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| [PHOTO: © UNICEF/HQ00-0631/LeMoyne] |
Washington: The World Bank approved a US$ 106 million credit, representing the first part of a two phase Loan to support the Government of India in its efforts to improve the nutritional outcomes for children less than six years of age, with a particular focus on 0-3 year-old children.
ICDS Systems Strengthening and Nutrition Improvement Project (ISSNIP) approved by the World Bank Board will focus on improving services for pregnant/lactating women as well as for children less than three years of age. The first phase of the Project will be implemented over a three-year period, to be followed, upon the successful achievement of its results, by a four-year second phase. Policy and institutional reforms as well as innovative pilots and programs will be tested in eight high-burden states (Andhra Pradesh, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Maharashtra, Rajasthan and Uttar Pradesh) with a special focus on 162 high malnutrition-burden districts in these states.
Today, India has one of the highest malnutrition rates in the world. One-third of the children are born with low birth-weight, 43 percent of children under five are underweight, 48 percent are stunted, 20 percent are wasted, 70 percent are anemic, and 57 percent are vitamin A deficient.
While malnutrition is not restricted to the poor in India, there are significant regional disparities in nutritional indicators with 60 percent of the burden of malnutrition found in the low-income states (Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Rajasthan, and Uttar Pradesh) and an additional 8-10 percent of the burden concentrated in specific geographical areas in the states of Andhra Pradesh and Maharashtra.
Over the years, despite being guided by a comprehensive and forward-looking framework, India’s flagship Integrated Child Development Services (ICDS) program on malnutrition has largely focused on food-based interventions and on children 3-6 years of age. However, research shows that exposure to repeated infections, inadequate utilization of health services, poor sanitation, and inappropriate child feeding/caring practices, especially during pregnancy and in the first two years of life, are among the key contributors to malnutrition. The government is undertaking a comprehensive review of the Integrated Child Development Services (ICDS) Program and is introducing new approaches to enhance the focus on pregnant/nursing mothers and children under three. Resources will also be targeted to regions with a high burden of malnutrition.
“Malnutrition during the first few years of a child’s life can have far-reaching effects. Undernourished children have higher rates of mortality and lower cognitive skills; they are more likely to drop out of school and are less productive later in life. Undernourishment can begin before a child is even born, with the critical period continuing until she turns two,” said Onno Rûhl, World Bank Country Director for India. “This Project will support the government’s efforts in building the necessary institutional capacity and systems needed to improve nutrition for expecting mothers and their children,” he added.
Consequently the Project is designed to improve government’s interventions in areas such as healthy pregnancy, timely and exclusive breastfeeding, appropriate diet and care, personal hygiene with particular focus on the 0-3 age group; investing in behavior change communications; empowering communities to demand and receive better quality child development and nutrition services; and increasing the technical efficiency of public resources under ICDS by strengthening the systems and achieving better multisectoral coordination with other health programs.
“We hope this Project will help the government’s efforts at strengthening its human resource policies, its management information system, its capacity building system, behavior change approaches and its engagement with communities within the Integrated Child Development Services (ICDS) Program. The aim is to reach all children in the first thousand days of their life with interventions proven to improve nutrition,” said Ramesh Govindaraj, World Bank’s Lead Health Specialist and the Project’s Task Team Leader.
“We also hope that the Project will help foster multisectoral convergence at the district level aimed at improving nutritional outcomes,” he added.
The Project will be financed by a credit from the International Development Association (IDA) – the World Bank’s concessionary lending arm – which provides interest-free loans with 25 years to maturity and a grace period of five years.