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According to the report entitled India Health Report: Nutrition 2015 by Public Health Foundation of India, Transform Nutrition and UK Aid (please click here to access):

• According to recent data from the Rapid Survey on Children-2014 (RSOC-2014), 38.7 percent of Indian children under the age of five years are stunted, 19.8 percent are wasted, and 42.5 percent are underweight. Stunting (low height for age) is a measure of chronic undernutrition; wasting (low weight for height) indicates acute undernutrition; and underweight (low weight for age) is a composite of these two conditions.  

• Stunting rates in under-three children declined by only 8 percentage points in more than a decade in this age-group -- from 53 percent in 1992-93 to 45 percent in 2006 -- reflecting an average annual rate of decline of 1.2 percent. During this period, wasting declined by 1 percentage point and underweight by 8 percentage points. However, the rate of progress accelerated since National Family Health Survey-3 (NFHS-3), and India's average annual rate of under-5 stunting decline between 2006 and 2014 has been 2.3 percent per year, compared with a rate of decline of 1.2 percent per year between 1992 and 2006.  

• The faster annual rate of reduction in stunting since 2006 i.e. 2.3 percent per year means that the rate of decline in India is finally approaching the rate of decline in other countries with similar levels of stunting, but this is not enough. Between 2011 and 2014, for instance, Nepal had a 3.3 percent average annual rate of decline in stunting rates compared to 2.3 percent in India. However, the rate of reduction in India is now similar to that of Bangladesh and Ethiopia (2.3 percent annual rate of decline in both countries). At this rate, India will achieve the current stunting rate of Ghana or Togo only by 2030, and the current stunting rate of China (10 percent) only in 2055. 

• Undernutrition is worse among children in scheduled castes (SCs) and scheduled tribes (STs). The RSOC highlights that stunting is about 9 percentage point higher in these groups, compared to higher caste groups (42 percent versus 33 percent). Underweight is highest among ST groups, with almost a 15 percentage point difference between ST children and children from "other" castes (37 percent versus 23 percent). Similarly, wasting is about 5 percentage point higher for ST groups (19 percent versus 14 percent). Analyses, using NFHS-3 surveys suggest that nutritional status of SC and ST children is lower than children of "other" caste groups at similar levels of wealth and mother's education. 


• Eight states in India have under-5 stunting rates that exceed the national average: Uttar Pradesh, Bihar, and Jharkhand have stunting rates close to 50 percent, while Chhattisgarh, Meghalaya, Gujarat, Madhya Pradesh and Assam have stunting rates between 40 and 45 percent. Stunting rates in Kerala and Goa, which are 19.4 percent and 21.3 percent, respectively, are among the lowest in the country. All other states range between 20 and 40 percent.

• All 29 states covered by the NFHS-3 and RSOC showed a reduction in stunting between 2006 and 2014. However, rates of progress vary tremendously. Six states, mainly in the northern and northeastern regions of India (Tamil Nadu, Mizoram, Sikkim, Arunachal Pradesh, Nagaland and Delhi) achieved an average annual rate of decline of more than 3 percent between 2006 and 2014 while Jharkhand, Manipur and Jammu & Kashmir, along with Uttar Pradesh and Bihar, showed slow rates of decline during this period.


• The national prevalence of children under age five years who are wasted is 15.1 percent according to RSOC (2014). 13 states have wasting levels higher than the national average: West Bengal, Goa, Kerala, Jharkhand, Arunachal Pradesh, Tripura, Madhya Pradesh, Karnataka, Odisha, Maharashtra, Gujarat, Andhra Pradesh and Tamil Nadu have the highest percentage of severely wasted children, whereas Sikkim has the lowest percentage of wasted as well as severely wasted children.


• The proportion of underweight children under age 5 ranges from 14.1 percent in Manipur to 42.1 percent in Jharkhand. Severe underweight prevalence varies between 2 percent in Goa and 16.8 percent in Tripura.

• Recent national-level data on burden of overweight and obesity among children and adults are not available, but available estimates range between 4.3 and 15.3 percent in urban areas.


• In 8 out of the 17 states covered by District Level Household and Facility Survey-4 (DLHS-4), more than 70 percent of children aged 6-59 months have anaemia. Similarly, more than half of Indian women in their child-bearing years, aged 15-49 years, in 13 states have anaemia. Anaemia prevalence ranges from 76.3 percent in West Bengal to 32.7 percent in Kerala.

• With little change over time, 75 percent of children under five years and over half of women of child-bearing age are anaemic.

Breastfeeding and complementary feeding

• Recent RSOC data indicate that 45 percent children were breastfed within 24 hours after birth (compared to 25 percent in NFHS-3) and 65 percent of children aged 0-5 months were exclusively breastfed (compared to 47 percent in NFHS-3). Rates of timely initiation of complementary feeding between 6 and 8 months of age appears to have declined slightly between NFHS-3 and RSOC, with only about half of children aged 6-8 months were being fed complementary foods in 2014, compared to 56 percent in 2006. 

• India's more than 65 million diabetics account for 17 percent of all diabetics in the world, and diabetes in India continues to rise.

• The prevalence of Vitamin A deficiency is 57 percent among children under five years. Goiter (caused by iodine deficiency) affects 26 percent of total population and 19 percent of school-aged children.


Rural Expert

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