NFHS findings

Context:  The Ministry of Health and Family Welfare has released data fact sheets for 22 States and Union Territories based on the findings of Phase I of the National Family Health Survey-5 (NFHS-5).

What are the worrying findings?

• Malnutrition: Of the 22 States and UTs, there is an increase in the prevalence of severe acute malnutrition in 16 States/UTs (compared to NFHS-4 conducted in 2015-16).
  • The percentage of children under five who are underweight has also increased in 16 out of the 22 States/UTs.
  • There is also an increase in the prevalence of other indicators such as adult malnutrition measured by those having a Body Mass Index of less than 18.5kg/m2 in many States/ UTs.
• Anaemia: Anaemia levels among children as well as adult women have increased in most of the States with a decline in anaemia among children being seen only in four States/UTs.
• Obesity: Most States/UTs also see an increase in overweight/obesity prevalence among children and adults, once again drawing attention to the inadequacy of diets in India both in terms of quality and quantity.
• Stunting: The data report an increase in childhood stunting in 13 of the 22 States/UTs compared to the data of NFHS-4.
  • There was a 10 pp decline in stunting among children under five between 2005-06 (NFHS-3) and 2015-16 (NFHS-4), from 48% to 38%, averaging 1 pp a year. This was considered to be a very slow pace of improvement.
• Starvation: Volunteers of the Right to Food campaign have listed over 100 starvation deaths based on media and/or verified fact- finding reports since 2015.
• Food insecurity: Field surveys such as ‘Hunger Watch’ are already showing massive levels of food insecurity and decline in food consumption, especially among the poor and vulnerable households.
  • In the Hunger Watch survey carried out in 11 States, two-thirds of the respondents reported that the nutritional quality and quantity of their diets worsened in September-October compared to before the lockdown.

What are the steps to be taken?

• Improvements: There are some improvements seen in determinants of malnutrition such as access to sanitation, clean cooking fuels and women’s status, a reduction in spousal violence and greater access of women to bank accounts.
• Interventions: Direct interventions such as supplementary nutrition, growth monitoring, and behaviour change communication through the ICDS and school meals must be strengthened and given more resources.
• Progress on maternity entitlements: Universal maternity entitlements and child care services to enable exclusive breastfeeding, appropriate infant and young child feeding, recognising women’s unpaid work burdens have been on the agenda for long, but not much progress has been made on these.
• Strategy: An employment-centred growth strategy which includes universal provision of basic services for education, health, food and social security is imperative.
• Expansion in social protection schemes: Such as the Mahatma Gandhi National Rural Employment Guarantee Scheme, the Public Distribution System, the Integrated Child Development Scheme (ICDS), and school meals have contributed to reduction in absolute poverty as well as previous improvements in nutrition indicators.

Way forward

• It is hoped that the experience of the pandemic, as well as the results of NFHS-5, serve as a wake-up call for serious rethinking of issues related to nutrition and accord these issues priority.