Private Sector Interventions In Malnutrition: What You Can Learn From The Azim Premji Philanthropic Initiative

G. Ananthapadmanabhan (Ananth) is the Chief Executive Officer of Azim Premji Philanthropic Initiatives (APPI), a grant making arm of Mr. Premji’s efforts to contribute to a just, equitable, sustainable and humane society. Ananth was earlier the Chief Executive of the Nobel Prize winning global Human Rights watchdog Amnesty International in India. Ananth graduated in 1988 from IIT Madras with a B Tech in Electrical Engineering.

BW Sustainability has developed a series on nutrition and malnutrition as part of its focus on the Sustainable Development Goals (SDG's). Our Sustainability editor Neeta Misra interviews Ananth Padman the CEO of the Azim Premji Philanthropic Initiative (APPI) on this issue.

Why does India face such a persistent problem around malnutrition? 

In recent times, there has been more focus in India on the economic aspects of development. However, malnutrition is a problem that goes beyond economics and poverty. Malnutrition is a complex problem which is a combination of social and biological factors like poor dietary habits, social norms that affect nutritional intake of food by women and girls, early marriage of girls, incorrect child rearing practices and lack of adequate knowledge on disease management among children. Hence, there needs to be a system’s approach to solve this problem.

Currently, the system is unable to tackle the malnutrition problem effectively since, what is a multi-faceted problem is sought to be tackled in silos by a few government departments.  

Though there are existing systems like the ICDS to tackle malnutrition at the community level - there is a scope to improve their service delivery. For example, there is a need to reduce the huge burden on frontline functionaries of ICDS on not just delivering services but also reporting on them.  

Finally, there is a tendency to locate malnutrition in a medical context rather than view it  as a  citizenship and rights issue that requires better access to entitlements through improved service delivery.

How are different states responding to this issue? 

Recognizing the multiple determinants of malnutrition, it is encouraging to see that many Indian states have now undertaken multi-sectoral responses to tackle this problem.

Kerala presents a perfect example of how improvement in wide range of social determinants like female education, age at marriage and WASH practices has led to reduction in malnutrition.

Maharashtra is another state which has been able to successfully implement multi-stakeholder response to the persistent problem of undernutrition by instituting Rajmata-Jijau Mother-Child Health and Nutrition Mission. Recent data and studies suggest that the state of Maharashtra was able to reduce child stunting at an accelerated pace majorly because of improvements across a wide range of determinants; and because of sustained action from the government and civil society over a period of more than 10 years.

On similar lines, State Nutrition Missions have also been recently set up in Uttar Pradesh, Jharkhand and Karnataka.

How is your (APPI) approach in Odisha different to what has been tried before and what do you hope to achieve by 2030? 

APPI’s aim is to reduce stunting in Odisha so as to enhance the health of generations, present and future. We hope to strengthen better reach and coverage of Health, Nutrition, Water and Sanitation (HNWASH) services as also, Agriculture, Livelihoods, Animal Husbandry and Fisheries while empowering deprived communities to access their benefits and entitlements.

With an overall goal of supporting Odisha to achieve World Health Assembly targets related to undernutrition by 2025 and Sustainable Development Goals by 2030.

Convergence: As part of our efforts we have brought together various nutrition specific and nutrition sensitive government departments to commit to addressing malnutrition through the Odisha Multi-sectoral Nutrition Action Plan. Nutrition therefore has moved beyond being merely an agenda of the WCD and the Health Departments.

System Strengthening: Additionally, APPI is working closely with the Govt of Odisha to strengthen the existing systems – mainly the ICDS which is the key program that reaches out to mothers and children. Throughout our programming, we are focusing on the 1000 day window –that is from conception till the child is nearly two years old. This is a critical period which if not attended to can result in irreversible cognitive damage to the young child.

Mainstreaming: Besides, the above, we are also demonstrating innovative models through grants to NGOS that can be scaled up and mainstreamed through the government systems.

Through all this we at APPI are trying to bring together government, NGOs and academic institutions together to solve for the problem of malnutrition.

What is the future of nutrition in India and the role of the private sector in achieving this?

In India – Malnutrition must be acknowledged as a multifaceted problem that requires a multi sectoral intervention. The National Nutrition Mission is a good example of a serious multi-sectoral effort taken by the government towards addressing it. Nutrition must remain the accountability of the state.

Private sector players and philanthropies can work closely with the government by forging long-term partnerships to support technological innovations, working closely with the government systems to improve the quality of service delivery, investing in infrastructure.