The ingredient to turn around nutrition outcomes

The Hindu

16-05-2025

The analysis of India's free foodgrain programme for 800 million people underscores a grim reality: that hunger and malnutrition remain pressing concerns. Yet, in India's long battle against malnutrition, women and girls remain the most overlooked section. Despite steady economic progress and numerous welfare schemes, nutritional inequality continues to be deeply gendered. Launched in 2018 with the vision of a malnutrition-free India by 2022, the Prime Minister's Overarching Scheme for Holistic Nourishment (POSHAN) Abhiyaan has the aim of improving nutrition for pregnant women, lactating mothers, adolescent girls, and young children. However, stark disparities persist.
Structural failures
The National Family Health Survey (NFHS)-5 reveals that 57% of women in the age group 15 to 49 years are anaemic, in comparison to 26% of men; nearly one in five women are underweight. In other words, women are far more likely to be malnourished than men in India. These figures point to structural failures in how we address nutrition. Even after merging schemes into 'POSHAN 2.0' and investing heavily, the needle has not moved enough for women.
Indeed, POSHAN Abhiyaan is India's largest nutrition programme with a hefty budget. In 2022-23, the Ministry of Women and Child Development was allocated nearly ₹24,000 crore for Saksham Anganwadi and Poshan 2.0, but by December 2022, only 69% of those funds had been utilised. Despite such spending, the prevalence of anaemia among women actually rose from 53% to 57% between the last two NFHS rounds, and about 18.7% of women remain underweight.
This contrast suggests that just pumping in resources into a women-centric nutrition scheme is not enough. In many Indian households, especially the poorer ones, women's nutritional needs are literally last in line. Entrenched cultural norms often mean that when food is scarce, women and girls eat least and last. Thus, malnutrition is not just a biomedical or food-supply issue; it is a social justice issue. If a woman lacks economic independence or decision-making power, she may have little control over her diet and health. Even government data underscores this link: the NFHS-5 found that 49% of women lack decision-making power over how their own earnings are spent. This financial dependence often translates into compromised nutrition — a result of gender-based deprivation.
The issue of empowerment
Studies have shown that empowering women financially is one of the most effective ways to improve nutrition. Nobel laureate Esther Duflo, for instance, finds that when women control extra income, they are more likely to spend it on nutrition and children's well-being. In a study we conducted among low-income communities, we observed that women with even a modest independent income or control over household spending were far less likely to be undernourished.
The missing piece in India's nutrition puzzle is women's economic and social empowerment. The state of women's employment suggests that female labour force participation has risen from about 23% in 2017-18 to around 33% in 2021–22 — a positive shift on paper. But a vast majority of working women are in insecure, low-paying jobs. According to the Periodic Labour Force Surveys, as of 2021-22 only 5% of working women held a regular salaried job, while nearly 20% were self-employed (mostly in small-scale or informal activities). Moreover, self-employed women earned on average 53% less than men in similar work. In effect, many women who do work are barely earning enough to survive, employment has not yet translated into the power to make decisions or invest in their own nutrition and well-being.
Thus, it is not enough to get women into the workforce; the quality and security of their jobs matter just as much. Without skills training, equal pay, and access to stable employment, women remain economically vulnerable even when they work.
As a result, even well-intentioned nutrition programmes such as POSHAN will have limited impact if women cannot afford or are not empowered to consume the nutritious food being provided. Government reports praise Poshan Abhiyaan for creating awareness and a 'Jan Andolan' around nutrition, but awareness alone cannot fill an empty stomach.
Need for convergence
If POSHAN 2.0 aims to eliminate undernutrition, it should work in tandem with schemes that boost women's incomes and status. First, it must set measurable targets not just for reducing anaemia or stunting, but also for increasing the proportion of women with independent incomes and decision-making power. Second, it must break the silos, making sure that nutrition, health, and livelihood departments work together on joint interventions in high-malnutrition districts. Third, it must use Anganwadi centres and health workers to not only distribute food and supplements but also to connect women with skill training, credit schemes, or job opportunities. An Anganwadi can double as a one-stop hub for women's welfare (meals, antenatal care, financial literacy workshops).
Ultimately, a malnutrition-free India will be possible only when women are not seen as passive beneficiaries of nutrition schemes but as active agents driving the health and the prosperity of their families.
Divya Bharti is a Researcher and Faculty Associate, KIIT School of Management