Andhra Pradesh and Tamil Nadu
Nutrition and Mortality Outcomes
Poverty and Nutrition
Food Consumption and Nutrition
The Political Economy of Nutrition
Resource Allocation for Nutrition
WHY NUTRITION IMPROVES
ABBREVIATIONS OF A.P. DISTRICTS (USED IN FIGURES)
ANNEX: NATIONAL INSTITUTE OF NUTRITION
Meera Shekar, Prahlad Rao, Stuart Gillespie and Vinodini Reddy
MAP 1: States of India
MAP 2: Andhra Pradesh (population in thousands, 1991)
MAP 3: Tamil Nadu (population in thousands, 1991)
This is one of the six country studies within the ACC/SCN Country Review of Nutrition-relevant Actions series carried out in selected developing countries. Part I of this paper Nutrition Assessment and Analysis in India tracks the changes in the nutritional profile in India over the last two decades. Part II here reviews nutrition-relevant actions in order to investigate potential reasons for the observed nutritional improvement. Given the size of the Indian continent and the diversity in nutritional profiles across the twenty five states in the country, this review is limited to two states - Andhra Pradesh and Tamil Nadu. Such a state-level focus is particularly relevant in view of the two-tier system of governance in the country (i.e the Centre and the State) creating a near-unique political and economic environment in each state.
Discussion of nutritional influences is encompassed here within the general framework that incorporates three pre-conditions for adequate nutrition - household food security, adequate health services and environment and adequate maternal and child care (see UNICEF 1991, Gillespie and Mason 1991). Within this, interventions in the field of nutrition, health, education, family welfare, agriculture, income-generation and employment are all encompassed within the scope of "nutrition-relevant actions". This review focuses on three types of actions - nutrition interventions, food interventions and poverty alleviation programmes - and broadly traces their effects on nutritional outcomes through their influences on these three preconditions. Nutrition interventions, as defined here, include (among other inputs) supplementary feeding, nutrient-supplementation and information-education-communication (IEC) components. We discuss the Integrated Child Development Services (ICDS), the Tamil Nadu Integrated Nutrition Programme (TINP), the Midday Meals Programme (MDM), the Vitamin A Prophylaxis Programme and the Anaemia Prophylaxis Programme in this section. One main food intervention is described - the Public Distribution System (PDS), which has a hidden or implicit nutritional objective in its aim to improve household food security. Poverty alleviation programmes focus on employment, income generation and/or income redistribution. We discuss an asset endowment programme - the Integrated Rural Development Programme (IRDP) and a wage-based one - the National Rural Employment Programme (NREP) in the latter section of this report.
Since many of the nutrition-relevant actions are conceived and designed nationally, wherever possible each intervention is discussed at a general design level, and subsequently complemented with more specific state-level information on coverage, implementation and quality control/evaluation.