Context to the Creche Program

Malnutrition Prevalance

Hunger and undernutrition continue to be major challenges affecting children across the world. The Global Hunger Index shows that India falls in the “serious” category, with a score of 25.8. This is not just about lack of food, but about a deeper problem of poor nutrition that affects children’s health, growth, and future from a very early age.

National data also highlights the seriousness of the issue. According to NFHS-5 (2019–21), 32.1% of children under five in India are underweight, meaning they do not have adequate weight for their age. Around 19.3% of children are wasted, which means they have very low weight for their height and are at immediate risk of illness and even death. In addition, only 12.3% of children between 6–23 months receive a minimally adequate diet, which is a crucial stage for brain development, physical growth, and immunity. This gap between what children need and what they receive is especially large among the most vulnerable populations.

Hunger is not just about not having enough food; it is about not having the right kind of nutrition at the right time. When children do not get proper nutrition in the first three years of life, the impact on their physical and mental development is often permanent. Conditions like wasting and being underweight are directly linked to how often children eat, what they eat, and the environment in which they are cared for.

This problem is even more severe among tribal and other marginalised communities in rural India. These communities often face poverty, limited access to healthcare, and isolation due to geography and social factors. As a result, food security is weak, diets lack variety, and parents have limited time and knowledge to provide proper feeding. Children between six months and three years are especially vulnerable because they are no longer fully breastfed and are not yet eating sufficient family food. They depend entirely on what is available at home, which is often inadequate.

Why Creches?

The Anganwadi system usually caters to children aged three and above, leaving younger children without structured care. Creches in the public system are limited and do not meet the actual demand. As a result, families struggle with childcare. Older siblings, especially girls, often drop out of school to take care of younger children. Mothers find it difficult to work, and in many cases, children are left in unsafe or unstimulating environments.

Creches create a safe, structured, and community-based space for children aged seven months to three years. They do not replace food provided at home but support it. Children receive 65–70% of their daily calorie needs and 100% of their protein requirements through meals at the creche. This is especially important for children who are underweight or malnourished, as it helps bridge the nutritional gap they face at home.

Creches also play a key role in monitoring children’s growth. Regular checks of weight and height help identify children who are undernourished or at risk. This allows early action, including referrals to health facilities when needed. In this way, creches act not only as feeding centres but also as spaces for early detection and support.

The Azim Premji Foundation Creche Initiative

Our creche initiative provides safe, nurturing spaces for children aged 7 months to 3 years. The program is community centric, with a high level of operational detailing around aspects including safety, quality nutrition and community engagement. We aim for spaces that have plenty of light, ventilation and are convenient for communities to bring their children.

We partner with grassroots NGOs that manage these creches. These organizations maintain strong community presence in vulnerable geographies which face significant challenges in child health and nutrition.

We began the program in Odisha, Jharkhand and Chhattisgarh and expanded subsequently to Bihar, Karnataka, Madhya Pradesh and Rajasthan. While we currently support ~1700 creches, the program is continuously expanding. We also support creches in informal settlements in cities (beginning with Bengaluru and Raipur) and have plans for expansion of the urban creche program as well.

Civil Society Creche Interventions in India

In many ways, our creche program has been shaped by pioneering civil society efforts in India. It has drawn significant inspiration from the Phulwaris run by Jan Swasthya Sahyog in Ganiyari, Bilaspur; the learnings from the Action Against Malnutrition project; and the Azim Premji Foundation supported creches run by the Public Health Resource Society in the southern districts of Odisha, which continue to function to this day. Building on these learnings, we have further refined our operating guidelines based on 2-3 years of on our ground experiences in running creches across many states.

Why These Guidelines?

These guidelines have been developed to standardise and improve how creches function, especially in terms of safety, nutrition and health. They provide clear and practical protocols for the civil society organization and the public on feeding, monitoring growth, counselling families, and referring children for care when needed. The aim is to ensure that every child in a creche not only receives proper nutrition today but also gets the support needed to grow well and reach their full potential.