1) The document summarizes findings from a survey of stakeholders in India on tackling malnutrition. 2) It provides data on the demographics of survey participants as well as their views on priority areas and determinants of malnutrition in India. 3) The survey findings indicate a need for more emphasis on and evidence around immediate determinants like breastfeeding and complementary feeding as well as underlying factors such as women's education and empowerment.

1. A Common Vision for
Tackling Malnutrition in India
Summary Findings

2. Profile of Survey Participants
Age
11
19
30
13
19
0 20 40 60 80 100
20-30 years
31-40 years
41-50 years
51-60 years
Older than 60 years
%
Gender
41
57
1 1
Male Female Other Prefer not to say
32
5
56
8
0
20
40
60
80
100
Research Civil Society Implementation
(program or
technical support)
Others
%
Primary area of work
14 10
41
11
24
0
20
40
60
80
100
Research
Institute
Government NGO University or
Academic
Organization
Others
%
Location Affiliation
43% - Delhi
37% - State
5%- District

3. Level of emphasis India should place on different malnutrition challenges
25
38
32 32 32
53
38 38
53
46
49
62
6
9
15
19
0
10
20
30
40
50
60
70
80
90
100
Stunting Wasting Low Birth
Weight
Anemia
among
Women
Overweight
among
Children
Overweight
among Adults
Adult High
Blood
Pressure
Adult High
Blood Sugar
%
Needs Attention Top Priority

4. Most relevant immediate determinants of undernutrition
34
32
46
28
35
3334
42 43
57 56
30
0
10
20
30
40
50
60
70
80
90
100
Early Initiation of
Breastfeeding
Exclusive
Breastfeeding
Timely
Introduction of
Complementary
Food
Minimum
Acceptable Diet
Maternal
Undernutrition
Childhood Illness
%
Needs Attention Top Priority

5. Most relevant underlying determinants of undernutrition
32 32
47 46
32
34
25
54
43
30
39 38
41
47
0
10
20
30
40
50
60
70
80
90
100
Girls Education Early Marriage Women
Economic
Participation
Women Social
Empowerment
Food Security Poverty Sanitation
%
Needs Attention Top Priority

6. Importance of areas of action related to food systems and agriculture for nutrition
44 44 46
39
44
35
14
24
41
20
35
22
0
10
20
30
40
50
60
70
80
90
100
Fortification of
Staple Food
Fortification of
Foods in Public
Programs
Diversifying Foods
in Public Programs
Home Gardening Large Scale
Production of
Diverse Foods
Biofortification of
Staple Foods
%
Needs Attention Top Priority

7. Interventions in the first 1000 days: Which
areas need most emphasis?
Interventions important to improve ANC
4.33
4.46
3.85
4.51
4.17
1
2
3
4
5
All providers (public and
private) given adequate
guidance on frequency and
components of ANC
Improve monitoring of public
provision of antenatal care
Increase private provider
compliance with ANC
guidance
Raise awareness among
beneficiaries on the
importance of early and
frequent antenatal care
Conduct implementation
research on demand and
supply-side reasons for low
coverage
AverageScore

8. 13
54
30
3
Low Medium High No response
Likelihood of an increase in private sector involvement in ANC in future
Interventions in the first 1000 days: Which
areas need most emphasis?

9. Interventions in the first 1000 days: Which
areas need most emphasis?
Measures to ensure quality of ANC in public
sector facilities and program platforms like VHSND
4.29
4.49
4.53
4.68
4.32
4.63
1 2 3 4 5
Assure Adequate Financing
Improve Infrastructure
Train Staff
Fill Sanctioned Staff Positions
Reassess Staffing Needs
Improve monitoring and use of data
for improvement
Average Score
Measures to increase consumption of IFA among
pregnant women
4.34
4.05
4.54
4.76
1 2 3 4 5
Improve procurement and distribution
of IFA
Improve financing processes for IFA
Train all healthcare providers on IFA
benefits and management of side-
effects
Raise awareness about IFA (benefits
and management of side-effects)
among communities
Average Score

