Nutrition policies are shaped at a national and state level in India; however programmes are implemented by the district administration.

This paper considers the implementation of nutrition programmes in two districts - Sabarkantha in Gujarat and Bijapur in Karnataka - drawing on a systems approach to (i) detail how policies and programmes related to nutrition are implemented through the district ecosystem; (ii) whether programmes are integrated and complementary, both within the state machine as well as with non-state programmes; and (iii) what the roles of state and non-state actors are in implementation.

The paper evaluates policy implementation in a complex sector where integration is especially important, given the multiple and interacting pathways for supporting improved nutrition. This includes considering nutrition specific programmes, together with the underlying pathways highlighted - food production and agriculture; food access and food security; health, water, sanitation and hygiene; and women's empowerment.