Explaining the reduction in child undernutrition in the Indian state of Maharashtra between 2006 and 2012: An analysis of the policy processes

- This study explores the policy processes which took place in the context of Maharashtra's decline in child stunting.
- Stakeholders identified how issue framing and evidence helped catalyse a political response.
- The resulting governance structure developed (the State's 'Nutrition Mission') was also seen as catalytic.
- A focus on system-wide capacity combined with a strategy of focusing on pockets of deprivation in high-burden areas.
- We construct a chronology describing the interrelationship between these factors with wider political triggers.

The Indian state of Maharashtra has been lauded as a 'success story' for its rapid and significant decline in undernutrition amongst children. Between 2006 and 2012, childhood stunting fell from 39 to 24%. Whilst the global policy and academic literature strongly emphasises the need to act on nutrition, there are still too few studies outlining the policy processes which been part of successful state-led strategies - particularly at a sub-national level. This study is intended to contribute to future policy via unpacking the unfolding story of policy and programme attention to nutrition. Stakeholder perceptions and opinions on the wider policy, political and contextual reasons for Maharashtra's decline in child undernutrition were sought and used alongside documentary evidence to construct a chronology of key events. Key factors identified via this process include the way in which issue framing and evidence helped catalyse a political response; the particular governance structures employed in response (the State's 'Nutrition Mission') and the way in which leadership and a focus on system-wide capacity combined in an innovative fashion to focus resources on pockets of deprivation in high-burden areas.