Assessing maternal nutrition policy and programmatic landscape in India: a qualitative study
Sukirti Chandra1, Avilasha Ghosh2, Himani Sharma3
1Indian Institute of Public Health, Gandhinagar, Gujarat, India.
Introduction:
Maternal nutrition is fundamental to the health of mothers and children. Over the years, the Indian government introduced several programs and policies to support women's nutrition during pregnancy and improve maternal and child health outcomes. However, significant contextual differences remain in service provisions and access across states. This study explores expert perspectives on factors that impact the implementation and reach of maternal nutrition services in India.
Methods:
The study was conducted in two phases. The first phase consisted of contextual mapping through desk review of policy documents, government reports, published literature, and descriptive secondary data from NFHS-4 and NFHS-5 to map maternal nutrition indicators and provide contextual evidence. In the second phase, fifteen national- and state-level experts from across policy, implementation, and research fields were purposively selected for semi-structured interviews. Following this, interviews were transcribed, coded and analyzed using a reflexive thematic analysis.
Results:
The desk review indicated that maternal nutrition programs in India are implemented through multiple local and centralized institutions and show substantial variation across states. State-specific initiatives to strengthen maternal nutrition were identified in 35 of the 36 Indian states and union territories. Qualitative findings complemented the desk review. Thematic analysis of expert interviews indicated that despite numerous maternal nutrition programmes in effect in India, effective implementation was constrained by three interconnected mechanisms: weak governance and health system capacity to translate policy into consistent frontline practice; fragmented monitoring systems that limit routine, data-driven course correction; and sociocultural norms that impact household decision-making and the reach and acceptability of maternal nutrition services.
Discussion:
Experts emphasized that strengthening implementation within existing government programmes, rather than introducing additional schemes, is central to improving maternal nutrition services and, ultimately, maternal health outcomes in India.
Related Concept Videos
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
03:12Key Elements for Plant Nutrition
01:29Assessment of the Gastrointestinal System II: Health Perception Pattern
Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include:
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...