A mother feeds her malnourished child in the Nutritional Rehabilitation Centre of Sheopur district in Madhya Pradesh, April 6, 2010. Credit: Reuters/Reinhard Krause
New Delhi: The nutritional level among children in India worsened over the last five years, according to health data released earlier this week. Eighteen of the 22 states and Union Territories (UTs) recorded a rise in the percentage of children under five years of age who are stunted, wasted and underweight compared with 2015-16, reversing decades of gains, showed the latest National Family Health Survey (NFHS).
States including Kerala, Gujarat, Maharashtra, Goa and Himachal Pradesh – which had lowered their rates of stunting in the previous decade – have reported a rise in stunted children in the fifth round of the NFHS (2019-20) survey. Sixteen states and UTs out of the 22 surveyed recorded a rise in the percentage of children under five years who are severely wasted and underweight in comparison to NFHS-4, the data showed.
The National Family Health Survey – a chief source of health data in India – covers over 400,000 households and collates data on marriage, fertility, vaccinations, nutrition and health status, among other indicators. India already has a poor score on the global hunger index – ranking just above 13 countries out of a total of 107, including North Korea, Haiti, Afghanistan and among others.
Surprisingly, the Road Scholarz twitter handle, which had tweeted about the report’s adverse findings, was suspended by the social media platform.
According to a ‘Hunger Watch’ survey published this week, the hunger situation remains grave among the marginalised and vulnerable communities in as many as 11 states even five months after the lockdown has ended, with a large number of families going to bed without food.
According to IndiaSpend, if the all-India rates of child stunting were to rise, as the phase-I data (of NHFS-5) indicate, this would represent the first increase in child stunting since 1998-99. However, it’s important to note here while making any comparisons that the data covered in NHFS 1, 2 and 3 on child nutrition were for children aged three years and below, while the data for the NHFS 4 and 5 covers children under five years and below. Therefore, making a direct comparison with this year can be difficult. As per previous data, the rates of child stunting for children below the age of three declined from 1998-99 to 2005-06.
Purnima Menon, senior research fellow at the International Food Policy Research Institute, told IndiaSpend, “I think what we are seeing right now is the impact of the economic slowdown of the last few years and some of those economic shocks that were experienced.”
“The increase in child stunting is ‘extremely worrying’,” said Menon, adding that there are parts of India where we really do not know how people have been living and how they have experienced the impacts of the last few years. She told IndiaSpend that NHFS-5 data was collected in 2019, and would not account for the food insecurity experienced in 2020 following the lockdown, urging the need for large sample surveys to understand the food insecurity situation in India.
There are three key indicators used to measure child under-nutrition: stunting (a lower-than-expected height for age), wasting (lower-than-expected weight for height), and underweight (lower-than-expected weight for age).
According to a World Bank 2019 report, India has the second highest number of stunted children in South Asia (at 38%), after Afghanistan (41%). Wasting is highest in India at 21%, followed by Sri Lanka at 15% and Bangladesh at 14%, the report said.
On the positive side, there has been an increase in the rates of child vaccination, showed the report. Seventy percent of the children under the age of two are fully vaccinated across seventeen states and UTs. This is important as the government is looking vaccinate its 1.3 billion population against COVID-19.
The report highlighted a decline in marital violence over the years, however sexual assaults against children have increased since 2015-16. In nine of the 22 states and UTs, more young women said they have experienced sexual violence as children than in 2015-16.
Health minister Harsh Vardhan, while releasing the report, said, “We have made remarkable progress in operationalising Ayushman Bharat – Health and Wellness Centers and crossed a major landmark in our journey. With 51,500 centres now functional, more than one-thirds of the target has been met. This has led to improved access to affordable primary healthcare services for more than 25 crore people.” However, health officials cautioned that the survey would have been unlikely to have captured the impact of the Ayushman Bharat scheme. The scheme provides a health insurance cover of up to Rs 5 lakh for 100 million poor families and was launched in September 2018.
Some other findings released earlier also point towards a decline in the country’s nutritional status due to economic slowdown. In a report titled ‘Pauses and Reversals of Infant Mortality Decline in India in 2017 and 2018’, released last month, demonetisation and economic slowdown were cited as the main causes for increase in overall infant mortality rate in the country.
According to a Lancet report, malnutrition was the predominant risk factor for death in children younger than five years of age in every state of India in 2017, accounting for 68·2% of the total under-five deaths, and the leading risk factor for health loss for all ages, responsible for 17·3% of the total disability-adjusted life years.