Addressing India’s malnutrition landscape Premium

A study by IIPH Hyderabad analyzes undernutrition in India, highlighting trends, state variances, and factors influencing children's nutritional status.

Malnutrition is a significant contributor to the disease burden in India. The United Nations Sustainable Development Goals (SDGs) have an ambitious target of eradicating malnutrition by 2030, prompting the World Health Organisation (WHO) to designate 2016–2025 as the decade of nutrition. Despite strides made in reducing undernutrition indicators through national nutrition programmes, progress in India has been sluggish. A study by the Indian Institute of Public Health (IIPH) Hyderabad examined undernutrition across the nation and evaluated the distribution of nutritional indicators among children under three at the state level, utilising data from the National Family Health Surveys (NFHS).

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This study published in the Clinical Epidemiology and Global Health journal centred on children below the ages of three and explored the prevalence and trajectory of undernutrition indicators across India, both nationally and at the state level. The analysis aimed to assess changes over a decade to understand the extent of the issue. Undernutrition can lead to vision impairment, weakened bones, protein deficiency, and gastrointestinal ailments in children.

“We firmly grasped the importance of comprehending the epidemiology of the condition before advocating for policy changes or interventions. It’s crucial to know who is affected, their locations, and how these factors evolve over time. Armed with this comprehensive understanding, we can aptly tailor existing policies and implement precise nutritional interventions,” said Sirshendu Chaudhari, Yashaswini Kumar, AY Nirupama, and Varun Agiwal, authors of the study.

Comparing data from NFHS-1 (1992–93) to NFHS-5 (2019–20), the study found that while the prevalence of wasting (low weight for height) increased marginally from 19.9% to 20.5%, stunting (impaired growth) and the incidence of underweight decreased from 51.9% and 34.1% to 45.8% and 29.4%, respectively. Wasting exhibited a slight increase of 0.21%. The study identified significant factors affecting children’s nutritional status, including maternal education and the child’s gender. According to the study, all states and union territories mirrored the national trend of decreasing rates of stunting and underweight among children, though no consistent trend was observed for wasting prevalence.

In the NFHS-1 survey, stunting prevalence ranged from 33.2% (lowest) in Nagaland to 63.8% (highest) in Bihar. By NFHS-5, this range decreased from 23.1% (lowest) in Manipur to 41.6% (highest) in Meghalaya. Similarly, underweight prevalence in NFHS-1 varied from 19.7% in Mizoram to 60.2% in Bihar, but in NFHS-5, it ranged from the lowest of 11.6% in Manipur to the highest of 39.7% in Bihar. In NFHS-1, wasting prevalence spanned from 4.5% in Mizoram to 26.8% in Rajasthan. However, in the 2019–2021 survey, these figures shifted, with the lowest wasting prevalence at 11.4% in Punjab and the highest at 27.7% in Maharashtra. In Chhattisgarh, Jharkhand, and Uttarakhand, stunting, underweight, and wasting rates have consistently decreased over time.

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