Nutrition, POSHAN, and Policy: Analysing the Child Nutrition Trends and Responses of the State in Southern India

Abstract Background: Malnutrition is a severe problem globally; however, over time, with the government’s support, the issue has been reduced significantly. However, in Southern India, between rounds 4 and 5 of the National Family Health Survey (NFHS), the malnutrition status has become higher. Objectives: This study focuses on existing trends in child undernutrition across five southern states, i.e., Tamil Nadu, Kerala, Karnataka, Andhra Pradesh, and Telangana and reviews the contribution of POSHAN Abhiyan and POSHAN 2.0 in eradicating child malnutrition in those states. Methods: The study conducted a comparative analysis using NFHS-4 and 5 data to examine regional disparities and policy gaps that affect the prevalence of malnutrition. Data were disaggregated by state, types of residence, and wealth index to identify the factors in this state, along with a qualitative review of POSHAN Abhiyan & POSHAN 2.0 to conclude findings. Findings: Results reveal that the households (HH) in rural areas significantly increased the odds of stunting in Andhra Pradesh (OR=1.35) and Kerala (OR=1.25), while their association with wasting and underweight was largely non-significant. Wealth disparities were consistent and evident that children from the poorest households had 2–3 times higher odds of stunting, e.g., Karnataka (OR=2.82) and Telangana (OR=2.54), wasting (Tamil Nadu OR=1.80), and underweight (Karnataka OR=3.25); Tamil Nadu OR=3.00) compared to the richest. This means the risk declined monotonically with increasing wealth, highlighting poverty as the dominant determinant of child undernutrition in Southern states. Socio-economic disparities and inconsistent policy implementation were significant barriers to progress. Novelty: This study is the first of its kind linking NFHS-4 and 5 data with a policy review to reveal overlooked urban–rural and intra-state disparities in child undernutrition in Southern India. Second, it connects nutrition outcomes to the implementation of POSHAN 1.0 and 2.0, highlighting policy gaps and the role of digital monitoring tools in achieving these outcomes. Keywords: Child Undernutrition & Malnutrition, Southern India, Nutrition Policy, POSHAN Abhiyan, POSHAN 2.0