Table 2

Adapted from Indian National Nutrition Strategy guiding principles11

A life cycle approachRecognising that there is an intergenerational cycle of undernutrition, as described in the situation analysis, a life cycle approach will be adopted, with a focus on critical periods of nutritional vulnerability and opportunity for enhancing human development potential.
Early preventative actionRecognising that growth and development deficits that compromise child health and survival and achievement of optimal learning outcomes are cumulative and largely irreversible—there will be emphasis on preventing under nutrition, as early as possible, across the life cycle.
Inclusive and gender sensitiveIt will be rooted in a rights-based framework that seeks to promote the rights of women and children to survival, development, protection and participation—without discrimination. In this, strategies for ensuring social inclusion of marginalised community groups will be pursued—recognising that nutritional vulnerability is compounded by multiple deprivations—based on socioeconomic status, high burden of disease, natural factors such as floods/droughts and/or other conditions such as lack of access to services. Efforts will focus on reaching the most vulnerable and deprived.
Community empowerment and ownershipFamilies and communities will be enabled for improved care behaviours and nutrition of children and women, to demand quality services, to contribute to increased service utilisation and to participate in community-based monitoring.
Valuing, recognising and enhancing the contribution of anganwadi workers, helpers and ASHAsThe approach will be to improve the working conditions, skills, development pathways and motivation of Anganwadi (nutrition) workers, helpers and also Accredited Social Health Activists—a frontline team of over 3.3 million women from the local community covering 1.34 million habitations across the country—recognising that they are prime movers of social change.
Decentralisation and flexibilityContextually relevant, decentralised approaches will be promoted, with greater flexibility at state, district and local levels for greater and sustained programme effectiveness and impact, in harmony with the approach of cooperative federalism. This will also enable utilisation of opportunities provided by the recommendations of the 14th Finance Commission with greater devolution of resources to states- mobilising and catalysing state resources and action for nutrition.
Ownership of Panchayati Raj institutions and urban local bodiesStrengthening the ownership of Panchayati Raj (village level governance) institutions and urban local bodies is a key principle—to ensure that local self-governments own, promote, monitor and sustain nutrition initiatives—effecting convergence of action at the grass roots. This is essential as the subjects allocated in the 73rd Amendment include those addressing the immediate and underlying determinants of undernutrition such as health and sanitation, family welfare, drinking water, women and child development, public distribution systems, agriculture, education, poverty alleviation and social welfare, among others. This is even more relevant in the light of the 14th Finance Commission Recommendations.
Foster innovationInnovation will be encouraged and recognised—including through quality circles which encourage a cluster of frontline teams to identify best practices and replicate the same—with a ripple effect and widening of the innovation. Best practices will be identified and local adaptation and replication or scaling up encouraged.
Informed by science and evidenceProgramme strategies will be evidence based, informed by the state of the science (as well as by the state of the practice) and updated as new evidence emerges related to nutrition, health and development.
Ensure that there is no conflict of interestAn underlying principle of action is that policy development and programme implementation must be transparent, open to public scrutiny and kept free from conflict of interest, with requisite safeguards. (This includes ensuring that representation on policy, technical advisory groups and various management committees at different levels is free from conflict of interest.)