NFHS-6 and Child Nutrition: A Sobering Reality for India

Context

The National Family Health Survey-6 (NFHS-6) brings to light a paradox for India. Long-term results such as stunting have improved, but wasting and underweight children continue to be a stark warning sign. It suggests a shift from calorie availability to dietary diversity and behaviour change in national policies. 

Key trends in child nutrition

1. The Good News: Structural Declines: Recent evidence shows measurable progress in chronic child undernutrition: 

• There has been a structural 17% reduction in stunting (low height-for-age) among children under 5 years, from 35.5% to 29.3%.
• The severe Wasting (low weight for height) decreased from 7.7% to 5.2%.
• There has also been an increase in early breast feeding and exclusive breast feeding indicators. 

2. Sobering Warning: Ongoing Vulnerabilities: There is a more troubling issue of acute malnutrition, however, given in the aggregate figures: 

• Underweight Prevalence: The proportion of underweight children under five saw only a marginal improvement, shifting from 32.1% to 31.8%. Almost one third of Indian children is underweight. 
• Wasting Plateau: Overall wasting decreased slightly, from 19.3% to 19%. This equates to almost 20% of children being acutely malnourished. 
• Lack of Dietary Diversity: The data shows that the issue is not just food availability, but quality. 12% of children aged 6 months to 23 months have a minimum acceptable diet. 

State-Level Disparities

The national averages may be misleading and there are varying trends at the micro-level, as in the case of large states in the country: 

• Setbacks in Large States: States like Uttar Pradesh and Rajasthan recorded an actual deterioration in wasting and underweight prevalence. The proportion of underweight children has risen from 39.4% to 41.1% in Jharkhand. 
• Regional Divides: There is a significant difference in the stunting rates, ranging from 20.1% in Kerala to more than 35% in states such as Bihar and Jharkhand. This illustrates disparities in outcomes of same country programmes. 

The Emerging Dual Burden

India is on a path of nutritional transition, marked by a double burden of malnutrition: 

• Under nutrition is affecting children and at the same time the country is seeing the increasing number of adult and adolescent obesity, especially for women. 
• The gradual transition from the burden of communicable diseases to Non-Communicable Diseases (NCDs) driven more by lifestyle choices and factors are likely to put a strain on public health systems. 

Policy Implications and the Way forward

Structural policy realignments are needed to overcome these remaining gaps and to achieve the Sustainable Development Goals (SDG 2): 

• Beyond Calories to Nutrition: Schemes need to shift from providing only subsidized staple grains to offering a balanced mix of macro- and micronutrients for infants. 
• Behaviour Change: Community-level behavioural change communication (BCC) investments are essential to help mothers to benefit optimally from supplementary nutrition and apply proper complementary feeding practices. 
• Targeted Interventions: States such as Jharkhand and Uttar Pradesh need micro-planning at the state or district level to help turn the tide on the alarming situation. 

Source: The Indian Express

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