NFHS 5 Report Highlights: Malnutrition In Children Has Worsened In Key States Of India, Experts Say We Need To Rethink Our Nutrition Plan
Highlights
  • 16 states/UTs show an increase trend in underweight and severely wasted
  • 13 states/UTs registered a surge in the percentage of stunted children
  • In NFHS 5 survey phase 1 only 22 states and UTs have been surveyed

New Delhi: One of the startling revelations in the first-phase data of the National Family Health Survey (NFHS) 5 for the year 2019-20 released by the Union Ministry of Health and Family Welfare recently shows that several states in India have either witnessed meagre improvements or sustained reversals on child (under 5 years of age) malnutrition parameters such as child stunting; child wasting; share of children underweight and child mortality rate.

According to the report, 16 states recorded an increase in underweight and severely wasted under 5 children among 22 states that were surveyed during the first phase of the NFHS report. Similarly, 13 states and UTs of the 22 surveyed registered a surge in the percentage of stunted children under five years of age in comparison to NFHS 4 (2015-16).

Child wasting reflects acute undernutrition and refers to children having low weight for their height. Instead of bringing it down, several states such as Telangana, Kerala, Bihar, and Assam as well as the UT of J&K have witnessed an increase. Others like Maharashtra and West Bengal have been stagnant on this front.

Whereas, when it comes to the proportion of underweight children, again, several big states, Gujarat, Maharashtra, West Bengal, Telangana, Assam and Kerala, have seen an increase. What’s worse is the fact that reversal in the downward trend has happened in child stunting as well, which reflects chronic undernutrition, and refers to the percentage of children who have low height for their age. Stunting, more than any other factor, is likely to have long-lasting adverse effects on the cognitive and physical development of a child. States like Telangana, Gujarat, Kerala, Maharashtra, and West Bengal — all saw increased levels of child stunting.

The present NFHS was conducted among 6.1 lakh sample households, involving household level interviews to collect information on population, health, family planning and nutrition related indicators. The results of 17 States and 5 UTs have been released now as Phase-I.

Speaking exclusively to NDTV’s Vishnu Som on the NFHS malnutrition report, Nobel laureate and economist Abhijit Banerjee said the current trends are worrying. He added,

If we look at the malnutrition statistics in our country, initially it went down a lot, then it was flat for long time, then again it went down and now again it is flat. Currently, the issue is that the income of the poor has not improved in our country. Malnutrition scales directly with the income of a person. I think, we need to get growth back in our country if we want to see a downward trend in our malnutrition numbers. Since 2016, India’s growth has been very slow and COVID-19 pandemic has made things worse.

Talking about areas where India has failed in last 10 years when it comes to protecting our most vulnerable people, Jean Dreze, Social Scientist, added,

In many major states of India, we haven’t seen any improvement when it comes to the malnutrition parameters for over four years. In fact, in six of the 10 major states of India, the incidence of stunting among children have increased and in seven out of 10 major states the incidence of underweight has increased. These are really catastrophic figures, it is quite a bombshell. And all this should be a cause of worry for all of us, in fact no other country in the world has the highest proportion of underweight children than India and that’s why I feel really there is a reason for an alarm here.

Highlighting the reasons behind these grim figures, Mr Dreze said,

We have seen a stagnant growth in India. In 2017-18, the figures of poverty were very worrying from the National Sample Survey and these are some of the indicators that tell us that things are not going well. One of the major reasons behind such trends in malnutrition area for the country is economic slowdown, secondly, the central government in India has turned its back on social policies and in particular on children. I think, in India, children have never become that much of the priority as it is and all these trends that are coming shows exactly that.

Reiterating the fact of importance given to children via social policies is less in India, Mr Dreze added,

Take for example the mid-day meal schemes. The budget given to this programme this year is only 11,000 crores as compared to 13,000 crores in 2014. Why it has decreased, knowing the fact that we need to make progress in nutrition. We need eggs in mid-day meals and schools for fixing the nutrition game, some states have already started doing it but to see the malnutrition numbers go down, we need to have it across the country. There is nothing better than egg for growing children and these are the little things we can do at lower expense. But yet we are not doing it.

