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Rethinking Effective Nutrition Convergence
The National Nutrition Mission has explicitly recognised the multisectoral nature of the challenge of malnutrition and has made “convergence” one of its key pillars. However, it does not yet have sharp operational clarity on how stakeholders can ensure that multiple programmes reach the same mother–child dyad in the first 1,000-day period. The article illustrates how data on co-coverage of interventions can be used to plan for and assess the success of efforts to strengthen convergence.
The need for a multisectoral approach to address malnutrition has been well-recognised in India’s policy framework for decades (Avula et al 2017; Garrett et al 2014). However, India’s nutrition strategy has focused on interventions delivered through single programmes, such as the Integrated Child Development Services (ICDS), and have not adequately taken into account linkages with other flagship programmes focused on health, water, sanitation, and gender, all of which have a strong bearing upon nutritional outcomes. Over the years, evidence has accumulated on (i) the limited potential of the ICDS alone to tackle India’s malnutrition challenge (Kandpal 2011); and (ii) the role of several underlying determinants in shaping India’s malnutrition burden (Jayachandran and Pande 2017; Menon 2012; Spears 2013). More recently, in March 2018, India’s National Nutrition Mission, or POSHAN Abhiyaan, explicitly recognised the multisectoral nature of the challenge of malnutrition and made “convergence” one of its key pillars. The articulated goal of this pillar is to ensure that all nutrition-related programmes converge on households with mothers and children in the first 1,000 days, the core target population for POSHAN Abhiyaan (MWCD 2018).
POSHAN Abhiyaan’s approach to achieving this stated convergence includes developing a framework of relevant interventions, indicators, and targets for programmes implemented by different departments. The convergence action plan committees, which are set up at each of the administrative levels (that is, national, state, district, block, and village levels) are expected to operationalise this framework. Together with the departments implementing programmes, the convergence action plan committees are expected to: (i) develop a convergent action plan incorporating the elements of the framework; (ii) conduct periodic reviews;
(iii) monitor and track progress of the actions in the plan; and (iv) facilitate efforts to achieve the targets. Although the overarching intent of convergence is clear, the operational guidance does not make explicit how stakeholders could ensure that multiple programmes reach the same mother–child dyad in the first 1,000-day period.
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