1. Callister, Lynn Clark PhD, RN, FAAN

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Malnutrition is a serious issue worldwide and is significantly associated with poverty. There is a strong relationship between gender inequality and hunger. This is a major problem in India as it is estimated that there are 195 million undernourished people living in India, which constitutes 25% of the global hunger burden (United Nations in India, 2017). Among the most vulnerable are women and children. Malnutrition has a greater impact on women than men because it affects not only their health but the health of their children (Merckel, 2016). Women and girls who are malnourished are at risk of giving birth to low birthweight infants, which is a strong predictor of below 5 child mortality rates (Merckel).


Inadequate nutrition is the cause of 45% of mortality in children under 5, or 3.1 million children yearly (United Nations, 2017b). Chronic malnutrition is associated with stunting, which results in decreased cognitive function and increased risk of chronic diseases. Twenty-five percent of children globally have stunted growth (United Nations). For years, India has been working on initiatives that will ensure higher levels of adequate nutrition and food security, particularly among the most vulnerable.


Health policy makers in India were significantly involved in generation of the Sustainable Development Goals (United Nations, 2017a). Involvement included Sustainable Development Goal 2: Achieve food security and improved nutrition and promote sustainable agriculture. Ration cards are being issued to the senior female member of the household. There is a Mid-Day Meal Program, in which meals are provided to 100 million children in primary schools.


Sustainable Development Goal 3: Ensure healthy lives and promote well being for all at all ages is another goal associated with challenges in India. This includes efforts in India to increase access to healthcare as well as improve the quality of that care. Building on a decades old initiative, village-level Anganwadi Centers have now been designated as public health resources providing primary healthcare, family planning, nutrition and health education, the reduction of maternal and infant and under-5 mortality, immunizations, and referral services. Health insurance is being provided to families living before the poverty level. There are 1,349,091 Anganwadi Centers in India with the largest number in the states of Uttar Pradesh and West Bengal (United Nations in India, 2017). These health centers offer incentives for healthcare providers and are in the process of generating a more integrative framework for guiding care and conducting center evaluations on health and nutrition outcomes.


Sustainable Development Goal 5: Achieve gender equality and empower all women and girls is an important aspect of improving life in India. According to the Women's Index Score (United Nations, 2016), which represents a composite ranking of maternal health and empowerment, India is ranked 125 globally with a maternal mortality ratio of 174 per 100,000 live births and a 24.5 rate of births to adolescent women per 1,000 births per women ages 15 to 19. Initiatives in India related to this goal include the Educate the Girl Child program and the Maternity Benefit Program for childbearing and breastfeeding women with the protection of wage loss during the first 6 months postpartum through a conditional cash transfer initiative. Women Empowerment Centers are being established on a village level affiliated with the Anganwadi Centers to more fully meet this goal. The empowerment of women is an important tool that can be used to ameliorate the effects of malnutrition.


Global groups involved in nutrition and food security include the United Nations Children's Fund (UNICEF), Food and Agriculture Organization (FAO), International Fund for Agricultural Development (IFAD), International Labor Organization (ILO), International Organization for Migration (IOM), United Nations Entity for Gender Equality and Empowerment of Women (UN Women), United Nations Development Program (UNDP), United Nations Educational, Scientific, and Cultural Organization (UNESCO), and World Food Program (WFO). The Zero Hunger Challenge (ZHC) associated with Sustainable Development Goals is particularly relevant in India (United Nations in India, 2017). Even with all of these resources, there is much work to be done to promote health and nutrition in India.




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United Nations. (2017a). Sustainable development knowledge platform: India. New York, NY. Retrieved from[Context Link]


United Nations. (2017b). Zero hunger. New York: NY. Retrieved from[Context Link]


United Nations in India. (2017). Nutrition and food security. New Delhi, India. Retrieved from[Context Link]