He also added that India’s malnutrition and nutrition numbers doesn’t tell us a complete picture as there is no data available for children above the age of 5-years old. Mr Dreze added,

NFHS 5 data tell us the statistics of children for children under the age of 5 years. We don’t have anything for children above that age group, who are receiving mid-day meals – there are a lot many children who are wasted, stunted or are undernourished in the age group above 5-years of age. And that’s what the government should be doing, we need a lot more collection of social statistics to see how programmes like mid-day meals, Integrated child development services are doing on ground and then figure out solutions.

Also Read: Policy Makers Need To Focus On The First 1,000 Days Of Life: Experts React To NFHS-5 Survey Trends

Dr Suneela Garg, Director Professor, Department of Community Medicine, Maulana Azad Medical College and Advisor, Indian Council Of Medical Research said, “Though in NFHS 5 we have reduced infant mortality and increased immunization coverage but child undernutrition in form of stunting has worsenef, even for richer states such as Kerala, Maharashtra and Goa. And that’s is a worrying trend.”

Further highlighting the reasons, she said,

“There are many reasons that are leading to reversing of 7the gains attained earlier. These can be: 

· Maternal nutrition
· Child’s weight at birth
· Sanitation
· Infant nutrition
· Multitasking of frontline workers beyond their scope
· Regular presence or absence of Peripheral health workers”

Dr Suneela Garg also added that the data shows that young women in 9 of 22 states are facing sexual violence as children, which can lead to early pregnancies and whole lot of complications overall. She said,

However, the most important overarching factor is economic slowdown in our country. We need to look at ICDS functioning and its evaluation. And a well-functioning of ICDS scheme without economic growth is not going to improve the nutritional status.

Talking about the remedial measures, she added,

What is urgently required is large sample surveys evaluating ICDS (Integrated Child Development Services), Village health and nutrition days (VHND). We also need to see that measurements are taken accurately by the trained person with the functional equipment. We need to see that practical monitoring of VHND days and ICDS scheme in terms of real work done is being done across the country, we need to monitor records and see what are the gains and losses that have occurred for a particular period in the areas. We need to regularize and monitor the food supply under supplementary nutrition programs. Poshan Abhiyan components should be implemented in true spirits like Inter-sectoral convergence for better service delivery, use of technology (ICT) for real time growth monitoring and tracking of women and children, intensified health and nutrition services for the first 1000 days. I think, India needs a Jan Andolan through strong community involvement and stakeholders.

Also Read: Top Highlights Of NFHS-5 Report: Malnutrition And Anaemia Have Increased In The State Of Gujarat Since 2015

Attributing poverty as the main reason of worrisome malnutrition trends in India, Dr. Khan Amir Maroof, Professor, Department of Community Medicine, University College of Medical Sciences & GTB Hospital, Delhi added,

Malnutrition is a multi-dimensional problem, but ‘availability and access to food’ is at the heart of the issue. The declining GDP impacts the food bowls of the most vulnerable. While we see an improvement in health services and also a decline in Infant mortality rate, which can be given direct impetus by investments, the issue of poverty is complex. Even though we should see the granular data to get to the factors which might have led to this, we need policies which can give money in the hands of the underprivileged.

Also Read: Early Initiation Of Breastfeeding Declines In 12 States And Union Territories, Reveals NFHS-5 Report

He also said that broadly NFHS 5 report IS A reflection of the country’s economic condition. He said,

As the economy moved into a bad shape, it impacted children’s nutrition status across the country. And the COVID pandemic must have worsened all this more. ‘How much’, we will come to know in the next few years when survey results of this year will come out. The internal migration, the lost jobs, reduced incomes, diversion of health functionaries to covid related duties all had potential to hit the children’s nutrition status.

Highlighting what changes are needed in India at policy level to tackle the issue of malnutrition, Dr Maroof said,

Policies which put more money in the hands of the vulnerable population. Policies which improve the quality of the nutrition services provided at the community level. We need more integration of health and nutrition platforms at the community level.

Talking about on-ground reality, Basanta Kumar Kar, recipient of the Global Nutrition Leadership Award said that NFHS 5 recent report signals an alarm bell for the country and added,

Our country needs a 360-degree shift in its nutrition action plan. Apart from schemes and policies, we need to work on ground ensuring that everyone gets easy access to the benefits and nutrition and thereby tackling the malnutrition crisis. The warriors or anganwadi workers working on ground to tackle this problem are themselves malnourished. In fact, our farmers, workforce engaged in industries who are pivotal to transform nutrition landscape are themselves malnourished. We need to invest on our workforce, specifically women and children so that they are empowered to address malnutrition in a much dignified way.

