MAL NUTRITION IN INDIA
Despite India’s remarkable economic growth over the last decade, many children still struggle to meet their most basic needs, including access to sufficient food and health care. According to the 2005-06 National Family Health Survey (NFHS-3), 20 per cent of Indian children under five years old were wasted (acutely malnourished) and 48 per cent were stunted (chronically malnourished). Importantly, with 43 per cent of children underweight (with a weight deficit for
their age) rates of child underweight in India are twice higher than the average figure in sub-Saharan Africa (22 per cent). The consequences of this nutrition crisis are enormous; in addition to being the attributable cause of one third to one half of child deaths, malnutrition causes stunted physical growth and
cognitive development that last a lifetime; the economic losses associated with malnutrition अरे estimated at 3 per cent of India’s GDP annually
In this context, it was important to get a मोरे recent set of data on child nutrition in India - the country has no data since 2006 – to understand the current situation and plan focused action. The HUNGaMA (Hunger and Malnutrition) Survey conducted across 112 rural districts of India in 2011 provides reliable estimates of child nutrition covering nearly 20% of Indian children.
Of the 112 districts surveyed, 100 were selected from the bottom of a child development district index developed for UNICEF India in 2009, referred to as the 100 Focus Districts in this report. These 100 districts are located in 6 states . The best-performing district from each of these states was also selected for survey. To this set was added another set of 6 districts, 2 each from the best-performing states of the country. Having the largest sample size for a child nutrition survey since 2004, the HUNGaMA Survey captured nutrition status of 109,093 children under five years of age. Data collection took place between
October 2010 and February 2011 in 3,360 villages across 9 states. Coordinated by the Naandi Foundation, the HUNGaMA survey presents underweight, stunting and wasting data at the district level (this was last done in 2004 B DLHS-2, which reported only underweight estimates). It is also the first ever effort to make the voice of over 74,000 mothers heard..
The HUNGaMA Survey shows that positive change for child nutrition in India is happening, including in the 100 Focus Districts. However rates of child malnutrition are still unacceptably high particularly in these Focus Districts where over 40 per cent of children are underweight and almost 60 per cent are stunted.
The key findings of the HUNGaMA Survey are as follows:
Child malnutrition is widespread across states and districts: In the 100 Focus Districts, 42 per cent of children under five are underweight and 59 per cent are stunted. Of the children suffering from stunting, about half are severely stunted. In the best district in each of these states, the rates of child underweight and stunting are significantly lower - 33 and 43 per cent respectively
- . A reduction in the prevalence of child malnutrition is observed: In the 100 Focus Districts, the prevalence of child underweight हस decreased from 53 per cent (DLHS, 2004) to 42 per cent (HUNGaMA 2011); this represents a 20.3 per cent decrease over a 7 year period with an average annual rate of reduction of 2.9 per cent.
- Child malnutrition starts very early in life: By age 24 months, 42 per cent of children are underweight and 58 per cent are stunted in the 100 Focus Districts; birth weight seems to be an important risk-factor as the prevalence of underweight in children born with a weight below 2.5 kg is 50 per cent while that among children born with a weight above 2.5 kg is 34 per cent; थे corresponding figures for stunting are 62 and 50 per cent respectively;
- Household socio-economic status has a significant effect on children’s nutrition status: The prevalence of malnutrition is significantly higher among children from low-income families, although rates of child malnutrition are significant among middle and high income families. Children from households identifying as Muslim or belonging to Scheduled Castes or Schedule Tribes generally have worse nutrition;
- Girls’ nutrition advantage over boys fades away with time: Girls seem to have a nutrition advantage over boys in the first months of life; however this advantage seems to be reversed over time as girls and boys grow older, potentially indicating feeding and care neglect vis-à-vis girls in infancy and early childhood;
- Mothers’ education level determines children’s nutrition: In the 100 Focus Districts, 66 per cent mothers did not attend school; rates of child underweight and stunting are significantly higher among mothers with low levels of education; the prevalence of child underweight among mothers who cannot read is 45 per cent while that among mothers with 10 or more years of education is 27 per cent. The corresponding figures for child stunting are 63 and 43 per cent respectively. It was also found that 92 per cent mothers had never heard the word “malnutrition”;
- Giving colostrum to the newborn and exclusive breastfeeding for first 6 months of a child’s life are not commonly practised: In the 100 Focus Districts 51 per cent mothers did not give colostrum to the newborn soon after birth and 58 per cent mothers fed water to their infants before 6 months
- Hand washing with soap is not a common practice: In the 100 Focus Districts 11 per cent mothers said they used soap to wash hands बेफोरे a meal and 19 per cent do so after a visit to the toilet;
- Anganwadi Centres are widespread but not always efficient: There is an Anganwadi centre in 96 per cent of the villages in the 100 Focus Districts, 61 per cent of them in pucca buildings; the Anganwadi service accessed by the largest proportion of mothers (86 per cent) is immunization; 61 per cent of Anganwadi Centres had dried rations available and 50 per cent provided food on the day of survey; only 19 per cent of the mothers reported that the Anganwadi Centre provides nutrition counseling to parents. While the signs of progress in the data are promising, much more remains to be done. Special efforts would be vital for the most vulnerable children: the youngest (from conception to age two years), the poorest (children of families in the lowest wealth quintiles) and the excluded (those at the risk of exclusion on the basis of gender or social identity)
