Increase in stunting and wasting among children!

The Union Minister of Health and Family Welfare, Dr Harsh Vardhan recently released the National Family Health Survey 2019-20, NFHS-5. It includes the factsheets of key indicators on population, reproductive and child health, family welfare, nutrition for 22 States/UTs of India. The National Family Health Survey, NFHS is a large-scale, multi-round survey that is conducted in a representative sample of households across India. Three rounds of the survey are being conducted since the first survey in 1992-93.
The good aspects of the report are that several of the 22 states and UTs, for which findings have been released, showed an increase in childhood immunization. There has been a drop in neonatal mortality in 15 states, a decline in infant mortality rates in 18 states and an increase in the female population (per 1,000 males) in 17 states. Also, the fertility rate decline and increase in contraceptive use were registered in almost all the states surveyed showing trends of population stabilization. But the sad aspects of the reports are that there has been an increase in stunting and wasting among children in several states, a rise in obesity in women and children, and an increase in spousal violence. In several other development indicators, the needle has hardly moved since the last NFHS-4.

The alarming aspects of the report are that the proportion of stunted children has risen in several of the 17 states and five UTs surveyed, putting India at risk of reversing previous gains in child nutrition made over previous decades. Worryingly, that includes richer states like Kerala, Gujarat, Maharashtra, Goa and Himachal Pradesh. The share of underweight and wasted children has also gone up in the majority of the states. Stunting, or low height for age, is caused by long-term insufficient nutrient intake and frequent infections while Wasting, or low weight for height, is a strong predictor of mortality among children under five. It is usually the result of acute significant food shortage and/or disease.

This negative trend is alarming and spells a worrisome rise in the burden of a young population prone to disease and early death. It signals huge loopholes in the government’s policies targeting malnutrition such as the Integrated Child Development Scheme, the National Nutrition Policy, the Mid-Day Meal Scheme for schoolchildren, and the National Food Security Act 2013. The government needs to investigate why despite better monitoring following scams that riddled these well-intentioned schemes; there is a rise in the number of stunted, wasted and underweight kids. The lacunae in policies designed to provide wholesome meals to children must be addressed in right earnest. With the UN’s goal of achieving zero hunger by 2030 just a decade away, India, faring poorly on the hunger index — 102nd out of 112 countries — cannot afford to be negligent.

The National Family Health Survey is a survey carried out on a massive scale across the country to collect information on many parameters which would ultimately help the Ministry of Health and Family Welfare (MOHFW) to frame policies and programs to help in the upliftment of the vulnerable groups in India. The first round of the National Family Health Survey was conducted in 1992-92.  Subsequently, four other rounds have taken place, the latest being NFHS 5 that started in 2018-19, however, is stalled currently amid the COVID-19 associated lockdown at various states. The Objective of conducting the NFHS is to collect information on the following aspects--- Fertility, Maternal and Child Health, Reproductive Health, Nutrition, Anaemia, Infant and Child Mortality and Family Planning.
 

- Prabhakar Purandare

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