Also Read: 115 Million Children Risk Malnutrition Due To COVID-19 Pandemic: India Child Well-being Report

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 (WaterSanitation 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 pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

17,66,30,634Cases
5,80,25,717Active
11,47,82,895Recovered
38,22,022Deaths
Coronavirus has spread to 193 countries. The total confirmed cases worldwide are 17,66,30,634 and 38,22,022 have died; 5,80,25,717 are active cases and 11,47,82,895 have recovered as on June 16, 2021 at 3:30 am.

India

2,96,33,105 62,224Cases
8,65,43247,946Active
2,83,88,100 1,07,628Recovered
3,79,573 2,542Deaths
In India, there are 2,96,33,105 confirmed cases including 3,79,573 deaths. The number of active cases is 8,65,432 and 2,83,88,100 have recovered as on June 16, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

59,24,773 7,652

1,41,440 8,982

56,69,179 15,176

1,14,154 1,458

Karnataka

27,77,010 5,041

1,62,303 9,859

25,81,559 14,785

33,148 115

Kerala

27,48,204 12,246

1,12,792 1,456

26,23,904 13,536

11,508 166

Tamil Nadu

23,78,298 11,805

1,25,215 11,669

22,23,015 23,207

30,068 267

Andhra Pradesh

18,20,134 5,741

75,134 4,879

17,32,948 10,567

12,052 53

Uttar Pradesh

17,03,207 270

7,221 890

16,74,072 1,104

21,914 56

West Bengal

14,68,044 3,268

20,046 1,125

14,30,949 2,068

17,049 75

Delhi

14,31,498 228

3,078 148

14,03,569 364

24,851 12

Chhattisgarh

9,88,172 609

11,717 943

9,63,113 1,544

13,342 8

Rajasthan

9,50,133 172

5,619 848

9,35,658 1,006

8,856 14

Odisha

8,59,526 3,405

44,358 3,436

8,11,780 6,799

3,388 42

Gujarat

8,21,078 352

8,884 658

8,02,187 1,006

10,007 4

Madhya Pradesh

7,88,649 224

3,610 331

7,76,424 528

8,615 27

Haryana

7,66,357 228

3,703 374

7,53,584 564

9,070 38

Bihar

7,17,949 410

4,360 412

7,04,075 813

9,514 9

Telangana

6,06,436 1,556

19,933 528

5,82,993 2,070

3,510 14

Punjab

5,89,153 628

10,802 1,111

5,62,701 1,691

15,650 48

Assam

4,66,590 3,415

41,184 475

4,21,378 2,906

4,028 34

Jharkhand

3,43,793 184

2,646 416

3,36,058 596

5,089 4

Uttarakhand

3,37,449 274

3,642 266

3,26,822 515

6,985 25

Jammu And Kashmir

3,08,726 715

12,407 1,125

2,92,114 1,830

4,205 10

Himachal Pradesh

1,99,197 321

4,050 382

1,91,737 691

3,410 12

Goa

1,63,048 327

4,175 231

1,55,926 548

2,947 10

Puducherry

1,13,192 355

4,668 279

1,06,828 629

1,696 5

Chandigarh

61,200 40

486 21

59,917 58

797 3

Manipur

61,096 785

8,744 301

51,354 476

998 8

Tripura

60,385 536

4,886 65

54,870 596

629 5

Meghalaya

42,759 450

4,430 99

37,579 542

750 7

Arunachal Pradesh

31,938 290

2,849 40

28,934 326

155 4

Nagaland

23,854 101

2,972 229

20,423 327

459 3

Ladakh

19,649 38

552 20

18,898 57

199 1

Sikkim

18,659 209

3,239 67

15,136 273

284 3

Mizoram

15,899 268

3,637 45

12,191 312

71 1

Dadra And Nagar Haveli

10,473 9

61 2

10,408 7

4

Lakshadweep

9,297 61

484 36

8,768 96

45 1

Andaman And Nicobar Islands

7,280 11

105 4

7,049 15

126

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1 Comment

  1. As long as religion is bought into health sector and policy decisions our country will have malnutrition in our children,
    The truth is always bitter!

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