India

With annual gross domestic product growth rates nearing 7% and a population of 1.3 billion people, 65% of whom are younger than 35, India is among the world’s fastest-growing economies. In the coming decades, however, it will be difficult for India to sustain inclusive and sustainable growth, unless it invests in an educated, healthy, and nutritionally secure population.

Malnutrition is a serious public health problem in India: 38% of Indian children under five are stunted and over 50% of women of reproductive age are anaemic. India faces the double burden of undernutrition and obesity: the cases of overweight adults are now almost equal to the number of underweight adults. The biggest driver of this burden is the poor quality of food. 

The Indian population, both in rural and urban areas, experiences low consumption of fruits and vegetables, whilst there are increasing trends in consumption of sugar-sweetened beverages and diets which elevate cholesterol (essentially unhealthy fats) and sodium (too much salt). This is reflected in an increase in overweight rates among the adult population, from 12% in 1999 to 20% in 2016.

These trends are also reflected among children and adolescents shifting from 1.9% to 6.8% respectively over the same time period. Changing these trends will require transforming behaviours and choices of both consumers and businesses. 
Improving the Indian food system will be key to transforming the current nutritional challenges that India is facing. 

GAIN’s contribution

GAIN has been working in India since 2003. For over 15 years, we have been working to encourage and promote the implementation of Large-Scale Food Fortification programmes. Moving forward, we wish to contribute to improving the food system in India by enhancing the quality of diets of the population at large, with a focus on addressing the micronutrient deficiencies of the most vulnerable. 

We work with a variety of partners – including the Government of India, state governments, civil society organisations, businesses, and development partners - to make healthier food choices more desirable, accessible and affordable and build a healthy society in India. 
 

Large-Scale Food Fortification

Since 2011, our Large-Scale Food Fortification projects in Rajasthan and Madhya Pradesh have promoted the fortification of wheat flour, edible oil, milk, and lentils. Through commercial channels and publicly-funded programmes, GAIN was able to reach large sections of the population, particularly the most vulnerable to malnutrition. We are currently expanding this work across 18 Indian States and union territories. By early 2019, our fortification projects in India had reached nearly 394 million people with at least one fortified staple. 

Better Diets for Children

Since 2016, GAIN has been facilitating the establishment and operationalisation of four decentralised units to produce and distribute fortified blended nutritious foods to approximately 65,000 people, including children, adolescent girls, and pregnant and lactating mothers in the Karnataka and Bihar States. This production model of complementary food - fortified with vitamins and minerals - has the potential to increase the coverage of fortified foods while positively influencing infant and young child feeding practices. 

Community-Based Management of Acute Malnutrition: POSHAN

GAIN supports the "Positive and Optimum care of children through a Social Household Approach for Nutrition" (POSHAN) programme in Rajasthan, the first large government-led programme for treatment of acutely malnourished children. So far, 17,366 children with severe and acute malnutrition were cured. The programme has achieved high recovery rates for children suffering from severe acute malnutrition and very low mortality rates.

Workforce Nutrition

The Workforce Nutrition programme in India aims to improve demand, access, and consumption of nutritious and safe foods by smallholders and workers in the tea supply chain. Implemented in partnership with tea estates and bought leaf factories, the first phase of the programme reached 43,297 workers and smallholders in Assam and Tamil Nadu. Currently, the second phase is being implemented in Assam to reach 6,000 tea estate workers.

Double Fortified Salt Evaluation Study

GAIN conducted a state-wide survey in Uttar Pradesh to assess nutrition status, specifically the prevalence of anaemia in preschool-aged children and women of reproductive age. This survey provided measures for anaemia and iron deficiency prior to the introduction of a double fortified salt distribution programme. Double-fortified salt delivers small but crucial daily amounts of iodine and iron. Proven to address iodine deficiency, this programme will help assess the effectiveness of fortifying salt to reduce anaemia.