New Delhi: The Union Ministry of Health and Family Welfare has released findings from the Comprehensive National Nutrition Survey, which collected data on the nutritional status of Indian children between the ages of 0 and 19. It has also, interestingly, collected data for micronutrient deficiencies – which is happening for the first time and at the largest scale in a government survey.
As many as 1,12,316 children and adolescents were surveyed for this by 2,500 survey personnel. Blood, urine and faecal samples were collected to analyse for micronutrient deficiencies.
While malnutrition and under nutrition are old problems in India, there has neither been data nor a specific policy focus on deficiencies of specific micronutrients. Micronutrients that are important for children and adolescents include vitamin A, vitamin B12, vitamin D, iodine, zinc, folate and iron.
Specific deficiencies in micronutrients are themselves important causes of morbidity and mortality. If they aren’t fatal, they can lead to significant impairments in cognitive development, physical growth and work productivity in adulthood.
Zinc is important for bone growth and immunity. Folate prevents birth defects and anaemia. Vitamin B12 is needed by the blood and nervous system, Vitamin A strengthens immunity and Vitamin D can prevent rickets. Vitamins and minerals are not produced by the body so it is important that children get them from their diet.
The government’s survey says that zinc deficiency was found among 19% of pre-school children and 32% of adolescents. Folate deficiency was prevalent among 23% of pre-school children and 37% of adolescents. The prevalence of deficiencies of Vitamin B12, Vitamin A and Vitamin D also hover between 14% to 31% for pre-school children to adolescents.
While small studies have been conducted in limited areas about micronutrient deficiencies, the government’s report says that they weren’t useful for a national level understanding. For example, these studies used surrogate measures, such as measuring anaemia to indicate iron deficiencies, measuring stunting to calculate zinc deficiencies and measuring night blindness to calculate vitamin A deficiency. They are also small studies in particularly deprived settings which could skew the data.
The World Health Organisation says that poverty has a strong association with undernutrition, obesity and micronutrient deficiencies because poor households have less access to nutrient rich food which is often expensive.
The government’s new survey says: “The current nutrition situation in India justifies its high level national commitment with strong policy initiatives based on evidence-informed interventions towards combating all forms of malnutrition in the country.”
The Indian government has made a commitment to achieve the 2030 Sustainable Development Goals and reducing undernutrition is key to meet India’s targets for maternal and child mortality reduction.
India’s POSHAN Abhiyan programme has committed to reduce stunting by 2%, underweight children by 2%, anaemia by 3% and low birth weight by 2% per annum.
Indian government scientists and doctors recently looked at multiple government data sets and concluded that malnutrition is still a leading cause of death for children under five. Out of the various indicators for malnutrition, low birth weight is the biggest. Despite the persistence of malnutrition in India over decades, this research was also the first comprehensive estimate of trends in child and maternal malnutrition in India.