- Percentage of stunted children under 5 has dropped by mere 0.2% in 4 years
- Proportion of overweight children has gone up by 1.5 per cent: NFHS-5
- Prevalence of anaemia among children has increased by 4.6 per cent
New Delhi: Andhra Pradesh is one of the 22 states and Union Territories assessed in phase 1 of the National Family Health Survey (NFHS-5) that has shown improvement under various health parameters. The tenth most populous state in the country (Census 2011), with a population of 8.46 crores (84,580,777) has reported a significant fall in infant and child mortality rates. But, malnutrition trends, especially the rise in obesity among children under-five seem to be a cause of concern. Let’s deep dive into the numbers and assess the health status of Andhra Pradesh.
Infant And Child Mortality Rate Declines
The first 28 days of life are called a neonatal period. According to the National Family Health Survey (NFHS-5) conducted in 2019-20, the neonatal mortality per 1,000 live births is 19.9 as opposed to 23.6 deaths per 1000 live births in 2015-16. The state has reported a drop of 3.7 per cent in neonatal mortality rate over four years.
The number of deaths of children under one year of age per 1,000 live births is called the Infant mortality rate (IMR). According to the National Family Health Survey (NFHS-5) conducted in 2019-20, the IMR of Andhra Pradesh stands at 30.3 better than 34.9 deaths per 1,000 live births recorded during 2015-16. The drop of 13 per cent is encouraging.
The under-five mortality rate (U5MR) is the number of child deaths under five years of age per 1,000 live births. The state of Andhra Pradesh has reported a decline of 13.7 per cent in the under-five mortality rate in the past four years. NFHS-4 conducted in 2015-16 recorded U5MR at 40.8 deaths per 1,000 live births that has now come down to 35.2 deaths.
The state has recorded an improvement in full vaccination coverage among children aged 12-23 months. It has increased from 65.3 per cent in NFHS-4 to 73 per cent in NFHS-5. According to the Ministry of Health and Family Welfare, full immunisation implies vaccinating children with BCG (Bacille Calmette-Guerin) which is a vaccine for tuberculosis (TB), vaccines to prevent measles – MMR (measles, mumps, and rubella) and three doses each of polio (excluding polio vaccine given at birth) and DPT (diphtheria, pertussis, and tetanus).
Infant And Child Feeding Practices Have Improved
According to NFHS-5, infant and child feeding practices have shown an improvement when compared to the data recorded under the NFHS-4. Among the children surveyed, 52 per cent of the children under 3 years of age were breastfed within one hour of the birth in 2019-20 which was only 40 per cent in 2015-16. However, there has been a decline of 2.2 per cent in the proportion of children being exclusively breastfed in 2019-20 (68 per cent) as compared to 2015-16 (70.2 per cent).
There has been a gain in the proportion of children in the age group 6-23 months receiving an adequate diet from 7.6 per cent in NFHS-4 to 9.3 per cent in NFHS-5.
Dr Arun Gupta, Senior Pediatrician and the central coordinator of the Breastfeeding Promotion Network of India (BPNI), said the state has made gains in early breastfeeding but even now it is inadequate. He added,
Complementary feeding that is initiated after the six months of birth seems to worsen. Only 8.2 per cent of breastfeeding children between 6-23 months of age are receiving an adequate diet. All these factors in undernutrition.
Malnutrition Indicators Show Negligible Improvement
The height and weight of a human body are directly dependent on the daily nutritional intake. An increase in malnutrition indicators hint at the rise in unhealthy dietary habits and feeding practices. In Andhra Pradesh, the percentage of children under five years of age who are stunted (low height for age) has dropped by 0.2 per cent in four years. Similarly, the prevalence of wasted children (low weight for height) and underweight children has come down by 1.1 per cent and 2.3 per cent respectively.
What hides the improvement is the rise in severely wasted and overweight children. The percentage of children under 5 years who are severely wasted has increased by 4.5 per cent (NFHS-4) to 6 per cent now. The proportion of overweight children has grown by 1.5 per cent – from 1.2 in 2015-16 to 2.7 in 2019-20.
Dr Gupta noted that more than the double increase in overweight children in the state is a cause of worry and said that it is probably because of an increase in the consumption of ultra-processed food. He added,
Marketing regulation to ban the advertising of ultra-processed foods and front of pack labeling that is providing nutrition labels on the front of such food products may be useful.
Anaemia Among Children And Adults
As per NFHS-5, while the prevalence of anaemia among children under five has increased, it has declined among men and women in the age group of 15-49 years. The data states that children between 6-59 months should have Haemoglobin (Hb) levels of 11g/dl. In Andhra Pradesh, in 2015-16, 58.6 per cent of children had less than ideal Hb levels. This number in 2019-20 jumped to 63.2 per cent, denoting an increase of 4.6 per cent.
Talking about the impact of anaemia among children and how it can be eradicated, Dr Gupta said,
Anemia has a long- term impact on the health and overall performance of the body. I would suggest investigation to find the type of anemia, and if it is iron deficiency anaemia, iron may be supplemented as medicine. Cooking in iron pots, iron rich green veggies, eggs, and liver can be a helpful part of diet.
The occurrence of anaemia among women has declined by 1.2 per cent when compared with the data from NFHS-4. Still, 58.8 per cent of the women in Andhra Pradesh are anaemic. Among men, anaemia has dropped significantly by 10.8 per cent. Talking about the high prevalence of anaemia and the solutions needed, Dr Purnima Menon, Senior Research Fellow at IFPRI (International Food Policy Research Institute), called for a careful diagnosis. She added,
Anaemia is definitely a challenging area. One has to look at the range of causes. We have research showing that it’s not just about iron supplements or diets, but also about sanitation; infection is one of many causes of anaemia. This has to be understood so that a full set of solutions can be deployed that addresses all causes, not a partial set of actions.
Women Are Adopting Hygienic Methods Of Protection During Their Menstrual Period
In Andhra Pradesh, more women from the age group 15-24 years are using hygienic methods of protection during their menstrual period, revealed NFHS-5 report when compared to the data from NFHS-4. Locally prepared napkins, sanitary napkins, tampons, and menstrual cups are considered to be hygienic methods of protection. 85.1 per cent of women surveyed are resorting to hygienic methods whereas, in 2015-16, it was only 67.5 per cent of women.
Access To Improved Drinking Water And Sanitation Facilities
In the last four years, the percentage of people living in households with improved drinking water source and sanitation facility has increased. In 2019-20, 96.7 per cent of the people had access to an improved drinking water source as compared to 95.6 in 2015-16.
Similarly, 77.3 per cent of people have access to improved sanitation facilities. This is an increase of 22.9 per cent when compared to the population having access to toilets in NFHS-4 which was 54.4 per cent.
NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.