India has attempted several nutrition Programme over the last 4 decades, with formulation of the Integrated Child Development Services (ICDS) and nationwide execution of the mid-day meal scheme.

Figure 1: Malnutrition Trends in India
Note: NFHS - National Family Health Survey

However, nutrition and stunting continue to be persisting challenges for the country.

While India’s malnutrition rates have dropped significantly, the country is still home to the largest number of stunted and wasted children (children with low weight-for-height) in the world. Owing to the cultural and geographical variance across states, combating malnutrition requires a granular approach. POSHAN Abhiyaan, the government’s national nutrition mission launched in 2018, aims to provide a convergence mechanism for the country’s response to malnutrition.

As of March 2020, 2.51 billion people in the country have participated in the Programme and recorded >36 million activities. A higher proportion of activities are focused on overall nutrition, anaemia, hygiene (water & sanitation), breastfeeding, growth monitoring and immunization.

Functioning of the convergence action planning is undertaken through the following process:

• At the national level, convergence is addressed through the National Council under the Vice Chairman, NITI Aayog and Executive Committee under leadership of the Secretary, Ministry of Women & Child Development. Both committees have representation from all aligned ministries, partners and select states & districts. These committees meet every 3 months. A progress report is submitted to the Prime Minister every 6 months.
• The Convergence Action Plan Committees at the State, District and Block Level are mandated to review progress, identify gaps, and introduce effective interventions (as required) based on specific targets. These committees are required to meet at least once in each quarter and the State-level Convergence Committee is chaired by the Chief Secretaries.

As of February 28, 2023, the Poshan Tracker Programme has registered a total of 99,963,025 beneficiaries, including lactating mothers, pregnant women, and children. Lactating mothers and pregnant women constitute 52,81,652 and 53,57,262 beneficiaries, respectively, emphasizing support for maternal health and nutrition. Children, ranging from infants to early childhood, make up a significant portion, with 46,59,293 aged 0-6 months, 4,08,00,370 aged 6 months to 3 years, and 4,28,64,448 aged 3 to 6 years. This comprehensive approach addresses the diverse nutritional needs of each group, aiming to combat malnutrition and promote overall health for a brighter future.

The Poshan Tracker app facilitates the real-time monitoring of nutrition indicators, Anganwadi Centres (AWCs), beneficiaries, and service delivery, thereby aiding interventions and evaluations. It enables the continuous monitoring and tracking of all AWCs, Anganwadi Workers (AWWs), and beneficiaries based on specific indicators. Beneficiary data is linked with Aadhaar to ensure accurate tracking and delivery of services down to the last mile. The Poshan Tracker plays a crucial role in Mission Poshan 2.0 by generating data, offering insights to Programme managers, and documenting the scheme's impact on nutrition indicators.

To address gaps and enhance the ongoing nutrition Programme, the components have been reorganized under Poshan 2.0 into the following primary verticals:

• Nutrition Support for POSHAN, encompassing the Supplementary Nutrition Programme (SNP) for children aged 6 months to 6 years, pregnant and lactating mothers, and adolescent girls aged 14 to 18 in Aspirational Districts and the Northeastern Region (NER).
• Early Childhood Care and Education (3-6 years) and early stimulation (0-3 years).
• Anganwadi Infrastructure, including modern and upgraded Saksham Anganwadi centres.
• Poshan Abhiyaan.

Funding and Impact of Mission Saksham Anganwadi and Mission Poshan 2.0

The Saksham Anganwadi and Poshan 2.0 scheme received a budget allocation of Rs. 21,200 crore (US$ 2.54 billion) for FY25, aimed at addressing malnutrition among children, adolescent girls, pregnant women, and lactating mothers, with over 80% of the women and child development ministry's budget dedicated to this initiative.

A total of Rs. 52,444 crores (US$ 6.29 billion) have been released to states from 2021 to 2024, with significant allocations of Rs. 18,367 crores (US$ 2.20 billion) in 2021-22, Rs. 14,892 crores (US$ 1.79 billion) in 2022-23, and Rs. 19,184 crores (US$ 2.30 billion) in 2023-24 (up to January). The initiative focuses on improving nutrition for children under six, pregnant women, and lactating mothers, and has successfully fostered behaviour change in nutrition practices through a nationwide campaign, supported inter-sectoral convergence, and utilized technology for real-time monitoring.

