Small Enterprises Yield Big Nutrition Gains

In India, the state of Kerala is addressing child malnutrition by using microenterprises to produce and distribute a fortified, wheat-based porridge mix known as Amrutham Nutrimix.

India is the world’s most populous country, with a rapidly growing economy. Despite this, about one-third of children between six months and five years old are underweight, while over two-thirds are anemic (Government of India 2022). India ranks 102nd out of 123 countries in the Global Hunger Index, reflecting a "serious" level of hunger, though conditions have been gradually improving since 2000 (Global Hunger Index 2025).

Against this backdrop, Kerala stands out for its comparatively low rates of child malnutrition. The state’s progressive policies—often called the “Kerala model”—emphasize human development metrics over GDP growth and include sustained state investment in public health and strong participation by civil society organizations in shaping and implementing policies. These same principles have been foundational to the success of Amrutham Nutrimix.

In 2004, to address persistent malnutrition among young children, Kerala launched the Take Home Ration Scheme, providing Amrutham Nutrimix to children between six months and three years old living in households below the poverty line. However, concerns soon emerged over the cost and quality of products. In response, Kudumbashree—the state’s poverty eradication and women’s empowerment program—proposed replacing the external suppliers with locally-run microenterprises formed through its network of women’s self-help groups. Beyond combating child malnutrition, this proposal of decentralized production through a community enterprise approach would also address women’s economic marginalization and reduce distribution disruptions caused by Kerala’s frequent floods.

Microenterprises Add Value

The innovative collaboration, coordinated by Kudumbashree, helps women’s groups secure bank loans and obtain the licenses required for food production and business operations. Each microenterprise, made up of five to 10 members, is required to operate from a 1,500- to 2,500-square-foot facility, and members must complete 40 to 50 days of training in Good Manufacturing Practices provided by Kudumbashree.

The microenterprises are then ready to produce the complementary food Amrutham Nutrimix, a porridge mix made from wheat, soybeans, chickpeas, peanuts, and jaggery (an unrefined sweetener) that caretakers prepare by mixing with water and heating.

Production begins with testing raw ingredients for acceptable moisture content and inspecting them for mold. Next, the wheat, soybeans, chickpeas, and peanuts are cleaned, roasted, ground, and cooled; mixed together with the jaggery; and packed into foil pouches.

From the production facilities, the finished product is delivered to local distribution centers before being supplied to nearby government-run preschools. To maintain quality standards, facilities undergo regular inspections, and product samples are routinely sent for laboratory testing.

A study undertaken in 2014 found that limiting Amrutham Nutrimix to porridge preparation was restricting its use. Researchers developed 20 alternative recipes using the product and conducted sensory testing; they found vegetable rolls, onion fritters, and amaranth pudding to be among the most popular (Subhashree et al. 2014). Promotion of these new recipes has greatly boosted engagement.

Between 2017 and 2018, Kerala partnered with the World Food Programme to test a fortified version of the product in Wayanad district. The vitamin-mineral premix used contained 11 nutrients, including calcium, iron, zinc, and multiple vitamins. Children in the test group showed improved levels of vitamin A, vitamin B12, and folate (WFP India 2021). Following the trial’s success, the fortified product was adopted throughout Kerala.

Today, more than 300 microenterprises produce about 18,000 metric tons of Amrutham Nutrimix annually, reaching over 850,000 children and providing an inspiring model for other Indian states and the national government.