Malnutrition is more widespread in India than in Sub-Saharan Africa. One in every three malnourished children in the world lives in India. About 50 per cent of all childhood deaths are attributed to malnutrition, according to UNICEF. As many as 48% of Indian children under the age of 5 are stunted, a sign of chronic malnutrition. Girl children are more vulnerable than boys to malnutrition and mortality (NFHS 3, 2005-2006).
From its inception, CINI’s work with deprived communities has focused on nutrition, an issues that remains key in India till the present day despite the country’s progress and exponential economic growth. A child who is malnourished in the womb and in her first two years of life is unlikely to grow to its full physical and mental potential. Lack of proper nourishment in the womb can cause brain damage, still birth and neo-natal death. A malnourished child is more susceptible to illness and may experience a restricted capacity for education. In a child, proper nutritional status is a prerequisite to attaining adequate health, education and protection.
The problem of malnutrition is not always as straightforward as simply lack of food. Many families do not always share food equally among their members. Mothers and infants, especially girls, are rarely given priority. Traditionally, in Indian families, women eat last. When food is scarce, men may receive more than women, boys more than girls, older children more than younger children. Diet may be imbalanced owing to limited understanding of nutrition as much as lack of food availability. For example, less than half of Indian children under six months are exclusively breastfed (NFHS 3, 2005-2006). CINI’s nutrition projects focus on educating women, especially pregnant and lactating mothers, to make the best of what is available. This process is usually entrusted to health workers, local women who are trained by CINI and can approach women in their homes in villages and slums.
Our ultimate aim is to ensure full physical and mental growth and development in children by ensuring appropriate nutrition throughout the critical periods of the life cycle. Our interventions seek to address a variety of determinants of malnutrition in children, adolescents and pregnant women, as they relate to healthcare, hygiene and sanitation, child care, appropriate feeding practices (including breastfeeding), growth monitoring and promotion, adoption of low-cost home available foods, promotion of gender equality.
In addition to promoting community-based nutrition interventions, we care for severely malnourished children in our Nutrition Rehabilitation Centre (NRC), where balanced food is provided in small but frequent amounts in order to increase a child’s weight safely over a period of several weeks. Our low cost model to rehabilitate severely malnourished children has been adopted in a number of state governments interventions as part of the National Rural Health Mission effort to reduce severe malnutrition.
In the early ’70s, CINI developed Nutrimix, a low cost nutritious food made from locally-available cereals (rice/wheat) and legumes (dal – lentils), which has have been promoted at the home and community level, as well as in Government health and nutrition programmes. With the help of a World Bank grant, Nutrimix has been commercialised as a social business venture by women’s Self-Help Groups to offer a socially-appropriate alternative to industrially-produced weaning foods.
To address iron deficiency anaemia, in addition to nutrition education, CINI has partnered with the Government and international NGOs to provide iron supplements to children and women.
Across an array of nutrition interventions, our primary concern from the beginning has been with the first 1000 critical days in the life cycle – the period spanning pregnancy and the two first years of a child’s life. Since the 1970’s, our home and community-based action has aimed to prevent malnutrition by breaking the vicious cycle of malnutrition and infection, enhancing access to health and nutrition information and education among local communities, and facilitating early access to healthcare.
We have carried out our work in nutrition in partnership with
- The family – to promote pregnancy weight gain through appropriate feeding and caring practices of pregnant women, breastfeeding promotion, introducing semi-solid low-cost nutritious foods from six months onward in the child’s diet (in terms of improved food quantity, quality and frequency), safe water and hygienic practices, early seeking of health care for childhood ailments, adequate feeding of girls and women, and empowerment of women to choose for themselves and their children
- The community – to enhance health and nutrition education involving women’s groups and local elected members (rural Panchayat Institutions and Urban Local Bodies), promote environmental sanitation, including use of toilets, maintenance of drainage and safe disposal of solid waste, prevent early marriage and pregnancy
- Institutional services – to ensure referral and treatment of severely malnourished children to Nutrition Rehabilitation Centres (NRC) managed by CINI and the Government
- Government – to train frontline anganwadi workers and supervisors of the national Integrated Child Development Services (ICDS) programme, the flagship nutrition initiative of Government of India