New Delhi: Tackling child undernutrition needs targeted health interventions as reliance on economic growth alone has had little impact in easing the situation, says a new study to be published in the April issue of Lancet Global Health journal.

“No association was seen between average changes in the prevalence of child undernutrition outcomes and average growth of per-head GDP (gross domestic product)…, emphasizing the need for direct health investments to improve the nutritional status of children in low-income and middle-income countries," the study says.

The study—Association Between Economic Growth and Early Childhood Undernourishment: Evidence From 121 Demographic and Health Surveys From 36 Low-income And Middle-income Countries—argues that while economic growth has been seen as a driver of improvement in population health, population level analyses miss sub-national socioeconomic factors that lead to prevalence of child undernourishment.

If there was a 5% increase in GDP per capita, there was a 0.7% chance of a decrease in the odds of children being stunted (having low height for age), a likely 1.4% decrease in the odds of them being underweight (low weight for age), and a 1.6% chance of decrease in the odds of them being wasted (low weight for height), the study said. But this was zero for children from the poorest households, the study said. The link between income growth and undernourishment was insignificant for children aged 0-11 months.

“First, the growth in incomes could be unequally distributed—if poor people are excluded from the benefits of growth, the effect of increased prosperity on average could be low. Second, even if rising incomes reach most households, they might not necessarily be spent in ways that enhance the nutritional status of children," the study said.

“A positive association would depend on how resources are allocated between food and non-food items, the quality of food purchased, and the distribution of food within households," it said.

The Lancet study, which is based on surveys carried out between 1 January 1990, and 31 December 2011, compares the change in aggregate national income with the change in the risk of an individual child being undernourished.

India has struggled with managing the problem of child undernutrition, which Prime Minister Manmohan Singh called “a national shame" in 2012. According to the Unicef, one-third of the world’s underweight and undernourished children live in India.

The last nationally representative data on undernutrition in India was collected almost 10 years ago by the health ministry in its National Family Health Survey’s (NFHS) third round in 2005-06. According to it, 48% of the children aged 0-5 were stunted or had low height for their age.

The Hunger and Malnutrition Report, 2011, produced by the non-government organization Naandi Foundation, said 42% of India’s children are underweight.

Malavika Subramanyam, an assistant professor at the Indian Institute of Technology- Gandhinagar, and one of the authors of the Lancet study, led a similar study published in 2011 that said direct investment in appropriate health interventions was necessary.

“The substantial increases in economic growth that the country experienced over the past two decades did not translate into a similarly substantial reduction in childhood undernutrition", and while undernutrition was declining with each round of the NFHS, the progress remained slow, Subramanyam wrote in that study.

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