New Delhi: India has been able to reduce the number of stunted children—those who are too short for their age—under five years of age by 9.1 percentage points in the past eight years, according to a Global Nutrition Report released on Thursday by the International Food Policy Research Institute, a global think-tank on food security.
The country has also brought about a remarkable improvement in the number of infants under six months of age who are exclusively breastfed—a key determinant of child nutrition—from 46.4% in 2005-06 to 71.6% in 2013-14.
The first-ever Global Nutrition Report tracks the progress of 193 member countries of the United Nations in improving their nutrition status.
The report found that of 122 countries with comparable data, 120 have at least one of the three common forms of malnutrition—under-five stunting, anaemia among women of reproductive age and adult overweight.
India suffers from both stunting and wasting (low weight for height) but not the problem of overweight among children under five, the report said.
This puts India in a group of
38 nations, among 117 for which data was available, including least developed countries like Sudan, Somalia and Ethiopia. Only 10 of the 117 countries do not have stunting, wasting and overweight levels that are serious. These include China, Venezuela, Colombia and the US.
The economic costs of undernourishment are high, the report said. Gross domestic product (GDP) totals in Africa and Asia are less than 90% of what they would be in the absence of undernutrition, and in China, approximately 95% of what they would be in the absence of obesity.
According to the report 38.8% of children under five in India suffer from stunting in 2013-14, a 9.1 percentage point reduction compared with 47.9% in 2005-06. Another 15% children under five suffer from wasting in 2013-14, a 5 percentage point reduction from the 2005-06 numbers.
The report took these numbers from the 2013-14 Rapid Survey on Children by the ministry of women and child development and Unicef, which are yet to be made public by the government.
Low sanitation coverage is a key constraint underlying India’s malnutrition problem, the report added.
Currently the world is not on course to meet the World Health Assembly (WHA) targets on nutrition set in 2012, the report noted. WHA, the decision making body of the World Health Organization, set six targets to be achieved by 2025: a 40% reduction in the number of children under five who are stunted; 50% reduction of anaemia in women of reproductive age; 30% reduction in low birth weight; no increase in child overweight; increasing exclusive breastfeeding in first six months to at least 50%; and reducing and maintaining childhood wasting to less than 5%.
“For India—the second-most populous country in the world—new and preliminary national data suggest it is experiencing a much faster improvement in WHA indicators than currently assumed. For example, if the new preliminary estimates undergo no further significant adjustments, then the numbers of stunted children under the age of five in India has already declined by more than 10 million,” the report noted.
Yet, India may not be able to meet several of WHA targets on under-five stunting, under-five wasting and anaemia in women of reproductive age. Further, India’s coverage on iron-folic acid supplementation to reduce maternal anaemia during pregnancy and for healthy conception is weak, the report said.
The Global Nutrition Report noted that Maharashtra, among the wealthiest states in India, has done commendably to reduce the share of children under five who are stunted from 36.5% in 2005-06 to 24% in 2012. Higher economic growth and poverty reduction, less leakage in the public distribution system, increased nutritional spending and filling up of vacancies under the flagship Integrated Child Development Services scheme together contributed to the improved numbers.
A rise in the age of mothers at first birth, improved maternal nutrition and literacy, coverage of antenatal visits, delivery in the presence of birth attendants and better child feeding practices were other factors that helped Maharashtra to improve its child stunting numbers.
The decline in stunting in Maharashtra is impressive but they were 10 years in the making and required sustained commitment from the government and civil society, the report observed.
“Despite the improvement in nutritional status that were achieved over a decade India is still among the worst performers with 39% child stunting. The experience of states like Maharashtra which started its own nutrition mission and opened village level centres where acutely malnourished children are fed five times in a day shows that tackling the nutritional challenge requires sustained focus and commitment,” said Dipa Sinha, fellow at the Centre for Equity Studies, New Delhi.
“The latest survey should be released by the government for public review. It is strange that a private research organization is releasing the data in bits and pieces while the government is silent on it,” she added.