming, but with rates of undernutrition that are still very high