Curbing Malnutrition and Micronutrient Defi ciencies in India… Food Based Strategies at the Centre of a Holistic Approach

India has the largest number of undernourished people in the world. Malnutrition is a major problem with nearly 55% of the pre-school children and one-third of women in the age group 15-49 years being underweight. The problem of malnutrition is causing an economic pullback as India tends to lose 3-4% of the Gross Domestic Product (GDP) in terms of loss of productivity. This glaring problem of malnutrition and micronutrient defi ciencies is multi-factorial. Important causes include lack of improvement in agricultural productivity owing to inadequate resources, lack of education and inadequate job opportunities. Increased informal workforce due to rural-urban migration along with unplanned growth of slums is one of the key issues in the urban set-up. Other factors catalyzing the problem include overpopulation, gender inequality, inadequate distribution of food through public distribution mechanisms and lack of coherent nutrition policies. The government policies should focus on growth in agriculture and on improving the food storing facilities. An accurate targeting of "in need" population, so that they get food at substantially low price along with introduction of holistic employment schemes is required. Nutrition based programmes should have in-built system of evaluation based on key nutritional indicators. Social determinants of health such as water, sanitation and women empowerment also have to be addressed to achieve long term gains in the health of the community. Community awareness and mass movement is required to ensure that demographic dividend might not turn into demographic nightmare. Keeping in view that nutrition is not a 'stand alone' subject, a multisectoral approach is needed.