Priyanka Kakodkar

Stunting Down, But Wasting Up, Says NFHS

As many as 36% of children below the age of five in Maharashtra are underweight for their age, a key indicator of malnutrition. What’s more alarming, this figure has dropped by only one per cent in an entire decade, according to the National Family Health Survey 4 conducted in 2015-16.The figures are all the more startling given that the state has been feted in recent years for reducing child malnutrition, notably for cutting down long term malnutrition among toddlers. In fact, the latest NFHS data does show a significant decline in stunting or low height for age, a reflection of long term malnutrition.

Stunting in children below five years has fallen by almost 12% in the last decade.

It fell from 46.3% when the NFHS 3 was conducted in 2005-6 to 34.4% by 2015-16 in the NFHS 4 survey . Yet, Maharashtra’s performann tackling more recent malnou ce in tackling more recent malnourishment among children continues to be poor. The state’s indicators for “wasting“ or low weight for height have soared over the last decade among children below five. Wasting is a reflection of recent food deprivation, even as recent as a year ago.

Over a quarter of the state’s children below the age of five are “wasted“ according to NFHS 4 data.The figure has risen by 9% over the last decade. In 2005-06, NFHS data showed 16.5% of children in this age group were wasted. By 2015-16, the figure had risen to 25.6%.

Even severe wasting–children who are severely underweight for their height–has shot up. NFHS data shows the number of severely wasted children below five has risen from 5.2% in 2005-6 to 9.4% in 2015-16.

Health activists point fingers at the national budget cuts to crucial programmes such as the Integrated Child Development Scheme (ICDS), meant to counter malnutrition in children below six years. “At the national level, the ICDS budget has seen an overall stagnation and then a cut. Nationally , there has been a 50% budget cut. This has impacted the ICDS programme,“ says Abhijit More from the public health advocacy group Jan Arogya Abhiyan.

The drought, which affected large swathes of farm land in the state, contributed to the crisis, he adds.Also, children under three years are finding themselves excluded from the supplementary food given through the ICDS in Maharashtra after the introduction of its Take Home Ration (THR) programme.

“THR was introduced with the argument that children below three years do not come to anganwadis to eat the food given there. But the THR packets are mostly inedible which means children below three years are in effect being excluded,“ says Dr More. This is the age group most vulnerable to malnourishment.

However, officials say the state is not short on funds for the ICDS programme. “We are able to implement the programme effectively with the existing budget,“ says Sanjay Kumar, additional chief secretary , women and child welfare department.The THR scheme, he says, is working well in several districts.

Officials admit, though, that efforts to reduce child malnutrition have hit a plateau. The ICDS provides only supplementary nutrition and a larger effort is required to improve the overall health and nutrition of children, they say . “We need to think about how to implement the existing programmes more effectively and also aim for a convergence between other departments including health, sanitation and social welfare,“ says Kumar.