Combating child malnutrition in 1000 days


1 month old baby Rupsa (picture below) was admitted to a Nutritional Rehabilitation Center with respiratory distress due to improper feeding in Kolkata. She was fed sugar and tap water as soon as she was born



2 year old Asik Laskar, who cannot sit, talk or eat on his own is severely malnourished and suffering from respiratory distress. His mother suspected “witchcraft”. What it was, was severe malnutrition along with cerebral palsy.


Malnutrition is an unfortunate reality in a world of abundance. While it robs some children from reaching their fullest potential, for some, it spells death.

 Despite India’s booming economy and growth in the recent decades, more than one third of the world’s malnourished children live in India. Nearly 6000 children die everyday in the country, due to malnutrition-related causes. The malnutrition figures for the country are worse than sub-Saharan Africa.

Prime minister Manmohan Singh condemned the situation, calling it a “national shame”.

This, when India runs the largest child development program in the world called ICDS (Integrated Child Development Services).  So what went wrong? What are some approaches the Government and NGOs can take to make a dent in the malnutrition figures of the country?


The good news is – with timely treatment, lives can be saved, damage can be limited. With education and advocacy, malnutrition can be entirely prevented.

In a vast and complex country like India, the causes of malnutrition are also varied. Most of the time, malnutrition starts in the womb. The mother is often very young, uneducated, malnourished, and does not have the required family support to experience a healthy pregnancy. The child therefore is born weak, susceptible to diseases and compounded with inappropriate childcare practices, suffers from malnutrition.

One of the major causes for malnutrition in India is gender inequality. Due to the low social status of Indian women, their diet often lacks in both quality and quantity. Women who suffer malnutrition are more likely to give birth to underweight babies, breastfeed for a shorter period of time and lack resources and knowledge to feed their children optimally.

Other leading factors include poverty, lack of knowledge about optimal feeding practices, superstitions and myths, seasonal migration, corruption, lack of access to health care and poor hygiene and sanitation.

What do the abysmally high child malnutrition rates mean for the individual and the country?

Deficiencies in nutrition inflict long-term damage to both individuals and society. Nutrition-deficient individuals are more likely to have infectious diseases such as pneumonia and tuberculosis, which lead to a higher mortality rate.

It also has consequences on a macro level, such as a greater disease burden on and lower economic output for the country.  In a country where labor and human capital is considered a major asset, it does not bode well if half the population is under-nourished and only marginally productive.

Importance of optimal nutrition in the first 1000 days of life

The first 1000 days of life, starting from conception till the child turns 2, is the “window of opportunity” where good feeding practices and care can lay a strong foundation of health for the rest of the child’s life.

That means nutrition and care for the pregnant woman is as important as feeding the child after it is born.



If a child does not receive adequate and appropriate nutrition during this critical period, the adverse effects on its health is irreversible. It has long term consequences such as poor physical, cognitive and emotional development, lower performance in school, reduced earning potential, undernourished progeny as well as greater susceptibility to illnesses and infections.

Health programs were largely failing to reach infants in the first two years of their lives, when malnutrition usually sets in and causes permanent mental and physical damage. The government lacked a coherent plan to overcome the shortcomings of the child health program, which depends on village health workers who are overburdened and poorly educated, trained and paid.

Community-engaged programs to combat malnutrition

Engaging the local community to take charge of their nutritional status, in the first 1000 days of a child’s life, is immensely effective in establishing a sustainable nutrition model.

A community level grass root intervention typically involves local community leaders, trained health workers either from the community itself, NGOs, and existing government infrastructure such as Anganwadis, ASHA workers and local health care facilities.


Community members are trained on how to use the resources that are already at their disposal to feed themselves and their children, how to practice sanitary habits, keep their environment hygienic, importance of immunizations, at-home remedies for simple illnesses as well as connecting them to available government entitles.


Typically, children and pregnant women who are moderately or severely malnourished are identified by health workers. They are provided targeted intervention such as regular weighing/measuring, lactation support, provision of folic acid supplements to pregnant women, training family members on healthy and hygienic cooking practices and promoting child care practices that will keep it healthy and disease-free.


In the process, the social causes of malnutrition in the community are also identified and counseling and behavioral change efforts are undertaken. This includes promoting the importance of a woman’s nutrition during pregnancy, lessening her work burden and promoting institutional delivery among others.


This creates a sustainable model that will go a long way in breaking the cycle of multi-generational malnutrition and keeping communities healthy.


NGOs play a crucial role in capacity building and training of government health workers, providing technical expertise, helping bridge community resources to provide a comprehensive nutrition program, measuring success of the programs and advocating for policies that will help improve nutritional outcomes of children.


With the right engagement and will from all sectors of society, malnutrition can be reduced and the unnecessary suffering of millions of children can be mitigated.


Healthy children are crucial to building a healthy nation.

As architects of future India, children deserve attention to their overall well being. There is a popular saying ” you are what you eat”. It is a calling for all those who care to contribute towards building a better India.  Good health through proper nutrition brings harmony in a family, society and nation at large.


Pooja Srivatsa

President – Child Nutrition Foundation (CNF)

CNF is a Bay-area (California) based non-profit organization, committed to raising awareness, supporting and implementing projects to fight maternal and child malnutrition in India. We implement nutrition-intervention projects in identified at-risk communities in partnership with local health workers, government and health care resources.

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  1. A very good article. Appreciate authors efforts. I will spread the message and pray & wish for good of all children in India.

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