Contents -- Figures, Tables, and Boxes -- Foreword -- Acknowledgments -- Acronyms -- Overview -- 1. Dimensions of Child Undernutrition in India -- Why Invest in Combating Undernutrition? -- Prevalence of Underweight -- Prevalence of Micronutrient Deficiencies -- Will India Meet the Nutrition MDG? -- Conclusions -- 2. The Integrated Child Development Services Program: Are Results Meeting Expectations? -- How ICDS Aims to Address the Causes of Persistent Undernutrition -- Empirical Findings on the Impact of ICDS -- Targeting of ICDS Program and Beneficiaries -- Characteristics and Quality of ICDS Service Delivery -- Monitoring and Evaluation -- Lessons from Successful Innovations -- 3. Enhancing the Impact of ICDS? -- Mismatches between Program Design and Implementation -- How Can ICDS Reach Its Full Potential? -- Next Steps: Rationalizing Design and Improving Implementation -- Appendix: Additional Figures and Tables -- Notes -- Bibliography -- Figures -- 1.1 The weight-for-age distribution of children under 3 in India compares unfavorably with the global distribution -- 1.2 The prevalence of undernutrition in children under 3 fell modestly in India,1992 and 1998 -- 1.3 The prevalence of underweight and stunting among children under 5 in rural India fell between the mid-1970s and the late 1990s -- 1.4 In terms of underweight, India compares poorly with other countries at similar levels of economic development -- 1.5 Girls whose families are poor, belong to a scheduled tribe or caste, live in a rural area, and are at risk of being under -- 1.6 By the age of 2, most of the damage from undernourishment has been done -- 1.7 Demographic and socioeconomic variation in prevalence of underweight children under 3, 1992/93-1998/99 -- 1.8 In 1998/99, more than half of all underweight children in India lived in just one-quarter of all villages and districts.

1.9 Urban-rural disparities in underweight among children, by state, 1992/93-1998/99 -- 1.10 Change in prevalence of underweight, by wealth tertile and state, 1992-8 -- 1.11 Trends in prevalence of iron deficiency in preschool children, by world region, 1990, 1995, and 2000 -- 1.12 Prevalence of anemia among children 6-35 months and women of reproductive age, by demographic and socioeconomic characte -- 1.13 Changes in prevalence of subclinical Vitamin A deficiency among children under 6, by world region, 1990, 1995, and 2000 -- 1.14 Proportion of children experiencing daytime and nighttime vision difficulties -- 1.15 Prevalence and number of iodine deficiency disorders in the general population, by world region and country -- 1.16 Predicted prevalence of underweight under different economic growth scenarios, 2002-15 -- 1.17 Projected percentage of children under 3 in poor states who are underweight, under different intervention scenarios, 199 -- 2.1 Causes of child malnutrition -- 2.2 The percentage of children 6 months to 6 years enrolled in the supplementary nutrition program, 2002, varies widely acros -- 2.3 ICDS coverage is higher in states with higher per capita net domestic product -- 2.4 In many states in which the prevalence of underweight is high, the proportion of villages with anganwadi centers is low -- 2.5 Fewer children are enrolled in ICDS in states in which the prevalence of underweight is high -- 2.6 Public expenditure by state and national governments is very low in states in which the prevalence of underweight is very high -- 2.7 Older children are more likely than younger children to attend an anganwadi center -- 2.8 The caste and tribe composition of children attending anganwadi centers varies somewhat across states -- 2.9 The percentage of children who attend anganwadi centers varies only slightly across wealth quintiles.

2.10 Attendance at anganwadi centers varies widely both across and within states -- 2.11 Percentage of anganwadi centers with growth-monitoring equipment in place -- Tables -- 1.1 Prevalence of micronutrient deficiencies in selected countries in South Asia (percent except where indicated otherwise) -- 1.2 Estimated productivity losses due to malnutrition in India -- 1.3 Percentage of children suffering from underweight, stunting, and wasting, by world region, 2000 -- 1.4 Prevalence of underweight and severe underweight in children under 3, by demographic and socioeconomic group, 1992/93-199 -- 1.5 Prevalence of underweight, 1992/93 and 1998/99, by state -- 1.6 Classification of states by change in gender differentials in prevalence of underweight -- 1.7 Wealth disparities in the change in underweight prevalence, by state, 1992/93 and 1998/99 -- 1.8 Under all likely economic growth scenarios, India will not reach the nutrition MDG without direct nutrition interventions -- 2.1 Range of services that the ICDS seeks to provide to children and women -- 2.2 Comparison of intermediate health outcomes and behaviors across children living in villages with and without an anganwadi center -- 2.3 Regularity of food supply to anganwadi centers and the availability of the take-home food program -- 2.4 Anganwadi center (AWC) infrastructure, by location -- 3.1 Menu of options for improving ICDS -- Boxes -- 1.1 How is malnutrition defined? -- 1.2 The "South Asian Enigma": Why is undernutrition so much higher in South Asia than in Sub-Saharan Africa? -- 2.1 Getting things right in the Bellary district of Karnataka: A report from the field.