India faces unique development paradox of being in the front rank of fast growing global economics and yet, in stark contrast around 35.7% of Indian children (<5 years) are underweight and 58.4% are anaemic. Half of the child deaths are linked to malnutrition (source: Lancet series on maternal and child nutrition- June, 2013). 35% of women in reproductive age have low body mass index (<18.5 kg/met square) and 53.1% suffer from anaemia (source: NFHS-National Family Health Survey- 4). These women enter pregnancy without adequate nutrition to support the growing foetus. Specially, under-nutrition among adolescent girls has a major implication on low birth weight pregnancies. In India, anaemic pregnant women give birth to 22% of the low birth weight children (Poshan- Ministry of Women and Child Development-MWCD, Govt. of India- June, 2015).
More worrisome, nutrition situation of Indian children and women has not improved significantly in spite of government flagship programmes over the years. Further, the situation of intergeneration cycle of malnutrition (the First 1,000 days to adolescence), is grim in 200 high burden districts of 19 states (Source: MWCD, Govt. of India).
Looking at the current under-nutrition challenges in India, there is need for a strong unified voice from diverse sectors to address the intergenerational cycle of malnutrition. All stakeholders need to put their hands together to assess the gaps and identify the future directions towards integrating nutrition specific interventions along with nutrition sensitive interventions like WASH, Education, and Livelihood through convergence of diverse sectors. It is a mandate of the hour that the government, development partners, corporate, civil society organisations and communities, should come together to strengthen multi-sectoral convergence approach for improving nutrition outcomes in India.
Across an array of nutrition interventions, CINI’s primary concern from the beginning has been with the first 1000 critical days in the life cycle – the period spanning pregnancy and the first two years of a child’s life. Since the 1970’s, CINI’s 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.
CINI’s ultimate aim is also 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 infant and young child feeding practices, growth monitoring and promotion, adoption of low-cost home available foods, promotion of gender equality.
CINI method within its institutional framework of Child Friendly Community (CFC) evolved from the learning that the key to ending intergenerational cycle of malnutrition in an integrated right-based manner. The only sustainable way to achieve this has been to form and strengthen community based partnerships that include “government service providers, community based institutions (PRI and SHG), and the community” with accountability in ensuring good governance and provision of integrated services to break the intergenerational cycle of malnutrition through the following actions:
- Add value to existing government programmes through capacity building, decentralised planning, behaviour change communication, sectoral convergence, and community based monitoring.
- Promote pregnancy weight gain at the family level through appropriate feeding and caring practices of pregnant women, infant and young child feeding practices (in terms of improved food quantity, quality, consistency and frequency), safe drinking 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.
- Enhance health and nutrition education at the community level involving women’s groups and local elected members, promote environmental sanitation, maintenance of drainage and safe disposal of solid waste, prevent early marriage and pregnancy.
- Provide institutional care of malnourished children at CINI managed nutrition day care centre and ensure referral and treatment of severe acute malnourished children with medical complications to government run Nutrition Rehabilitation Centres (NRC).
- 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 complementary food.
- Improve adolescent nutrition using Iron Folic Acid (IFA) supplementation, quality of food (introducing Nutrimix), peer to peer approach to change eating habits, early marriage etc.
- Train frontline workers and supervisors of national flagship programmes (Integrated Child Development Services (ICDS) and National Health Mission (NHM) in India.
- Prevent intrauterine malnutrition and ensure appropriate growth and development in the first two years through 1000 day approach, using the electronic tracking system.
Dr. Samir Chaudhuri
Mr. Swapan Bikash Saha
Child In Need Institute (CINI)
 PRI-Panchayati Raj Institutions have been introduced under the 73rd Amendment Act of the Constitution of India. Rural Development includes measures to strengthen the democratic structure of society.. It also includes measures to improve the rural infrastructure, improve income of rural households and delivery systems pertaining to education, health & safety mechanisms.
 Self-Help Group refers to self-governed, peer controlled, informal group of people with same socio-economic background and having a desire to collectively perform common purposes (productive and emergent needs).
 CINI Nutrimix developed in 1974 as a low cost, locally produced nutrition supplement, being promoted through a social business model.