India's focus on nutritional improvement among children - according to the global hunger report

Table of Contents
1. The Global Hunger Index and its indicators
2. India's current nutritional profile (key figures)
3. Major government programmes and interventions
4. Causes and pathways of child malnutrition in India
5. Implementation challenges observed
6. Lessons from other countries
7. Evidence-based measures to accelerate improvement
8. Socio-economic consequences of persistent child malnutrition
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India, as the world's most populous nation, faces a major public-health and development challenge in child malnutrition. The Global Hunger Index (GHI) 2024 placed India at 105th out of 127 countries with a score of 27.3; however, India has officially questioned the methodology of the index. The report highlights that a large share of Indian children experience undernutrition in the form of stunting and wasting, with serious implications for cognitive development, schooling, long-term health and national productivity. The government has responded with multiple nationwide interventions, but persistent implementation gaps, economic pressures and structural inequalities continue to hinder progress.

The Global Hunger Index and its indicators

The Global Hunger Index assesses national hunger using four indicators. Understanding these indicators clarifies where policy action is required.

• Undernourishment - the share of the population with insufficient caloric intake to meet minimum dietary energy requirements.
• Child stunting - the proportion of children under five who are too short for their age, reflecting chronic undernutrition and poor growth over a long period.
• Child wasting - the proportion of children under five who are too thin for their height, indicating acute malnutrition and recent or severe weight loss.
• Child mortality - the under-five mortality rate, which reflects both direct nutritional causes and broader healthcare and living-condition factors.

India's current nutritional profile (key figures)

• GHI 2024 rank: 105/127 with a score of 27.3.
• Child wasting rate: 19.3% (NFHS-5), among the highest globally.
• Child stunting rate: approximately 35.5% (NFHS-5) among children under five.
• High food inflation: Persistent food inflation in recent years (generally in the 5-8% range) has exerted pressure on household food security and nutrition programmes.
• Mid-day meal coverage: over 11-12 crore children are beneficiaries under PM POSHAN.; recent reports suggest food inflation has reduced meal quality for many.
• Public distribution and relief: PMGKAY has been extended for five years from 2024 and subsumed under the National Food Security Act to provide free foodgrains to about 813.5 million beneficiaries.

Major government programmes and interventions

• Poshan Abhiyaan (launched 2018) is now continued under Poshan 2.0 for integrated nutrition support, a national nutrition mission focused on convergence, monitoring, capacity building and behaviour change to reduce malnutrition.
• Mid-Day Meal Scheme / PM POSHAN - provision of cooked meals in schools to improve child nutrition and school attendance; rebranded and continued with the objective of improved nutritional outcomes.
• Integrated Child Development Services (ICDS) - Anganwadi-based delivery of supplementary nutrition, early childhood care and pre-school education, immunisation linkages and referral services.
• PMGKAY has been extended for five years from 2024 and subsumed under the National Food Security Act to provide free foodgrains to about 813.5 million beneficiaries.
  
• Micronutrient interventions and anaemia control - supplementation, counselling on infant and young child feeding, and national efforts to reduce anaemia among children and women.
• Anaemia Mukt Bharat (AMB) - aims to reduce anaemia among children, women and adolescents through a life-cycle approach, focusing on supplementation, testing and behaviour change.
• Collaborations with international agencies such as UNICEF and WHO to support community-based nutrition programmes and strengthen maternal and child health services.

Causes and pathways of child malnutrition in India

• Poor maternal nutrition and healthcare during pregnancy, leading to low birth weight and increased child vulnerability.
• The "first 1000 days" (from conception to two years) are critical for physical and cognitive development, and deficiencies during this period have long-term irreversible impacts.
• Inadequate infant and young child feeding practices, including delayed initiation of breastfeeding and suboptimal complementary feeding.
• Poverty and food insecurity, aggravated by food price rises and intermittent shocks to supply chains.
• Poor access to clean water, sanitation and hygiene (WASH), increasing the burden of infections that worsen nutritional status.
• Social and gender inequalities that restrict girls' and women's access to adequate food and healthcare.
• Operational weaknesses in delivery systems: irregular supply, staff shortages, leakages and weak monitoring.
• Climate change and extreme weather events that disrupt agricultural production, incomes and local food availability.

Implementation challenges observed

• Leakages and poor implementation - diversion of resources, irregular supplies and shortfalls at Anganwadi and school level reduce programme effectiveness.
• Gender disparity - socio-cultural norms can prioritise boys' nutrition over girls' in some households, worsening outcomes for girls.
• Urban-rural divide and marginalisation - rural areas, tribal populations and other marginalised groups often have less access to services.
• Fiscal and inflationary pressures - sustained food inflation raises the cost of providing adequate meals and supplements.
• Monitoring and data gaps - incomplete or delayed data on child growth and programme coverage weakens timely corrective action.
• The Poshan Tracker is used for real-time monitoring of beneficiaries, service delivery and nutritional outcomes.
• Delays in updated NFHS data and limitations in real-time monitoring systems affect evidence-based policy interventions.

Lessons from other countries

• Bangladesh - made notable gains through community-level nutrition interventions, female health worker networks, focused maternal nutrition and strong monitoring.
• Vietnam - emphasised maternal education, targeted community programmes and improvements in sanitation and healthcare, yielding faster declines in stunting.
• Common lessons: localised, community-centric approaches; strong monitoring and data use; integration of nutrition with sanitation and maternal care; and sustained political commitment.

Evidence-based measures to accelerate improvement

• Strengthen and fund Anganwadi centres to ensure regular, high-quality supplementary nutrition, growth monitoring and early childhood services.
• Improve the quality and nutritional value of school meals under PM POSHAN and protect allocations during inflationary periods.
• Scale up proven interventions: promotion of early and exclusive breastfeeding, age-appropriate complementary feeding, and micronutrient supplementation.
• Promote food fortification (e.g., fortified staples) and diversify household diets through nutrition-sensitive agriculture and livelihood support.
• Integrate WASH interventions with nutrition programmes to reduce infections that contribute to wasting and stunting.
• Enhance social protection targeting, use digital platforms for direct benefit transfers where appropriate, and close leakage points.
• Invest in community mobilisation, behaviour change communication and women's education to change feeding and care practices.
• Build climate resilience into food systems to protect the food supply of vulnerable communities from extreme weather shocks.
• Strengthen routine data systems, timely growth monitoring and decentralised accountability to correct shortfalls quickly.

Socio-economic consequences of persistent child malnutrition

• Lower educational attainment and reduced cognitive development among affected children.
• Higher disease burden and healthcare costs for families and the state.
• Reduced productivity and earnings in adult life, which hinder national economic growth.
• Intergenerational transmission of poor nutrition where undernourished girls grow into undernourished mothers.

India's focus on child nutrition is visible in policy commitments and continued public spending, but results depend on closing implementation gaps, shielding programmes from inflationary shocks and addressing structural inequalities. Collaboration with international agencies and learning from successful global models can help. As Mahatma Gandhi said, "The best way to find yourself is to lose yourself in the service of others." Ensuring better nutrition for every child is both a moral imperative and a strategic investment in human capital formation and the realisation of India's demographic dividend.