Addressing Malnutrition Among Infant and Primary Age Groups

Date: August 20, 2014 Category: ,

Nutrition and Education Project for
Critical Age Group 0–5 Years

Project Leaders: Dr.  Ron Fernandes; Dr. Uma Muppadi
In Partnership with Watershed Organization Trust, Inc. (WOTR), Pune, India

According to the United Nations Children’s Fund (UNICEF):

  • Child malnutrition is more common in India than in Sub-Saharan Africa. One in every three malnourished children in the world live in India.
  • The prevalence of malnutrition varies across states, with Madhya Pradesh recording the highest rate (55%) and Kerala among the lowest (27%).
  • Malnutrition in children is not affected by food intake alone; it is also influenced by access to health services, quality of care for the child and pregnant mother as well as good hygiene practices. Girls are more at risk of malnutrition than boys because of their lower social status.


Locality and Target Population
Five Tribal villages of Banar, Barbati, Gadadevari, Khinha and Mukhas-Kalan in Narayanganj block of Mandla district in Madhya Pradesh. Many of these children are severely malnourished.

S.No Village Growth Monitoring Results as of  June 2014
1 Banar 77 children whose growth is being monitored3 are severely malnourished11 are underweightMore than 50% at the risk of being underweight
2 Barbati 54 children whose growth is being monitored6 are severely malnourished,27 are under weight15 at the risk of being underweight
3 Gadadevri 42 children whose growth is being monitored4 are under weight
4 Khinha 29 children whose growth is being monitored1 is severely malnourished1 is underweight
5 Mukhas Kalan 51 children whose growth is being monitored5 are severely malnourished,14 are under weight23 at the risk of being underweight

The IDS Nutrition and Education project implemented by WOTR aims to create awareness regarding the importance of balanced diet and essential nutrition required for healthy children living with their parents in a village located on a watershed. It trains mothers with children in the age group of 0–5 years to assess the growth of their children and to provide them with training on their food, health and nutritional needs. It also aims to leverage the resources of Anganwadis (courtyard shelters) initiated by the Government of India in 1975.

Anganwadis are funded through the Integrated Child Development Services (ICDS) program to address child hunger and malnutrition. Although the Anganwadi system can be underfunded and poorly managed, WOTR organizes and trains the poor, especially women, to effectively utilize Anganwadi resources to ensure their children’s health by providing training and guidance to the mothers and the Anganwadi workers and by building local institutions.

All of these villages depend on rainfall for irrigating crops. WOTR adopts a holistic approach by intervening in the village ecosystems (watersheds) by building rainwater harvesting systems to enhance the livelihoods and to provide sustainable incomes to the villages. This in turn enables families to provide more nutritious foods and better healthcare for their children.

The graphs below show the change in weight outcomes for boys and girls whose growth is being monitored in one village, Gadadevari, since the inception of the project. The cost is $14 per child per year (Rs. 820).

Comparative Analysis of Growth Monitoring Results

Growth Monitoring 1

Growth Monitoring 2

We discovered the importance of social networking in projects for successful project outcomes. Growth monitoring and education interventions are now reaching 273 children out of a total of 429 children in these 5 villages. The challenge is to reach the remaining children; we plan to use social networks in these villages as well as social pressure to encourage mothers to enroll children in growth monitoring.

We also learned that concurrent investments in ecosystem interventions are central to successful outcomes. Our efforts to conserve soil and water in these villages are resulting in improved agricultural production and water availability, which leads to increases in socio-economic status. This results in better nutritional status for children as well as enrollment in schools and higher school attendance.

Propagation and Growth
Our goal is to reach all the remaining children in these villages as well as those who are born over the period of the project. By educating mothers on the nutrition needs of their children we hope that this will better prepare them to meet the needs of future children. We also expect some diffusion effects where the positive outcomes for the children in these five villages can be spread (with some encouragement from us) to other nearby villages and those in the district.

To learn more about this project, go to Nutrition and Education.