Terms of Reference
OPERATION RESEARCH
Title : Reframing Child Nutrition: A Household-Centric Operational Research Study on Dietary Diversity, Feeding Practices and the Emerging Double Burden of Malnutrition among Children Under Six in India
1. Background and Context
India continues to face a substantial burden of child undernutrition, particularly during the first two years of life, which are critical for growth, cognitive development, and long-term health outcomes. According to the National Family Health Survey (NFHS-5, 2019–21), 35.5 percent of children under five years are stunted, 32.1 percent are underweight, and only 11.3 percent of children aged 6–23 months receive a minimum acceptable diet, indicating significant gaps in both dietary diversity and feeding frequency (International Institute for Population Sciences & Ministry of Health and Family Welfare, 2021). Nutritional status of children is impacted by household behaviours including the living conditions, status of WASH, knowledge, education level of parents, gender of child, etc. Despite significant improvements in the antenatal care, institutional deliveries, immunization, IFA consumption, etc. the nutrition component has not gained improvement.
Despite expanded coverage of nutrition services under the Integrated Child Development Services (ICDS) and Poshan Abhiyaan, improvements in feeding practices have remained limited. Evidence suggests that these gaps are not solely due to food availability or service access, but are shaped by intra-household dynamics, including:
- Allocation of food and financial resources
- Decision-making authority regarding child feeding
- Intergenerational norms and beliefs
The UNICEF Conceptual Framework on Maternal and Child Nutrition highlights that child nutrition outcomes are influenced by care practices, household food security, and the broader social environment (UNICEF, 2020). However, program delivery in India remains largely mother-centric, with limited structured engagement of other household members.
Within many households:
- Fathers influence food purchase and financial decisions
- Grandmothers influence feeding practices and norms
- Mothers may lack autonomy despite being primary caregivers
This leads to a disconnect between knowledge and behaviour. Evidence from behaviour change programs indicates that knowledge alone is insufficient unless supported by enabling household conditions and shared decision-making (Alive & Thrive, 2017; Doyle et al., 2018).
There is limited operational evidence in India comparing different caregiver engagement models within existing systems. This study seeks to address this gap.
2. Operational Research Approach
This study adopts an Operational Research (OR) approach refers to the systematic comparison of alternative program implementation models under real-world conditions to improve program effectiveness and inform scale-up.
Key features include:
- comparison of multiple delivery models
- focus on behaviour change and program functionality
- generation of actionable evidence for scaling-up
The study focuses on proximate outcomes such as dietary diversity, feeding practices, and caregiver engagement, including long-term anthropometric outcomes.
Interested evaluators/agencies are invited to submit:
- Technical proposal outlining approach and methodology
- Team composition and relevant experience
- Financial proposal with a detailed budget
- Sample of previous strategic work on education
ChildFund India reserves the right to modify this ToR based on programmatic and contextual requirements.
Please do mention reference number in your proposal i.e. PRA/CFI/BAN/2026-27/010
For detailed information, please check the complete version of the RFP attached below.