National Family Health Survey on malnutrition

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National Family Health Survey (NFHS) provides the data on nutrition indicators at National & State level. As per NFHS-3,(2005-06), 42.5 % children under 5 years are underweight, 48 % are stunted, 19.8 % are wasted; and 40.4% children under 3 years are underweight, 44.9 % are stunted and 22.9% are wasted. The rate of malnutrition has declined from 42.7% in 1998-99 (NFHS-2) to 40.4% in 2005-06 (NFHS-3) for children below 3 years of age. As per NFHS-3, the state-wise details of under nutrition in children under 5 years and women are as given below.

S.No State Undernutrition
Children (6-59 months) % Women (15-49 yrs) % (BMI below normal)
1 Andhra Pradesh 32.5 33.5
2 Assam 36.4 36.5
3 Arunachal Pradesh 32.5 16.4
4 Bihar 55.9 45.1
5 Chhattisgarh 47.1 43.4
6 Delhi 26.1 14.8
7 Goa 25.0 27.9
8 Gujarat 44.6 36.3
9 Haryana 39.6 31.3
10 Himachal Pradesh 36.5 29.9
11 J&K 25.6 24.6
12 Jharkhand 56.5 43.0
13 Karnataka 37.6 35.5
14 Kerala 22.9 18.0
15 Madhya Pradesh 60.0 41.7
16 Maharashtra 37.0 36.2
17 Manipur 22.1 14.8
18 Meghalaya 48.8 14.6
19 Mizoram 19.9 14.4
20 Nagaland 25.2 17.4
21 Orissa 40.7 41.4
22 Punjab 24.9 18.9
23 Rajasthan 39.9 36.7
24 Sikkim 19.7 11.2
25 Tamil Nadu 29.8 28.4
26 Tripura 39.6 36.9
27 Uttar Pradesh 42.4 36.0
28 Uttrakhand 38.0 30.0
29 West Bengal 38.7 39.1
India 42.5 35.6

Ministry of Health and Family Welfare is nodal for conducting National Family Health Survey (NFHS) and District Level Household Survey (DLHS) to provide data on health and nutrition indicators. No recent data/report from Ministry of Health and Family Welfare on nutritional indicator amongst women and children is currently available in the country, other than the NFHS-3 (2005-06).

Further, as per the survey on ‘Causes of Death – 2001-03 in India’ by Registrar General of India, nutritional deficiencies are responsible for only 2.8% death of children aged 0-4 years.   As per the report, some of the major causes of death of children below 4 years are perinatal conditions (33%), respiratory infections (22%), diarrheal diseases (14%), other infections and parasitic diseases (11%), accounting for 80% of the deaths in this age group.

The problem of malnutrition is complex, multi-dimensional and inter-generational in nature. The approach to deal with the nutrition challenges has been two pronged:   First is the Multi-sectoral approach for accelerated action on the determinants of malnutrition in targeting nutrition in schemes/programmes of all the sectors. The second approach is the direct and specific interventions targeted towards the vulnerable groups such as children below 6 years, adolescent girls, pregnant and lactating mothers.

The Government has accorded high priority to the issue of malnutrition in the country and is implementing several schemes/programmes of different Ministries/Departments through State Governments/UT Administrations. The schemes/programmes include the Integrated Child Development Services (ICDS), National Rural Health Mission (NRHM), Mid-Day Meal Scheme(MDM), Rajiv Gandhi Schemes for Empowerment of Adolescent Girls (RGSEAG) namely SABLA, Indira Gandhi Matritva Sahyog Yojna (IGMSY) as direct targeted interventions. Besides, indirect Multi-sectoral interventions include Targeted Public Distribution System (TPDS), National Horticulture Mission, National Food Security Mission, Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), Nirmal Bharat Abhiyan, National Rural Drinking Water Programme etc.

Further, Government has approved the strengthening and restructuring of ICDS with special focus on pregnant and lactating mothers and children under three. The restructured and strengthened ICDS has been rolled out in three phases with focus on the 200 high burden districts for malnutrition during 2012-13 ; additional 200 districts in 2013-14 including districts from the special category States and NER and the remaining districts in 2014-15. Besides International Development Association (World Bank) assisted ICDS Systems Strengthening and Nutrition Improvement Project (ISSNIP) has been approved for 8 states having higher under nutrition.

An Information Education and Communication Campaign (IEC) to generate awareness against malnutrition has been rolled out in the country since 28th Dec, 2012. In addition, Government has approved a Multi-Sectoral Nutrition Programme to address Maternal and Child Under nutrition in 200 high burden districts and to begin with in 100 districts amounting to Rs. 1213.19 crore during the 12th five year plan. The National Food Security Act 2013 is also a step towards contributing to household food security. A Pilot Scheme on Nutri-farm by Ministry of Agriculture is being implemented in 100 high malnutrition burden districts of 9 states during the year 2013-14.