The fifth round of the National Family Health Survey (NFHS 2019-20) was released recently covering important milestones on nutrition and health status to the present day. A lot has changed on a child’s nutritional status with better development in some indicators and deterioration in others.
NFHS-4 (2015-16): The percentage of children (aged 6-23 months) who do not meet the minimum dietary adequacy as defined under the Infant and Young Child Feeding (IYCF) practices by WHO is 83.9%, a decline of just over 2 percentage points from last year when it stood at 86.3%.
Dietary adequacy: Dietary inadequacy is defined as consumption below the minimum food intake level of a nutrient recommended by the Indian Council of Medical Research for healthy growth and development. Goa experienced the largest percentage point decline (11.1%), and Jammu and Kashmir observed the highest increase in its percentage of children not meeting dietary adequacy over the last three years (76.5% to 86.4%).
Anaemia prevalence: Anaemia is a major public health concern in our country with about half of all children affected. Anaemia prevalence among children increased by about eight percentage points from 51.8% to 60.2%. The prevalence of anaemia in childhood increased in 18 of the 22 States/Union Territories.
Initiatives: The Ministry of Health and Family Welfare (MoHFW) has launched the POSHAN Abhiyaan and the Anemia Mukt Bharat or AMB Strategy with efforts to improve Iron and Folic Acid (IFA) supplementation. While the World Health Organization (WHO) has successfully established scaling up of iron and folic acid supplementation in programs, its initiatives have not been able to affect behavior change for consistent use of iron supplements. This is because the underlying issues of Anaemia related care and treatment needs of women and children are complex in nature.
Typology: The NFHS-4 survey found that a lower proportion of children below 5 years experienced dietary failures, compared to children between the ages of 5 and 18 years. A classification of nutritional status using a combined typology based on children who experience dietary failure and anthropometric failure is crucial.
Nutrition agenda: Dietary factors can clearly be a major determinant of stagnancy in the nutritional status of Indian children. Therefore, nutrition agenda needs to be considered from food as a right perspective. This can help improve the coverage and quality of primary health services.
Quality data: One of the challenges of writing about nutrition in India is that the available data are either not representative, not current or not public. In such a scenario, it is imperative to raise one’s voice for a national nutrition monitoring system that can capture the real picture of what Indians eat. Data available in a timely manner and in public domain, is empowering, as the NFHS has demonstrated over the last 25-plus years.
The topic of child under nutrition often leaves people and governments confused and conflicted over the adoption of appropriate strategies to reduce its burden globally. We need to reframe our current approach to handling this issue by setting a simple and pragmatic policy goal on providing affordable (economic and physical) access to quality food items, particularly for lower socioeconomic populations groups. This should be a priority for all nations in a bid to ensuring optimized nutritionally balanced diets of essential nutrients that are required for normal growth, development, and maintenance of body tissues.