Effective Global and National Strategies to Combat Undernutrition in Women and Girls

Undernutrition in women and girls is not just a health issue – it is a development crisis. When women are malnourished, the consequences ripple across generations, affecting their children’s growth, cognitive development, and long-term economic productivity. Globally, roughly 36 percent of pregnant mothers suffer from anaemia, largely due to iron deficiencies and poor diets. Recognizing this, international organizations and national governments have developed layered strategies – from global declarations to grassroots programmes – aimed at breaking the intergenerational cycle of malnutrition. This post traces the evolution of these strategies and examines how they work on the ground.

The early global commitments to food security 🔗

The fight against hunger and malnutrition has deep roots in international policy. The 1948 Universal Declaration of Human Rights was among the first global instruments to recognize the right to adequate food and nutrition as a fundamental human right. This laid the philosophical groundwork for all subsequent interventions.

A more targeted effort came with the 1974 World Food Conference, which produced the Universal Declaration on the Eradication of Hunger and Malnutrition. This declaration moved beyond recognizing food as a right – it called on governments and international agencies to develop concrete strategies, cooperate across borders, and prioritize the nutritional needs of vulnerable populations, including women and children. These early commitments set the stage for the goal-driven frameworks that would follow decades later.

Millennium Development Goals: linking nutrition with broader development 🔗

In September 2000, the United Nations Millennium Summit brought together world leaders who agreed on 8 specific goals with 18 measurable targets. Several of these goals directly or indirectly addressed undernutrition in women and girls.

MDG 1 aimed to eradicate extreme poverty and hunger, targeting a reduction in the proportion of people suffering from hunger. MDG 4 focused on reducing child mortality, an outcome closely tied to maternal and child nutrition. MDG 5 sought to improve maternal health – a goal impossible to achieve without addressing the nutritional status of mothers.

The MDGs made an important connection clear: well-nourished adolescent girls grow into healthier mothers, who are more likely to deliver healthy babies and raise well-nourished children. Malnutrition during pregnancy contributes to low birth weight, stunting, and increased child mortality. By placing hunger, child survival, and maternal health as interlinked goals, the MDGs elevated nutrition from a sectoral concern to a development priority.

What the MDGs achieved – and where they fell short 🔗

While the MDGs drove significant reductions in hunger globally between 2000 and 2015, critics noted that the framework’s focus on undernutrition was too narrow. It did not adequately address the “double burden” – where undernutrition and overweight coexist – or the specific nutritional needs of adolescent girls. These gaps informed the design of the next global framework.

Sustainable Development Goals: a broader, more ambitious agenda 🔗

In 2015, the United Nations adopted the Sustainable Development Goals (SDGs) as the successor to the MDGs, setting a 2030 deadline for transformative change. Several SDGs directly target malnutrition in women and girls.

SDG 2: Zero Hunger 🔗

SDG 2 aims to end hunger, achieve food security, improve nutrition, and promote sustainable agriculture. Its Target 2.2 specifically calls for ending all forms of malnutrition by 2030, including achieving internationally agreed targets on stunting and wasting in children under five. Critically, it explicitly mentions the need to address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons.

Progress has been mixed. According to recent UN data, an estimated 8.2 percent of the global population faced hunger in 2024, and projections suggest approximately 670 million people will still be facing hunger by 2030 – essentially the same proportion as in 2015.

SDG 3: Good health and well-being 🔗

SDG 3 targets reducing maternal mortality and ensuring universal access to reproductive healthcare. Since maternal malnutrition is a primary driver of complications during childbirth, achieving SDG 3 depends on improving the diets and nutritional status of women before, during, and after pregnancy.

SDG 5: Gender equality 🔗

SDG 5 recognizes that gender discrimination directly fuels nutritional inequality. In nearly two-thirds of countries, women are more likely than men to report food insecurity. When resources become scarce, gender norms often mean women and girls eat last and eat least. SDG 5’s focus on empowering women economically and socially is therefore essential for any lasting improvements in female nutrition.

UNICEF’s programmatic priorities for women’s nutrition 🔗

UNICEF has been a leading force in addressing maternal and adolescent malnutrition globally. Its Nutrition Strategy 2020-2030 outlines several programmatic priorities specifically targeting the nutrition of women and adolescent girls across the life cycle.

Priority 1: Improving women’s nutrition before pregnancy 🔗

UNICEF works to make nutritious foods more accessible and affordable for women even before they conceive. This includes supporting large-scale food fortification programmes – such as salt iodization and fortification of wheat flour, rice, and cooking oil with essential vitamins and minerals. Behaviour change communication campaigns promote nutritious diets and shift social norms around women’s food intake.

