Undernutrition remains a significant global health challenge. The World Health Organization (WHO) states that nearly half of all deaths among children under five are due to undernutrition. In 2022, it was estimated that worldwide, 390 million children were underweight. Stunting and wasting continue to jeopardize children’s health. These conditions, combined with micronutrient deficiencies, lead to an estimated 3.1 million child deaths annually (UNICEF, WHO, World Bank).

In Kerala, NFHS-5 (2020) data highlights a concerning rise in undernutrition. Wayanad faces severe nutritional challenges, particularly among its tribal population. Stunting increased from 27.7% to 31.3% between 2016 and 2020, signaling deep-rooted issues linked to food insecurity, parental illiteracy, and limited healthcare access (Philip et al., 2015). A study conducted by the NGO United Way Bengaluru (UWBe) in 26 Anganwadi centers in Wayanad further confirmed high rates of stunting and underweight, reinforcing the urgent need for targeted nutritional interventions.

Wayanad, a scenic district nestled in Kerala’s Western Ghats, is famous for its lush landscapes and rich biodiversity. It is also listed as an Aspirational District under the NITI Aayog framework.

The Noolpuzha Gram Panchayat, which has the second-largest tribal population in Kerala, presented a unique challenge. Many tribal families had irregular access to cooked meals, which directly contributed to undernutrition and anemia among mothers and children. The rise in undernutrition, especially among children in tribal communities, has prompted intervention strategies aimed at improving nutritional outcomes and reducing health disparities.

Under United Way Bengaluru's (UWBe’s) "Rural Rising" initiative, interventions were implemented to improve the nutritional status of children in Noolpuzha. The program, in collaboration with the Women and Child Development (WCD) Department, CSR partners, and the support of the District Administration, introduced the 'Cooked Meal'/’Nutrition Initiative’ intervention, particularly focusing on children aged 3-6 years, an age group highly susceptible to undernutrition. The intervention included the provision of locally sourced, culturally aligned, and nutritionally balanced meals designed by the district nutritionist as per the Recommended Dietary Allowance. This was a landmark initiative in demonstrating effective Public-Private-Partnership (PPP) in the development of communities. The initiative received SABERA (Social and Business Enterprise Responsible Awards) appreciation for bringing an integrated behavioral change model towards addressing undernutrition among tribal children in Wayanad, implementing a cooked-meal initiative through Anganwadi Centres.

A Collaboration-led Intervention

The nutrition initiative followed a multi-pronged strategy to address the challenges and is a part of a broader vision that includes interventions in education, health, and livelihood, aiming to break the cycles of poverty and undernutrition in rural communities.

The intervention, structured in three key phases, first, began with upgrading the infrastructure of Anganwadi Centers (AWCs) to create child-friendly environments. These improvements included providing nutritious meals six days a week, in alignment with the Integrated Child Development Services (ICDS) program. The second step involved employing nutrition promoters - local community members who were trained to engage with families, raise awareness about nutrition, and encourage healthier cooking habits. Third, it included the establishment of community-based initiatives like the demonstrative kitchens/Co-Active Kitchens for Enrichment (CAKE), where mothers could observe and practice preparing nutritious meals together in a supportive environment. By empowering families, especially mothers, to take an active role in improving their children's nutrition, the intervention sought to create lasting behavioral changes. The program used a holistic approach, fostering bottom-up change where local communities could take charge of their health and development.

Observations and Outcomes

A crucial aspect was an emphasis on changing long-standing behaviors regarding nutrition. The intervention introduced the children to tasty, nutritious meals, which would encourage regular attendance at the Anganwadi centers. Over time, mothers were educated on the importance of cooking balanced meals at home, and the program aimed to make the meals both affordable and easy to prepare. Nutrition promoters played a vital role in influencing mothers' behavior. By conducting home visits and offering personalized advice, these promoters helped raise awareness about the impact of nutrition on children’s health. They also facilitated better tracking of the children's nutritional growth and improved overall community engagement. The ICDS department in Wayanad district has played an important role in co-creating the program. Their timely input and involvement in every phase of the initiative have made a huge difference in the positive outcomes.

Mothers began to see significant improvements in their children's health, which motivated them to continue cooking nutritious meals at home. Multiple instances were observed of children insisting that their mothers prepare the meals that they regularly enjoy at the Anganwadi centre, resulting in mothers learning these recipes at the CAKE events and putting in efforts to prepare them at home. This simple, yet powerful, change illustrated the profound impact on both children and mothers.

With the successful implementation of 400 co-active kitchens, the program has directly impacted over 700 children. Over 21 months, there was a 61% increase in the children in the normal nutrition category and a 47% reduction in children suffering from protein-energy malnutrition.

Additionally, a social return on investment (SROI) study revealed that for every rupee invested in the initiative, there is a return of INR 7.4, demonstrating that the provision of nutritious meals in Anganwadi centres generated substantial benefits for children’s health and development relative to the investment.

Sustaining the Impact: Scaling Up and Replicating Success

The partnership between the Government of Kerala, UWBe, CSR partners, and local communities has demonstrated the power of collaboration. The initiative’s success in improving children’s health and community participation highlights its potential for replication and scalability, contributing to the broader goal of sustainable rural development. The Gram Panchayat of Noolpuzha, acknowledging the initiative’s impact, has committed to sustaining it beyond the CSR phase. The local government has incorporated funding for the initiative into its 2025-26 fiscal budget, ensuring its continuation and scalability. The ‘Nutrition Initiative' program serves as a model for similar interventions in other regions of Kerala, with the scope to expand to Pan India. We invite like-minded people, organizations, corporates, philanthropists, and foundations to contribute and help scale this initiative.