 The ICICI Centre for Child Health and Nutrition (ICCHN) focuses its efforts towards ensuring that infants in the poorest communities across India are born healthy and grow and develop to their full potential in the critical first three years of life. Its work is organised around gaining a deep understanding of the complex and contextual reasons for the alarmingly high rates of child mortality and malnutrition in India and investing in the development, innovative implementation and evaluation of effective strategies to achieve widespread improvements in these vital outcomes.
The status of knowledge and practice in the area of early child health and nutrition is constantly evolving as our understanding of the biological pathways and social determinants of early child growth and development become at once clearer and more complicated. At the same time, there is a widely accepted set of efficacious and feasible interventions through which we can prevent the majority of child mortality and malnutrition in developing countries. There also exists a long history of policy and programmatic experience along with the emergence of relatively newer actors and approaches within health and other related development sectors in India and internationally.
In such a context, ICCHN has sought to develop an approach and strategy that is both grounded in long standing tenets of public health and primary health care and nutrition, while engaging dynamically with the latest research, fresh ideation, innovation and application at scale. Building its work at this interface of knowledge and practice, ICCHN facilitates and supports a variety of action-research projects and resource partnerships in diverse contexts. These range from developing and evaluating technical interventions and field-based delivery strategies to supporting district, city and state-level initiatives to strengthen public systems and programmes. Throughout, the focus is on generating and translating strategies with the greatest potential for securing large-scale and sustainable improvements in child survival and development in India.
Given the multi-dimensional nature of the challenge, ICCHN’s strategy is built on an understanding of the interrelationships between the biological pathways, socio-economic determinants and systemic contexts that influence child health and nutrition. In doing so, we engage with a range of perspectives and experiences, including those of scientists and field practitioners, ‘evidence-based’ and ‘rights-based’ approaches, NGOs and governments, researchers and policymakers, and technical experts and implementers. This conscious effort at integrating diverse sources of knowledge and experience into a more creative and effective practice is a common element across the Centre’s different initiatives.
The key analytical perspectives that define ICCHN’s current understanding and approach to child health and nutrition in the Indian context are briefly outlined below.
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Child mortality and malnutrition are among the most stark and significant dimensions of poverty in India, but investing in early child health, nutrition and development is one of the most important and farsighted ways to build human capacity, especially the capacities of the poorest of the poor to participate in larger social, economic and political processes.
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Early child health is intertwined – biologically and socially – with the health, nutritional and social status of women across their lifecycles. Effective strategies focused on impacting child health and nutrition in India must take a multidimensional approach to women’s health, nutrition and socio-economic status.
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The proximate determinants of child mortality and malnutrition in India are limited in number and are largely preventable. They are, however, interactive and synergistic and occur in contexts of chronic deprivation and multiple deficiencies. Single vector approaches will therefore remain partial in their impact; instead integrated actions are required.
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While there can be no ‘magic bullet’ against child mortality and malnutrition, a number of highly effective and feasible intervention packages do exist. These combine essential preventive, promotive and curative services and involve figuring out how to work effectively at different levels – within households, communities, and health facilities
- There has also been significant progress in developing interventions to address specific nutritional deficiencies; however, this remains an area of considerable technical and programmatic debate, especially on the question of maternal supplementation and in determining an optimal mix of supplementation, fortification and dietary diversification strategies.
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The achievement of these outcomes requires the active participation of a range of actors and institutions. Facilitative and long-term investments are needed to support and sustain state-civil society partnerships, build and strengthen innovative local resource institutions and expertise, and conduct rigorous and relevant research that learns from and responds to diverse Indian contexts.
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