NFHS-5 Data Shows 1 in 3 Children below 5 Years of Age in India are Stunted, Underweight

Among India’s most serious and marginally addressed development challenges is malnutrition, which contributes significantly to the country’s disease burden. Despite program commitments since 1975, such as the establishment of Integrated Child Development Services (ICDS) and national coverage of the Midday Meal Scheme, India continues to struggle with the high rate of undernourishment. Improving nutrition and managing stunting remain significant challenges, and can only be addressed through a cross-sectoral strategy.

Stunting has lifelong consequences for human capital, poverty and equity. It leads to lower educational potential and fewer career opportunities. According to the National Family Health Survey (NFHS)-5, India suffers from unacceptably high levels of stunting, despite marginal improvement over the years. In 2019-2021, 35.5% of children under five were stunted and 32.1% were underweight. India ranks 116 out of 174 countries in the Human Capital Index. Underinvestment in health and education is slowing economic growth. The World Bank says, “A 1 percent loss in adult height due to childhood stunting is associated with a 1.4 percent loss in economic productivity.” Stunting also has lasting effects on future generations. Furthermore, with 57 percent of women diagnosed with anemia in 2019-21, this will have lasting effects on their future pregnancies and children. The situation worsens when children are fed inadequate diets.

ambitious goals

Poshan Abhiyaan 2018 aims to make India free of malnutrition by 2022. The plan is to reduce the prevalence of stunting in children (0-3 years) by about three percentage points per year by 2022 from NFHS-4 levels, and achieve a one-third reduction in Anemia in children, adolescents and women of childbearing age.

This is an ambitious target, especially given that the decline in stunting from 48 percent in 2006 to 35.5 percent in 2019-21 is only one percentage point per year. This promise calls for serious inter-ministerial alignment and convergence of nutrition programs and strict monitoring of progress towards these goals.

Available data on stunting tell us where future programs should be focused. The prevalence of dwarfism tends to increase with age and peaks at 18-23 months. Timely nutritional interventions of breastfeeding, age-appropriate complementary feeding, complete immunization, and vitamin A supplementation have been shown to be effective in improving outcomes in children. However, NHFS data shows that only 41.8 percent of babies are breastfed within one hour of birth, 63.7 percent are exclusively breastfed for six months, 45.9 percent are given complementary foods at the appropriate time, and 11.3 percent are breastfed at the appropriate time. Only 100 percent of children under two years old are receiving enough food. diet. Data confirm that complementary feeding practices are poor and need urgent attention.

It is well known that most growth stumbling occurs during this critical period, from six months to two years, when complementary feeding plays an important role in manipulating a child’s nutritional intake. It is clear that the adoption of appropriate complementary feeding practices requires behavioral changes with reference to the informed selection of appropriate nutrients and the following of recommended feeding practices. Vitamin A deficiency can lead to an increase in infections such as measles and diarrheal diseases. About 30 percent of children do not get full immunization and vitamin A supplements. It must be provided for disease prevention.

Differences across states and counties

According to NFHS-5 data, India has more stunted children in rural areas (37.3 per cent) than in urban centers (30.1 per cent), possibly due to the lower socioeconomic status of families in rural areas. The intergenerational cycle of malnutrition must be addressed with effective interventions for both the mother (before and after pregnancy) and the child, to address the heavy burden of stunting.

In terms of geographic regions, Meghalaya (46.5 percent), Bihar (42.9 percent), Uttar Pradesh (39.7 percent) and Jharkhand (39.6 percent) have very high rates of stunting, while states/UT with lower rates include Sikkim and Puducherry by 22.3 percent and 20 percent, respectively. Comparison of NFHS-4 with NFHS-5 results shows that a few states (Mahya Pradesh, Uttar Pradesh and Uttarakhand) reported a reduction in stunting of at least 6 percentage points, and Rajasthan recorded a decrease of 7.3 percent.

While nutrition has improved in all states, interstate variability remains high. The two states with the lowest rates of stunting in children in 2015-2016 (NFHS-4) but showing the highest rate of stunting according to the NFHS-5 survey are Goa (from 20.1% to 25.8%) and Kerala (from 20.1% to 25.8%). from 19.7 percent to 23.4 percent).

Given these data, it is necessary to push for a convergence of health and nutrition programs from conception until the child reaches the age of five. A well-planned and effective Behavioral and Social Communication (Behavioral and Social Change) strategy is essential because behaviors are ingrained in society and family traditions. What is really needed is effective monitoring and implementation of programs to address malnutrition and prioritize reducing child undernutrition in the national development agenda.

Dr. Shoba Suri is a Senior Fellow in the Health Initiative at ORF. She is a registered dietitian with experience in community and clinical research. The opinions expressed in this article are those of the author and do not represent the position of this publication.

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