Monitoring last-mile delivery of supplementary Nutrition through Poshan Tracker

On April 10, 2023, the Ministry underscores the importance of efficient nutrition delivery through SNP and POSHAN Abhiyaan. With widespread ICT adoption and millions of beneficiaries registered, tracking nutrition receipt via Aadhaar verification, QR codes, and SMS alerts is essential for transparency and accountability. Poshan Tracker's SMS alerts confirm THR delivery to beneficiaries. States must now implement mandatory QR coding for last-mile tracking under Mission Poshan 2.0, reporting compliance promptly to the Ministry.

Cost sharing ratio under POSHAN Abhiyaan

On August 1, 2022, operational guidelines were issued to all states and union territories regarding the implementation of Saksham Anganwadi and POSHAN 2.0. These guidelines also served to clarify the cost-sharing arrangement between the central government and state/UT governments for all components under the POSHAN Abhiyaan. The cost-sharing ratio under the POSHAN Abhiyaan varies depending on the type of state or union territory (UT). States and UTs with a legislature witness a 60% contribution from the central government and 40% from the respective state or UT government. Conversely, northeastern (NER) and Himalayan states benefit from a higher central government share, covering 90% of the costs, with the state or UT contributing 10%. Additionally, for UTs without a legislature, the central government bears the entire cost, relieving the state or UT government of any financial burden.

POSHAN Gyan Portal

On April 13, 2021, NITI Aayog, in partnership with the Bill and Melinda Gates Foundation and the Centre for Social and Behaviour Change, Ashoka University, launched POSHAN Gyan, a national digital repository on health and nutrition.

The repository enables search and has information pertaining to communication materials on 14 thematic areas of health and nutrition across diverse languages, media types, target audiences and sources. The POSHAN Gyan repository has been sourced from the Ministries of Health & Family Welfare and Women & Child Development. The website provides an intuitive interface for multiparametric searches, multiple downloads at any point in time, easy content sharing via social media and easy viewing on any type of smartphones.

POSHAN Tracker Mobile Application

One of the major objectives under the POSHAN Abhiyaan is to leverage technology for monitoring and improve service delivery for beneficiaries including children (0-6 years), pregnant women and lactating mothers. In this direction, a robust ICT-enabled platform— ‘POSHAN Tracker’—was developed by the MoWCD and launched on January 13, 2021, to ensure real-time monitoring of providing supplementary nutrition for improving nutritional status of beneficiaries and real-time information for prompt supervision and management of services.

Pilot Programme under Mission POSHAN 2.0

In February 2021, the union government under Mission POSHAN 2.0 and in accordance with the Ministry of AYUSH (Ayurveda, Yoga, Naturopathy, Unani, Siddha, Sowa-Rigpa and Homoeopathy) formulated a plan to develop a robust AYUSH-based nutrition and health system. For this, a pilot Programme will be rolled out at ~10,000 Anganwadi centres to test the efficacy of AYUSH-based intervention and nutritional support in addressing problems of malnutrition and malnourishment. Data generated in this initiative will be scientifically evaluated and analysed by the MoWCD. The objective of the Programme is to create a mechanism to promote “healthy diet and lifestyle modification as per Ayurveda” as well as prevent and overcome malnutrition by providing proper AYUSH care to pregnant and lactating mothers, and children at various stages.

Tackling Malnutrition during the Pandemic

The foremost strategy adopted by the centre to handle nutrition schemes and services during the Covid-19 crisis has been the provision of supplementary food and rations at the doorstep of beneficiaries through Anganwadi centres and workers. The life insurance cover for Anganwadi workers has been increased from US$ 400 (Rs. 30,000) to US$ 2,655 (Rs. 2,00,000) to boost their morale. Online training sessions have been organised by the MoWCD at which a total of 700,000 beneficiaries have discussed the necessary safety and security protocols for the pandemic and psychosocial issues it has thrown up. An effective policy is being worked out to open Anganwadi centres and amplify services. The reverse migration that occurred during the pandemic-induced lockdown, forcing many migrant workers and their families in urban areas to return to their villages, has increased the number of beneficiaries that local Anganwadi centres have to support.

Engaging the Private Sector in POSHAN Abhiyaan

In March 2019, IMPAct4Nutrtion, an initiative convened by UNICEF, Tata Trusts, Sight and Life, CSRBOX, CII, WeCan and NASSCOM Foundation was launched in New Delhi. IMPAct4Nutrition is a platform for the private sector to actively engage and build a social movement with their employees, customers and employees’ families who form a part of their business ecosystem and support the POSHAN Abhiyaan. The platform helps in engaging and supporting the private sector to increase nutrition awareness and improve Nutrition Literacy – or health, hygiene, food, and literacy. Besides becoming a part of the POSHAN Abhiyaan, it has also given companies a chance to impact social and economic change by promoting malnutrition-free families.