Improving Nutritional Outcomes: Ground-level lessons for India's nutrition

As India moves from food security to nutrition security, this book serves as a guide for policymakers, bridging the gap between theory and grassroots realities

Improving Nutritional Outcomes: Connecting the Dots through Grounded Action

By Vandana Prasad & Arti Ahuja

Published by Routledge

427 pages  ₹1,995

 

India’s nutrition trajectory is at a complex and critical stage. According to the Global Hunger Index, India’s undernourished population fell from 18 per cent in 2000 to 12 per cent in 2025. Behind that progress is a vast, interconnected public health ecosystem. India has indeed made gains in maternal and child health, but overall outcomes remain uneven, and we still lag severely in conditions such as anaemia and stunting. 

Conversely, one in four adults in India is now overweight or obese. Over 40 million children fall into the same category, prompting the Indian Council of Medical Research to recently recommend policy measures to curb the consumption of unhealthy foods and the health ministry to introduce child obesity checks in schools. 

India, believe experts, is transitioning from food security to nutrition security. What’s clear is that we urgently need to build greater access to wholesome food systems for everyone, particularly vulnerable communities. With that goal in mind, this new book on nutrition is essential reading. 

Improving Nutritional Outcomes: Connecting the Dots through Grounded Action provides a meticulous overview of what has worked so far and what lies ahead. Edited by public health expert and community paediatrician Vandana Prasad and retired IAS officer Arti Ahuja, the book brings together decades of academic and practical experience to examine gains in nutrition security through grassroots work, policy, and the implementation of large-scale public health programmes. 

The book forms one part of a six-volume collection examining innovations, practice and the future of public policy in India. This volume, focused on community nutrition, features essays that tell an expansive story through state-wise case studies, data, and ground evidence from programmes implemented in the remotest corners. Its contributors include policymakers, public health and nutrition experts, medical professionals, bureaucrats, development practitioners, and data specialists. 

The editors hope that by documenting the achievements of key innovations, these models will be scaled where applicable. There’s special emphasis on nutritional outcomes for vulnerable groups, the role of women, and decentralised approaches to solving India’s nutrition problem. 

How do large-scale models get implemented on the ground? How does empowering communities improve nutrition in villages? How does diversity in farm production affect health in farming families? The book offers insights for policymakers, public health and development experts, academics, and researchers. 

The first part sets the context at a time when the country confronts a triple burden — not just of malnutrition and over-nutrition, but micronutrient deficiencies as well. It zooms in on projects and campaigns that have dealt with the primary drivers of malnutrition, such as poverty, inequity, and gender discrimination. 

The second part examines multi-sectoral community action and how it plays out on the ground when tailored for different cultures and regions. One such initiative is Ekjut, a long-running participatory approach in rural India, where community workers found workable, local solutions to common health concerns. Another programme, implemented in tribal communities in Rajasthan, shows how nutrition and growth monitoring, when woven into day-care facilities, can prove both practical and effective. 

The third theme that drives the book is public policy in action, exploring the successes and limitations of government programmes such as POSHAN, the National Rural Livelihoods Mission, and Jeevika. An illuminating chapter on childhood stunting in India, which affects 46 million children under the age of five, demonstrates how four states have achieved progress through interventions in nutrition, household conditions, and maternal health, driven by political and administrative will, and an engaged civil society. 

A thread running through the book reveals how vital women’s collectives across the country are — including the immense network of Asha workers — in tackling malnutrition, improving dietary diversity, and increasingly, addressing obesity. This indispensable labour urgently needs better compensation and support for their long-standing demands from the government. 

Consider the case of Sumitra, a member of the Ho tribe and secretary of a self-help group in a remote village, who led major behavioural changes to improve maternal and child nutrition while steering community members away from faith healers and informal health providers. Over 20 years, she has helped create a new cadre of nutrition champions in Jharkhand, Odisha, and other states. 

The book also dives deep into “Special Action for Children”, highlighting critical gaps in programmes for the vital first three years of a child’s life. It flags the lack of coverage in adolescent nutrition and health, as well as for children with disabilities.

 

The book serves as an important bridge between theory and grassroots realities. The editors have mined the breadth of field-level research to connect the dots in ongoing policy discourse across different levels, departments and sectors, and more crucially, to link micro-level actions to macro-level impacts. 

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The reviewer is a Delhi-based author and journalist