 Home to 20 percent of the world’s children, India accounts for 40 percent of its under-fed child population despite progress in food production and disease prevention. Through interest-free IDA credits, the World Bank has been supporting the government of India in its efforts to combat malnutrition.
The Tamil Nadu Integrated Nutrition Project was the first Bank project to make large-scale use of growth monitoring (of children 6-36 months old) as a means to target the most needy and monitor their progress. Growth monitoring is also an important educational tool to explain to mothers why one child is receiving food and another not and to give them objective feedback about how they are caring for their children.
Targeted supplementary feeding, the next essential project component, was an innovation that is now copied in many projects around the world. The feeding, for relatively brief periods, is focused on helping very young children recover their growth. Previous programs had concentrated on prolonged feeding of older children. The program relies heavily on local nutrition workers, working in conjunction with local women's and girls' groups. The groups are taught behavior-change strategies. They learn to promote birth weight recording, regular monthly weighing, and spot feeding, while participating in community assessment, analysis, and problem-solving.
Surveys later showed that mothers who took part in the project knew much more about good nutrition and health practices than other mothers. They breastfed for longer, and fewer of their children needed supplementary feeding. Severe malnutrition fell significantly, by 44 percent between 1992 to 1997, although moderate malnutrition was still quite widespread. Costs per beneficiary were lower than for less targeted nutrition programs. The project also contributed to a sharp reduction in the infant mortality rate. The World Bank is continuing its support for Tamil Nadu and is assisting four other Indian states to mount similar programs.
Updated: July 2002
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