Priority 2: Enhancing nutrition during pregnancy 🔗

During pregnancy, energy and micronutrient needs increase significantly. UNICEF promotes micronutrient supplementation (iron and folic acid or multiple micronutrients), calcium supplementation, deworming, weight gain monitoring, physical activity, and adequate rest. Nutritional counselling during antenatal care visits helps women and their families make informed dietary choices. A full course of micronutrient tablets for an entire pregnancy costs approximately $2.20, making this one of the most cost-effective health interventions available.

Priority 3: Supporting breastfeeding mothers 🔗

UNICEF promotes healthy eating and continued micronutrient supplementation for breastfeeding women. Nutritional counselling and support during postnatal care visits help sustain breastfeeding practices, which benefit both mother and child.

Priority 4: Targeted support for adolescent mothers 🔗

Adolescent mothers face compounded nutritional risks – they are still growing themselves while nourishing a baby. UNICEF supports specialized counselling services, micronutrient supplementation, and balanced energy-protein supplements for pregnant adolescent girls and other nutritionally at-risk women.

Priority 5: Preventing obesity and overweight in women 🔗

Recognizing the double burden of malnutrition, UNICEF also advocates for policies that discourage consumption of ultra-processed foods and promote healthy dietary patterns. This includes working with governments on fiscal measures, food labelling regulations, and marketing restrictions.

In 2024, UNICEF launched the Improving Maternal Nutrition Acceleration Plan, targeting 16 million women across 16 countries with essential nutrition services. The plan focuses on countries with high prevalence of anaemia and low birth weight, aiming to deliver integrated packages of care through existing health systems.

India’s national interventions against undernutrition 🔗

India carries one of the world’s heaviest burdens of malnutrition, and has developed an extensive policy framework to address it. These initiatives combine direct nutritional support with systemic reforms.

National Nutrition Policy 1993 🔗

India’s National Nutrition Policy of 1993 established a two-pronged approach. Direct interventions included expanding maternal care and nutrition programmes, special attention to adolescent girls, and large-scale food fortification (such as iodization of salt and fortification of wheat flour). Indirect interventions focused on strengthening food security through the Public Distribution System (PDS), improving primary healthcare access, expanding safe water and sanitation infrastructure, and promoting nutrition education.

POSHAN Abhiyaan (National Nutrition Mission) 🔗

Launched on International Women’s Day in March 2018, the POSHAN Abhiyaan (Prime Minister’s Overarching Scheme for Holistic Nutrition) represents India’s most ambitious nutrition programme to date. It targets children aged 0-6 years, adolescent girls, pregnant women, and lactating mothers across all 36 states and union territories.

The mission operates through a four-pillar strategy:

Inter-sectoral convergence: The programme integrates services across health, education, agriculture, water and sanitation, rural development, and social protection sectors. It brings together multiple schemes – including the Integrated Child Development Services (ICDS), Pradhan Mantri Matru Vandana Yojana (PMMVY), and the Mid-Day Meal Scheme – under a unified umbrella.

Technology for real-time monitoring: The Poshan Tracker, a mobile phone-based application, helps over 1.4 million frontline Anganwadi Workers monitor the nutritional status of women and children. This replaced 11 paper-based registers previously used, enabling real-time service tracking and data-driven decision-making.

Intensified services for the first 1,000 days: The programme places special emphasis on the critical window from conception to the child’s second birthday. Anganwadi Workers conduct priority home visits during this period, providing nutritional counselling and monitoring growth.

Jan Andolan (People’s Movement): A nationwide awareness campaign designates September as National Nutrition Month (Poshan Maah) and organizes community-based events celebrating milestones like pregnancy and the introduction of complementary foods.

The results have been measurable. According to World Bank analysis, in the 11 focus states where implementation was closely tracked, child stunting decreased from 41% to 37% between 2015-16 and 2019-21, while wasting fell from 22% to 20%. National Family Health Survey (NFHS-5) data confirms broader improvements, with undernutrition declining from 35.7% to 32.1% and stunting improving from 38.4% to 35.5% nationally.

The programme has now evolved into Mission POSHAN 2.0, which further emphasizes diet diversity, food fortification, millet-based nutrition, and community-level nutri-gardens called Poshan Vatikas.

Direct intervention programmes in India 🔗

Beyond the overarching POSHAN framework, India runs several targeted programmes that deliver nutritional support directly to vulnerable women and girls.

