The Policy Process of Increasing Micronutrient Programming in India
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Deficiencies of micronutrients—particularly iron, iodine, vitamin A, zinc, and folic acid—wreak havoc on survival, health, and productivity around the world. Micronutrient deficiencies are often called “hidden hunger” because they do not manifest themselves in immediate physical signs but are insidious in causing disease. They are particularly problematic in India because of the sheer numbers of people affected: 35 percent of the world’s malnourished children live in India, and 42 percent of children in India are stunted. The Indian government has not met its current goals related to reducing micronutrient deficiencies. In order to increase the profile of programs aimed at eliminating micronutrient deficiencies on the policy agenda, the Micronutrient Initiative (an international nongovernmental organization, or NGO), created an India Micronutrient National Investment Plan (IMNIP), which laid out the rationale and costs for addressing the problems. This plan has been well received and appears to have significantly influenced likely funding allocations to micronutrient programs. Several features of the process by which the IMNIP was conceptualized, written, shared, and used were essential to influencing the national policy process; these features include relevancy, timing, stakeholder involvement, information, publicity, leadership, and saliency. The IMNIP has clearly addressed questions of why and when micronutrient programs should be increased, and it has made plausible suggestions concerning what programs best tackle the problems and how they should be carried out. It is debatable who should be responsible for planning, funding, carrying out, and monitoring micronutrient programs; possible parties include the national government, state governments, NGOs, and the private sector. A take-home message is that policy decisions are often ambiguous and that debate about the best way to administer policy continues even after policies or budgets are passed. As a staff member of an NGO that provides nutrition programming consulting, your assignment is to recommend to the Government of India how to address remaining questions about implementation, funding, monitoring, and enforcement of the micronutrient programs and to try to make sure the government takes note of your recommendations.
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