10. Interventions in the first 1000 days: Which
areas need most emphasis?
Measures to ensure that all pregnant women are
counselled on breastfeeding
4.64
4.45
4.53
3.71
1 2 3 4 5
Ensure wide-spread dissemination of
guidance
Raise awareness among private-care
providers
Monitor public provider compliance
with guidance on breastfeeding
counselling
Incentivize provision of breastfeeding
counselling
Average Score
Measures to improve IFA coverage among
children
4.49
4.05
4.58
4.7
1 2 3 4 5
Improve procurement and distribution
of pediatric IFA
Improve financing processes for
pediatric IFA
Train all healthcare providers (on
benefits and side effects management)
Raise awareness of IFA (benefits and
side effects management) among
communities
Average Score

11. Interventions in the first 1000 days: Which
areas need most emphasis?
Measures to improve coverage of child weight
measurement
4.62
4.6
4.62
4.63
1 2 3 4 5
Ensure equipment is available
Ensure that providers are adequately
trained
Identify mechanisms to ensure
coverage and quality of weighing
Raise beneficiary awareness of
growth monitoring
Average Score
Measures to improve women counselling on their
child weight measurement
4.62
4.63
4.45
4.5
1 2 3 4 5
Awareness of providers about
importance of counselling after
weighing
Training of providers on growth-
related counselling
Ensure that providers have job aids
Identify mechanisms to ensure
coverage and quality of counselling
Average Score

12. Interventions in the first 1000 days: Which
areas need most emphasis?
Measures to improve THR uptake
4.41
4.46
4.42
4.72
1 2 3 4 5
Examine THR formulations and
delivery mechanisms across states
Strengthen the supply chain to
ensure availability of THR
Raise beneficiary awareness of THR
Ensure quality of THR
Average Score
Importance of areas of work around the ICDS THR
for women and children
4.23
4.36
4.5
1 2 3 4 5
Update THR composition guidance
Assess reasons for opting-out of ICDS
services in low coverage-high
performance states
Assess beneficiary perceptions of THR
and other ICDS and health program
services
Average Score

13. 38
41
37
39
32 30
28 28 29
25
44 44
30
39 39
34
41
44
51 52
35 34
27 28
0
10
20
30
40
50
60
70
80
90
100
Awareness
about healthy
diets
Awareness
about
unhealthy
food
Regulate
marketing of
unhealthy
food
Regulate sales
of unhealthy
food
Mandatory
labelling
norms for all
foods
Ban or reduce
junk food and
beverage in
school
Policies to
reduce prices
of healthy
foods
Last-mile
availability of
healthy foods
Opportunities
for physical
activity
Work life
balance
Early
screening for
high blood
sugar
Early
screening for
hypertension
%
Needs Attention Top Priority
Level of emphasis India should place on overweight and non communicable diseases

14. Knowledge Needs: level of confidence on the available evidence for understanding
the determinants of different malnutrition outcomes
39
43 42
44
24
34 35
49
44
42
39
46 47 46
0
10
20
30
40
50
60
70
80
90
100
Stunting Wasting Low birth
weight
Anemia Childhood
overweight
Adult
overweight
Adult NCDs
%
We know enough We need to know more

15. Knowledge Needs: level of confidence on the available evidence for understanding
how to improve the following determinants of poor nutrition
75
51
34
44
25
23
32
23
37
51
41
53 54
47
0
10
20
30
40
50
60
70
80
90
100
Breastfeeding Complementary
feeding
Maternal
undernutrition
Maternal
anemia
Healthy and
diverse diets for
all
Unhealthy
eating
Low levels of
physical activity
%
We know enough We need to know more

16. Knowledge Needs: level of confidence on the available evidence for delivering
interventions at scale with quality
59
25
43
35
13
51
43
18
35
54
44 46
48
39 38
57
0
10
20
30
40
50
60
70
80
90
100
Breastfeeding
counselling and
support
Monitoring and
compliance with
code of marketing of
breastmilk
substitutes
Complementary
feeding counselling
High quality
complementary
foods
Cash transfers for
families with young
children
Growth monitoring
and counselling
Screening, referral
and management of
severe wasting
Fortified staple
foods
%
We know enough We need to know more