Reforming ICDS must to check malnutrition in India: World Bank

New Delhi, May 11 (UNI) The prevalence of underweight children is highest in India and the country needs to make significant changes in its Integrated Child Development Services (ICDS) to address the current malnutrition crisis, according to a new World Bank Report released today.

Stressing the urgent need to overcome persistant malnutrition in India, the report titled 'India's Undernourished Children: a call for Reform and Action' says that effective implementation of health nutrition and education investments is critical to reach the Nutrition Millennium Development Goals.

India has nearly double the prevalence of malnourished children as compared to Sub-Saharan Africa. Malnutrition in India is a concerted phenomenon as a relatively small number of states, districts and villages account for a large share of burden, the report points out.

Child malnutrition is a leading cause of child and adult morbidity, mortality, cognitive and motor development. Estimated to play a role in about 50 per cent of all child deaths from malaria (57 per 23cent), diarrohea (61 per cent) and pneumonia (52 percent). Overall, child malnutrition is a risk factor for 22.4 percent of India's total burden of diseases, the report says.

In addition to its consequences for morbidity, mortality and cognitive development, malnutrition of this magnitude has severe long term impact for individual educational achievement, labour productivity and for economic growth, it points out.

In India, child malnutrition is mostly the result of high level of exposure to infection and inappropriate feeding and caring practices and has its origin almost entirely during the first two to three years of life.

However, the commonly held assumption is that food insecurity is the primary or even sole casue of malnutrition. Consequently, the existing response to malnutrition in India has been skewed towards food-based interventions and has placed little emphasis on schemes addressing other determinants of malnutrition.

Reduction in prevalence of malnutrition over the last decade has been small as it has fallen from 53 per cent to 47 per cent between 1992-93 and 1998-99 respectively Analysing the ICDS programme in overcoming malnutrition, the report suggest several reforms in the programme.

''The need to re-examine the functioning of ICDS is an urgent one. The prevalence of underweight among children in India is highest in the world and most often children suffer from at least one micronutrient deficiency,''said Meera Shekar, World Bank Senior Nutrition Specialist.

Eventhough the ICDS programme in general appears to be well designed and well placed to address teh multidimensional causes of malnutrition in India, there are three main 'mismatches' between the programme's design and its actual implementation that prevent it from reaching its potential.

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