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In response to the COVID-19 pandemic, India implemented a stringent nationwide lockdown. Although food value chains and allied activities were exempted from the lockdown, there were widespread disruptions in food access and availability. Using two panel-datasets, we distinguish the pandemic's impact on non-staples versus staples in relation to household food availability and women’s diet diversity at the national, state, and district levels in four economically backward districts of Uttar Pradesh (Maharajganj), Bihar (Munger), and Odisha (Kandhamal and Kalahandi). Both the primary and secondary data indicate a decline in household food expenditures and women’s dietary diversity in May 2020 compared to May 2019, particularly for non-staples like meats, eggs, vegetables and fruits. This occurred despite special PDS, direct benefit transfer, and ration from aanganwadis rations reaching 80%, 50%, and 30% of surveyed households, respectively. While national and state-level expenditures recovered to the pre-lockdown levels by June 2020, the district-level expenditures did not recover. Our findings contribute to the growing body of evidence of women's disproportionate vulnerability to economic shocks, the impact of a staple grain focused safety net program, and restricted markets on the access and availability of diverse nutritious foods. This paper makes a case for policy reforms towards PDS diversification to include nutrition-rich foods and market reforms to remove supply-side bottlenecks and expansion of direct benefit transfers for healthy food access. We also highlight the importance of gender-responsive safety nets and their increased coverage for improving intrahousehold nutritional disadvantages.

This commentary analyses the recently launched National Family Health Survey (NFHS-5) (2019–2020) factsheet to investigate the claim of an open defecation free (ODF) India. The official data from Swachh Bharath Mission (SBM) was used to declare India ODF on 2 October 2019. The SBM statistics reported that India has achieved 100% sanitation coverage, that is, the fraction of households with access to individual household latrines (IHHLs). However, the NFHS-5 data shows that even though India witnessed an improvement in sanitation in the past four to five years, we are far from achieving universal elimination of open defecation. In an attempt to evaluate the differing claims made regarding India’s ODF status by two Government of India’s data sources, I explain the distinction in their objectives. While the SBM captures access to IHHLs, NFHS-5 records the place which the members of the household usually use for defecation. The two datasets jointly suggest that access to toilets does not concurrently translate to its usage. Hence, determining the ODF status of Indian communities on mere access to toilets is an inadequate representation of the sanitation environment. There is substantial merit in moving the sanitation outcomes from access to the adoption of toilets.

India hosts the highest number of malnourished children in the world. Tackling this challenge requires urgent implementation of targeted policies. However, the current research is not clear on which specific interventions the policymakers should undertake to yield the biggest improvement in child malnutrition in India. Hence, our study aims to contribute to the existing literature by using a novel regression decomposition technique, called the Shapley–Owen decomposition which can estimate the relative contribution of the factors influencing malnutrition. Using the NFHS-4 data, we classify the drivers of child undernutrition (besides age and gender) into different groups, such as infections and medicines, birth characteristics, food intake, child’s environment, mother’s anthropometry, her characteristics, environment, and socio-economic factors. The decomposition informs us that the child’s age and the mother’s anthropometry are the most important determinants of child height and weight outcomes (respectively). This means that access to adequate nutritional provision during the early years of the child’s life is critical to reducing the burden of malnutrition in India. Further, targeting young girls as the beneficiaries of the welfare schemes will improve their anthropometry, which will ensure healthier children in the future. Given the rising challenge of malnutrition in India, there has been a push to enhance investment in a combination of interventions that ensure optimal food intake, its absorption, adequate sanitation, betterment of maternal nutrition as well as education and access to social safety nets. It is in this context that our study is among the first to provide rigorous econometric analysis to determine which among these is the most important. Hence, this guides policymakers to the specific sectors they could target to improve the nutritional well-being of children in India. JEL Codes: C01, D69, I15, I30, O20, P46

Aims: The objective of this study was to assess the prevalence of overweight, obesity and abdominal obesity and their associated factors in a large sample of urban Indian schoolchildren. Methods: This is a cross-sectional study conducted in 5 cities in India. Height and weight were measured in 38,296 children and waist circumference was measured in 29,244 children aged 8–18 years. The prevalence was compared with respect to age, gender, type of school and city of residence. Results: The mean ± standard deviation for age was 13.3 ± 2.4 years and 18.3 ± 4.3 kg/m2 for BMI. The prevalence of overweight and obesity in 8- to 18-year-old children, respectively, was 14.4 and 2.8% by IOTF cutoffs, 14.5 and 4.8% by CDC cutoffs and 18.5 and 5.3% by WHO cutoffs. When applying the cutoffs specific for Indian ethnicity in 14- to 18-year-old children, the prevalence was higher (21.1 and 12.3%, respectively) as compared to the IOTF, WHO and CDC cutoffs. The overall prevalence of abdominal obesity in urban Indian schoolchildren was 4.5%. The prevalence of overweight and abdominal obesity was significantly higher in females than males (p < 0.001). High socioeconomic status and residing in cities with a population greater than 4 million were independently associated with overweight and abdominal obesity (p < 0.001). On extrapolating these data, more than 15 million children would currently be overweight and 4 million abdominally obese in urban India. Conclusions: There is a substantial burden of childhood obesity in India, which necessitates comprehensive urban-based campaigns for its prevention and control.

Increasing prevalence of childhood obesity calls for comprehensive and cost-effective educative measures in developing countries such as India. School-based educative programmes greatly influence children's behaviour towards healthy living. We aimed to evaluate the impact of a school-based health and nutritional education programme on knowledge and behaviour of urban Asian Indian school children. Benchmark assessment of parents and teachers was also done. We educated 40 196 children (aged 8–18 years), 25 000 parents and 1500 teachers about health, nutrition, physical activity, non-communicable diseases and healthy cooking practices in three cities of North India. A pre-tested questionnaire was used to assess randomly selected 3128 children, 2241 parents and 841 teachers before intervention and 2329 children after intervention. Low baseline knowledge and behaviour scores were reported in 75–94 % government and 48–78 % private school children, across all age groups. A small proportion of government school children gave correct answers about protein (14–17 %), carbohydrates (25–27 %) and saturated fats (18–32 %). Private school children, parents and teachers performed significantly better than government school subjects (P P P