Home / News / India /  IMR improves in India, but malnutrition remains worrying, shows NFHS-5

The Under 5 and infant mortality rate (IMR) has come down in 18 states and union territories but in parallel 16 states recorded an increase in underweight and severely wasted under 5 children among 22 states that were surveyed during the first phase of the fifth National Family Health Survey (NFHS-5).

The survey was released by the Union health minister Harsh Vardhan on Saturday. Similarly, 13 states and UTs of the 22 surveyed registered a surge in the percentage of stunted children under five years of age in comparison to 2015-16. These states are Goa, Gujarat, Himachal Pradesh, Kerala, Maharashtra, Meghalaya, Mizoram, Nagaland, Telangana, Tripura, West Bengal, Lakshadweep and Dadra & Nagar Haveli and Daman and Diu.

The present NFHS is being conducted on 6.1 lakh sample households, involving household level interviews to collect information on population, health, family planning and nutrition related indicators. The results of 17 States and 5 UTs (Assam, Bihar, Manipur, Meghalaya, Sikkim, Tripura, Andhra Pradesh, Andaman and Nicobar Islands, Gujarat, Himachal Pradesh, Jammu & Kashmir, Ladakh, Karnataka, Goa, Maharashtra, Telangana, West Bengal, Mizoram, Kerala, Lakshadweep, Dadra Nagar Haveli and Daman & Diu) have been released now as Phase-I.

Phase II covering the remaining 12 States and 2 UTs had their fieldwork suspended due to covid-19, which has been resumed from November and is expected to be completed by May, 2021, the government said. According to the union health ministry, substantial improvement in maternal and child health indicators over NFHS-4 (2015-16) was recorded in the present survey. The fertility rate has further declined, contraceptive use has increased and unmet need has been reduced in most Phase I states. The survey also found considerable improvement in vaccination coverage among children age 12-23 months across all states/UTs. Women’s empowerment indicators (including women with bank account) also portray considerable progress, the government said.

The neonatal mortality rate (NMR) (per 1,000 live births) dropped in 15 states and UTs in comparison to NFHS-4 (2015-16), while the infant mortality rate (IMR) and the under-five mortality rate (UMR) fell in 18 states and UTs, the NFHS-5 report indicated.

The NFHS-5 contains detailed information on population, health, and nutrition for India and its States and Union Territories. This is a globally important data source as it is comparable to Demographic Health Surveys (DHS) Programme of 90 other countries on several key indicators and can be used for cross country comparisons and development indices, the union health ministry said.

Wasting percentage increased in under 5 children in 12 states and UTs in comparison to NFHS-4. The data showed a rise in wasting in Assam, Bihar, Himachal Pradesh, Kerala, Manipur, Mizoram, Nagaland, Telangana, Tripura, Jammu and Kashmir, Ladakh and Lakshadweep, while Maharashtra and West Bengal showed no change.

“One of the significant improvements from POSHAN Abhiyaan is considerable improvement in vaccination coverage among children age 12-23 months across all states and UTs. However, the malnutrition indicators as have worsened are raiding serious concern, with the proportion of children with stunting rising, wasting going and anaemia. This needs a deep reflection and identify the poor performing pockets and the community-based care of children with Severe Acute Malnutrition (SAM). The Community Based Care for Acute Malnutrition has to be mainstreamed as routine part of the government system," said Sujeet Ranjan, Executive Director, The Coalition for Food and Nutrition Security, a firm advocating for improved nutrition policies and programs in India.

On the contrary the NFHS-5 also showed that 20 states and UTs saw rise in the percentage of overweight children under 5 years of age. According to the NFHS-5 (2019-20), sex ratio of the total population (females per 1,000 males) increased in 17 states and UTs in comparison to NFHS-4 (2015-16). And Himachal Pradesh, Kerala, Andaman and Nicobar Islands, Jammu and Kashmir and Ladakh saw a drop in sex ratio of the total population.

“The worsening of nutritional status including proportion of severely acute malnourished children reflects that enough efforts were not made for prevention and management of malnutrition in the states reported increased prevalence of under notion, stunting and wasting," said Daya Krishan Mangal, Dean Research, IIHMR University, Jaipur.

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