Targeted action on child malnutrition is needed urgently

Malnutrition is a severe state that arises when the body receives an inadequate amount (undernourishment) or an excess (over nourishment) of essential nutrients necessary for proper human functioning. In simpler terms, it signifies the absence of proper nutrition. This condition negatively impacts the body’s growth and structure, resulting in stunting, wasting, undernourishment, and contributing to children being either underweight or obese.

According to progress reports from the United Nations, there are approximately 150 million children globally facing stunted growth, 41 million children under the age of 5 dealing with obesity, one-third of the population lacking consistent access to sufficient food, and around one in ten individuals experiencing issues related to hunger. India has not overcome the challenge of malnutrition.

Zero-food children in India

A recent study conducted by Harvard University, published in the JAMA Network Open, revealed that the prevalence of “zero-food children,” referring to children aged 6 to 23 months who had not consumed any milk, formula, or food in the last 24 hours, is alarmingly high, reaching up to 21% in some countries. India stands out with the largest number of zero-food children, accounting for almost half (6.7 million) of such cases among the 92 countries studied. Nigeria, Pakistan, Ethiopia, and the Democratic Republic of the Congo follow as the countries with the next highest numbers. The research, analyzing 276,379 children from 92 low and middle-income countries, emphasized the critical need for targeted interventions to enhance infant and young child feeding practices, particularly in regions such as West and Central Africa and India, where the issue is most urgent.

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India challenges study claims

In response to the study’s claims, the Indian Ministry of Women and Child Development issued an official statement, challenging the accuracy and methodology of the research. The Ministry contends that the study’s exclusion of breast milk from the definition of food for infants aged six to twenty-three months significantly distorts the findings. They emphasized that only 1.5% of children are reported as non-breastfed, contradicting the study’s assertions. The Ministry criticized the opaque methodology of the research, stating that it relies on single-day recalls from purportedly contacted individuals. They argued that the term “zero food children” lacks a scientific definition, and the authors themselves acknowledge deep misgivings and limitations in their study. The Ministry questioned the absence of primary research and highlighted publicly available data showing nutritional indicators for over 8 crore children on the Poshan Tracker. They assert that the report appears politically provocative and maliciously timed.

While the government may choose to dispute this specific study, it remains undeniable that the overall national data concerning malnutrition among children cannot be disregarded. The National Family Health Survey 5 (NFHS-5), conducted from 2019 to 2021, had unveiled critical insights into the prevalence of malnutrition among children under 5 years in various states and union territories across India. Stunting, an issue indicative of impaired growth due to chronic malnutrition, emerges as a significant concern with staggering disparities observed nationwide. The top 10 districts with the lowest stunting percentages, including Jagatsinghapur and Puri in Odisha, showcase relatively better child nutrition outcomes, while the bottom 10 districts, led by Pashchimi Singhbhum in Jharkhand, exhibit alarming stunting rates.

Malnutrition and weight loss

Shifting focus to wasting, an acute indicator of malnutrition characterized by rapid weight loss in relation to height among children under 5 years, the provided data highlights of noteworthy districts with the lowest wasting rates, such as Sikkim’s North District and Ludhiana in Punjab, present percentages ranging from 4.5% to 7.4%. While the bottom 10 districts, led by Karimganj in Assam, display alarming wasting rates, reaching as high as 48%.

Underweight prevalence, measured by weight-for-age, unveils further insights into the malnutrition landscape. Bihar at the forefront with a 41% rate, alongside Jharkhand and Gujarat, underscores the pressing need for region-specific policies to address chronic malnutrition challenges. Conversely, states like Kerala, Punjab, and Delhi report lower rates, indicating a diverse nutritional landscape.

Additionally, the report also revealed that the occurrence of anemia varies across six demographic groups. Among men aged 15-49 years, the prevalence is 25.0%, while for women in the same age group, it is 57.0%. In adolescent boys (15-19 years), the rate is 31.1%, and for adolescent girls, it is 59.1%. Pregnant women (15-49 years) experience a prevalence of 52.2%, and among children aged 6-59 months, the rate is 67.1%, signifying high prevalence among children (6-59 months) and adolescent girls.

Tailored intervention required

These NFHS-5 findings necessitate a nuanced and targeted approach, recognizing the complex interplay of socioeconomic, cultural, and environmental factors contributing to malnutrition. The urgent call for tailored interventions considering the unique challenges faced by each state emphasizes the significance of community engagement and locally relevant solutions. Collaborative efforts between government bodies, NGOs, and communities are crucial for sustainable initiatives that aim to break the cycle of malnutrition and foster healthier outcomes for India’s future generations.

Although the current government may contest the data presented by Harvard University, the NFHS-5 findings should be viewed as a persuasive prompt for action. This underscores the importance for policymakers and stakeholders to prioritize the creation and execution of tailored strategies, in order to address the complex problem of child malnutrition in India comprehensively and effectively.

Moumita Barman is a Research Associate at the Centre for Development Policy and Practice (CDPP). She has a Master’s degree in Public Policy and Governance from TISS, Hyderabad. Her research interests lie in Gender, Social Conflict, Caste and Religion in India, Education, and Rural Livelihoods.

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