The Lancet series shows that there are proven effective interventions to reduce stunting and micronutrient deficiency. Among the most effective measures listed are breastfeeding, Vitamin A supplements and fortification. For maternal nutrition, it is iron, folic acid and calcium supplements. The series says immunisation of pregnant women may have a larger impact compared to a school-meal programme.

In India, not only is the reach poor but also there is complete lack of clarity on how and what to give as supplementary nutrition. For years, the debate has been whether these children should be provided hot cooked meals or micronutrients in a packet. The commissioners have often written to the government complaining about how the entire supply of food had passed into the hands of private contractors. They not only supply ready-to-eat food powders that were not only culturally inappropriate and calorifically inadequate, but in many cases never reached the ICDS centre at all.

Most of these debates are a part of Supreme Court hearings on the issue. The court had passed an order in 2006, saying every child, adolescent girl and pregnant woman should be covered under the programme. It also asked the government to provide an aanganwadi centre in every habitation. This would translate into 14 lakh aanganwadi centres. Two years later, four lakh centres are yet to be sanctioned. The ones sanctioned last year exist only on paper.

The Lancet study points out that there are no technological silver bullets to solve the problem of undernutrition. Long-term investments are a prerequisite. While no one in the government would disagree with this, the money does not match their verbal pledges. If every child under six in 14 lakh aanganwadis has to be covered, the government will have to increase its budgetary allocation to the programme by 71 per cent. The government is spending less than a rupee on every child when it should be spending Rs 2.

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