A New Approach to Fighting Child Malnutrition in India

By Knowledge@Wharton | August 31, 2014

India’s demographic dividend is often touted as one of the country’s strengths. More than half of its 1.2 billion population is younger than 25. In the coming decades, India is expected to be one of the few countries where the working population will exceed the number of retirees. Even so, India is struggling with a huge problem: The country has the world’s largest population of malnourished children. Each day, some 1,500 children die of malnutrition. A government report titled, Children in India 2012 — A Statistical Appraisal notes that “48% of children under age five years are stunted … which indicates that half of the country’s children are chronically malnourished.” According to UNICEF, one in three malnourished children in the world is Indian. It is estimated that reducing malnutrition could add some 3% to India’s GDP.

The Indian government has been trying to address this problem through its Integrated Child Development Services (ICDS) program. Launched in 1975, the ICDS operates a network of daycare centers called anganwadis across the country. These centers are meant to provide supplementary breakfast and lunch, along with immunizations and pre-school education, to children ages 3-6, and cater to the health needs of pregnant and lactating women. Anganwadi workers are also responsible for going door-to-door to counsel mothers with infants aged less than three years. Some 1.33 million anganwadi centers sprawl across India; each typically caters to 30 children.

The anganwadi programis estimated to be the world’s largest child nutrition provider. But, as the state of malnourishment in India shows, the anganwadis themselves need a shot in the arm. That is what Indian Impact, an online platform that focuses exclusively on malnutrition, is looking to provide. Launched in November last year, the Hyderabad-based nonprofit has a two-pronged approach. It offers individuals and corporations an easy way to help improve their nearest anganwadi center, and supports NGOs that are working to reduce malnutrition.

Bridging the Gap

Indian Impact lists the anganwadis in a given area and a checklist of essential items that each center needs. Individuals or businesses can go to the Indian Impact website, locate their nearest anganwadi center, see what it needs and make donations (only in kind) directly to the centers. Donors are required to share the details of their donations with Indian Impact so that members and volunteers can ensure that the donated items are used for the benefit of the children and not pilfered.

Donors registered with Indian Impact can also adopt anganwadi centers and fulfill all of their requirements. In addition, Indian Impact has partnered with the Akshaya Patra Foundation, which runs centralized kitchens and distributes nutritious meals to government schools. Organizations can partner with Akshaya Patra through Indian Impact to distribute meals to their adopted anganwadi centers. At present, anganwadis listed by Indian Impact are limited to Hyderabad. In a year, once it has sufficient understanding of this space, Indian Impact plans to expand beyond Hyderabad to other cities and states. Indian Impact has obtained formal approval for anganwadi adoption from the state government’s department of women development and child welfare in Andhra Pradesh. Once it expands to other states, the organization plans to get approvals from other state governments as well.

“What we are providing is a go-to-market platform that gives instant results as well as significant outreach.” –Ridhima Parvathaneni

Indian Impact also selects and lists on its website reputed NGOs that are doing effective and innovative work to reduce malnutrition, but need funds and manpower in order to scale. Individuals and corporations can donate funds or volunteer their services for any of these projects. NGOs are required to send regular status reports to their donors and also provide proof of utilization to the Indian Impact team.

“We are providing a go-to-market platform that gives instant results, as well as significant outreach,” says Ridhima Parvathaneni, president of Indian Impact. Parvathaneni first thought of working in the sector during her last year at college in March 2013 when she read an article on the alarming levels of malnutrition in India. She wanted to develop “an innovative solution to generate awareness (about malnutrition) and to bridge the crucial gap between those who want to help and those who are in dire need of that help.”

She put together a six-person leadership team with capabilities in different areas, including strategy, research, marketing, branding and web-development, and launched Indian Impact that November. Apart from this core team of six, who are involved with the strategy and creative aspects of the organization, Indian Impact has a monitoring team of 20.

Parvathaneni has also involved her family business, the Seaways Group — one of the largest shipping and logistics conglomerates in India — where she heads new business initiatives, to fund Indian Impact as part of its corporate social responsibility. “One could have chosen the traditional NGO approach, where you work on the ground in a specific locality,” she notes. “But the impact (would be) limited. The situation calls for a solution that will accelerate and magnify the rate of malnutrition reduction. Such a compounding effect is possible through our technological platform.”

Partnering for a Cause

Nilam Sawhney, principal secretary at the department for women, children, disabled and senior citizens for the government of Andhra Pradesh, is upbeat about the initiative. The department has formed a committee to assist firms adopting anganwadis through Indian Impact to help expedite the process, and also track adoption and the consequent improvement. According to Sawhney, this collaboration between her department, Indian Impact and corporations in India “will help create model anganwadis” that can be replicated across the region “for higher efficiency and success rate in reducing malnutrition.”

