How childhood stunting reduced in Tamil Nadu: An analysis of change between 1992 and 2016

India comprises one-sixth of the world’s population and one-third of the global burden of undernutrition. Between 2006 and 2016, India made progress in reducing stunting among children below five years; the progress, however, has not been uniform across all its states (Menon et al. 2018). There are interstate differences in stunting reduction despite a common national policy framework for nutrition-specific and nutrition-sensitive programs. Given the paucity of insights on what factors drive successful change in nutritional outcomes such as stunting at the state level in India, we conducted studies in the four states of Chhattisgarh, Gujarat, Odisha, and Tamil Nadu. In this report, we document the story of change in Tamil Nadu, which is one of the exemplary states in India. With a long history of nutrition and health reforms, it stands out as a leader in social development. We aimed to update prior work on Tamil Nadu to assess more recent changes in nutritional outcomes, determinants, and coverage of interventions. Our key goals were to: 1) examine changes in child stunting, known determinants of stunting and key health and nutrition interventions between 1992 and 2016; 2) assess the contribution of diverse determinants and intervention coverage changes to the changes in stunting between 2006 and 2016; and (3) interpret the changes in the context of policies, programs, and other changes in the state.