Integrated Child Development Services (ICDS) 🔗

Operational since 1975, ICDS is one of the world’s largest programmes for early childhood care and maternal nutrition. It provides supplementary nutrition, pre-school education, immunization, health check-ups, referral services, and nutrition counselling through a network of Anganwadi centres. The scheme specifically bridges the gap between the Recommended Dietary Allowance (RDA) and the Average Daily Intake (ADI) for pregnant women, lactating mothers, and children aged 6 months to 6 years.

Iron and folic acid supplementation 🔗

Anaemia remains pervasive among Indian women and girls. The government’s iron-folic acid (IFA) supplementation programme distributes weekly iron and folic acid tablets to adolescent girls through schools and Anganwadi centres, and daily supplements to pregnant women during antenatal care. This is one of the most straightforward and cost-effective interventions for reducing anaemia and associated risks during pregnancy.

Pradhan Mantri Matru Vandana Yojana (PMMVY) 🔗

This maternity benefit scheme provides a cash transfer of ₹5,000 (in instalments) to pregnant and lactating mothers for the birth of their first child. The cash incentive compensates for wage loss during pregnancy and encourages women to seek proper rest, nutrition, and institutional healthcare services.

Mid-Day Meal Scheme 🔗

While primarily targeting school-age children, the Mid-Day Meal programme (now PM POSHAN) plays an important role in improving the nutritional status of adolescent girls. By providing a cooked meal during school hours, it ensures at least one nutritious meal per day and helps improve school attendance – a critical factor for girls’ long-term empowerment and nutritional awareness.

Scheme for Adolescent Girls (SABLA / SAG) 🔗

This programme specifically targets out-of-school adolescent girls aged 11-14 years. It provides supplementary nutrition, life skills education, health and hygiene awareness, and vocational training through Anganwadi centres. SABLA recognizes that addressing nutrition during adolescence is essential for breaking the cycle – a well-nourished adolescent girl is far more likely to become a healthy mother.

Why these interventions matter for the long term 🔗

The strategies described above – from the Universal Declaration of Human Rights to India’s POSHAN Abhiyaan – share a common understanding: undernutrition in women and girls is both a cause and a consequence of inequality. When a girl is malnourished in childhood, she is more likely to be stunted as an adolescent, anaemic during pregnancy, and unable to nourish her own children adequately. This creates a cycle that repeats across generations.

Effective interventions target multiple points in this cycle simultaneously. Global frameworks like the SDGs set direction and accountability. International organizations like UNICEF provide technical guidance and funding. National programmes deliver services on the ground – through frontline workers, supplementary nutrition, cash transfers, and food fortification.

The evidence suggests that when these layers work together – policy commitment at the top, technology and data in the middle, and community-level action at the base – meaningful progress is possible. India’s experience with POSHAN Abhiyaan, backed by over 10 crore registered beneficiaries and declining stunting rates, demonstrates what coordinated, multi-sectoral action can achieve – even in the face of enormous scale and complexity.

But challenges remain. The COVID-19 pandemic disrupted essential services, pushing millions into food insecurity. Climate change threatens food systems. And deeply entrenched gender norms continue to limit women’s access to nutritious food in many communities. Sustaining progress will require not just maintaining existing programmes, but adapting them to these evolving threats.

What do you think? Can technology-driven monitoring systems like India’s Poshan Tracker be a model for other developing countries tackling undernutrition? And how can global frameworks like the SDGs better hold governments accountable for improving women’s nutritional outcomes?

References

1. https://www.unicefusa.org/stories/unicef-launches-multi-country-push-improve-maternal-nutrition
2. https://www.un.org/sustainabledevelopment/hunger/
3. https://sdgs.un.org/goals/goal2
4. https://www.unwomen.org/en/news/in-focus/women-and-the-sdgs/sdg-2-zero-hunger
5. https://www.unicef.org/nutrition/maternal
6. https://www.unicef.org/nutrition/maternal-nutrition-acceleration-plan
7. https://www.pib.gov.in/PressReleasePage.aspx?PRID=1910409&reg=3&lang=2
8. https://www.worldbank.org/en/country/india/brief/transforming-india-s-nationwide-nutrition-program
9. https://www.ibef.org/government-schemes/mission-poshan
10. https://www.unicefusa.org/stories/inside-look-how-unicef-tackling-global-nutrition-crisis-women-and-girls
11. https://www.indiascienceandtechnology.gov.in/st-visions/national-mission/poshan-abhiyaan-national-nutrition-mission-nnm