Devika Deshmukh, program director for child health and nutrition at SNEHA, a Mumbai-based NGO that works at reducing malnutrition in urban slums and is listed on Indian Impact’s website, says that Indian Impact is “a step in the right direction.” SNEHA’s experience, she adds, has shown that issues such as “poor newborn care, suboptimal infant and young child feeding practices, lack of access to and poor functioning of the public health care systems, and exclusion of children aged less than 36 months from ICDS anganwadis” are some of the factors that lead to child malnutrition in India. “At SNEHA, we realize that there is a need for joint collaboration with the government, NGOs and other private bodies. We work closely with ICDS and we see the positive impacts of such partnerships.” According to Deshmukh, apart from raising money, Indian Impact needs to evolve into a knowledge and information center for all malnutrition-related information. “Indian Impact can help advocate our model in other metro slums,” she notes.

Indian Impact has benefited hugely from the support of corporate stalwarts and philanthropists Ratan Tata and G.M. Rao. The duo helped launch the initiative, giving it high visibility. Both the Tata Trust and GMR Group’s Varalakshmi Foundation have been working in the area of malnutrition and Indian Impact hopes to leverage their experience. The Varalakshmi Foundation, for instance, supports 180 anganwadis by providing infrastructure, teachers and teaching methodologies.

According to Rao, it is important for Parvathaneni and her team to understand the dynamics of the anganwadi system and why it has failed to deliver. Speaking at the launch, he noted that the anganwadi program is “highly politicized and highly unionized.” Pointing out that “in most of the states, the anganwadi jobs are auctioned,” Rao cautioned: “The union will not brook any interference. You have to be very careful.” Tata added: “Other than identifying what needs to be done, Indian Impact must get more deeply involved in the implementation of the solution.”

Leveraging Business Competencies

Ratnaja Gogula, professor of marketing and strategy at the ICFAI Business School in Hyderabad, says the key strength of the Indian Impact model is in encouraging businesses, NGOs and citizens “to get involved hands-on in resolving basic issues faced by anganwadi centers.” But, while this is “commendable,” it could be “diminutive and time-(consuming) to address the enormous problem of child malnutrition.” Gogula suggests that in order to make a significant impact, “Indian Impact should pick some of the programmatic and operational issues faced by ICDS and devise them as CSR projects that appropriately tie in with the business competencies of corporations.”

Gogula points to a 2011 report titled, Broad Framework of Implementation for a Restructured ICDS by an inter-ministerial group (IMG). Some of the programmatic and operational gaps in the ICDS identified by the IMG include inadequate convergence of programs and services, and weak linkages with public health system; poor data management, information system, analysis and reporting; inadequate and inappropriate training; non revision and indexation of cost to rising prices of food, fuel and transportation; an inefficient fund transfer mechanism, and inadequate monitoring systems. The key challenge for the Indian Impact team, Gogula says, is to “identify companies and NGOs that can … contribute to resolving the issues faced by ICDS and bring them on board.”

Creating a website “is easy. Attracting people to it is the difficult part,” says Dhaval Udani, CEO of Give India, a donation platform that lists 200 NGOs in diverse areas like child welfare, education and women’s empowerment. Commenting on Indian Impact’s single point agenda of reducing malnutrition as compared to GiveIndia’s multi-pronged approach, Udani says: “The pros are that you can focus more on a specific cause and drill down deeper in terms of projects (and their) impact, and provide more specific information related to the cause itself…. The obvious con is that it loses out on people not interested in the specific area of work.”

Multi-pronged Approach

To attract people to its cause, Indian Impact is banking on multiple initiatives. For instance, in order to reach out to the student community it is partnering with schools and colleges so that each school/college elects some students as brand ambassadors for Indian Impact. To give a boost to its anganwadi adoption program, the organization is in talks with various corporations. Indian Impact is also looking to establish mutually beneficial partnerships. September, an accessory label, has created a limited edition collection of footwear for Indian Impact called the ‘Good Soul Collection.’ A fixed percentage of the sales from the limited edition goes to Indian Impact.

Users of Uber in Hyderabad have the option to contribute a fixed percentage of their ride’s sales to Indian Impact. On specific dates, Uber users can hand over their contributions for anganwadis to the Uber drivers, who in turn drop it off at the Indian Impact office. “Such convenience increases donations for Indian Impact and also makes citizens aware of the Uber experience,” says Parvathaneni. She also has plans to merchandise certain products such as hand sanitizers, cell phone wipes and bags under the Indian Impact brand to add to the revenue stream.

So far, more than 380 anganwadis have been adopted by individuals, businesses and schools. Around 2,500 peoplehave signed up for teaching at the anganwadis and over 2,000 for donating meals. Parvathaneni hopes to increase the numbers steadily over time. But more important is the impact they create, she says.

“Every anganwadi uses a color-based chart, wherein if a child measures low in a certain set of measurements every month, he/she is placed in red (acutely malnourished), or orange (moderately malnourished) and so on,” says Parvathaneni. “So our first step would be to see on a monthly basis, the number of reductions in the ‘red’ zone. Or how many children have dropped from orange to yellow.” Using a computerized model, Indian Impact plans to identify common trends that cause these reductions and standardize and replicate them across different centers. “We believe that having robust standard operating procedures will help us scale and make a significant impact,” she notes.