Provisional data from the new Comprehensive Nutrition Survey in Maharashtra (CNSM) released recently shows that the State has been able to improve the nutritional status of children below two years of age by a significant percentage for the first time since the shocking results of the National Family Health Survey (NFHS- 3) in 2005-2006. The prevalence of stunting in children below two years has reduced by 16 per cent to 22. 8 per cent for the first time since 2005-2006, when it was pegged at 39 per cent. In addition, children under two years reported a reduction in wasting (or being too thin for height) from 19.9 per cent to 15.5 per cent and in being underweight (too thin for age) from 29.6 per cent to 21.8 per cent.
The CNSM 2012 is the first ever State-specific nutrition survey with a focus on infants under two and their mothers. The International Institute of Population Sciences (IIPS) and UNICEF are involved in the study which examined a representative sample of 2,809 children from each of the six administrative divisions of Maharashtra. The results give a boost to the State, which has been under fire for its deaths due to malnutrition, especially in areas like Melghat, Thane and Nashik.
Announcing the results, Dr. Victor M. Aguayo, Chief, Nutrition UNICEF, said that Maharashtra had shown almost no decline in the prevalence of stunting from 1999 to 2006. However, the CNSM study showed a reduction during the 2006-2012 period.
This was due to improvements in three key areas — infant and young child feeding practices, access to health services and healthy environments and care for women before and during pregnancy. The study showed improvement in infant feeding practices, micronutrient nutrition in the form of vitamin A supplementation and iodised salt, access by women to at least three ante- natal care visits and having toilets at home.
The survey indicated that prevalence of malnutrition among children under two years was higher in Scheduled Caste and Scheduled Tribe children. Problems of poor complementary foods persist in children under two years who need more dietary diversity, consumption of iron rich foods and a good diet. Though the figures of stunting show an improvement, as also wasting and being underweight, there are significant disparities in the prevalence of stunting, Dr. Aguayo pointed out. For instance, Nashik division, which has a large tribal population, has a 32.3 per cent prevalence of stunting but Nagpur and Pune divisions are better off with prevalence of stunting at 15.3 per cent and 16.7 per cent respectively.
What was happening in Maharashtra was a game changer and it was showing the rest of India what can be done and how nutrition needs should be understood and tackled, he added.
Dr. F. Ram, director of IIPS, said that the study looked at children and mothers and the sample included 369 children from tribal areas. The sample size of children was far better than the NFHS- 3 for children under the two years category. The NFHS had examined 1,100 or so children. Data collection for CNSM took place between February-May 2012.
Despite the improvement in nutritional status, overall the situation seems grim as India has the largest number of stunted children in the world. Of the 195 million children under five years who are stunted the world over, 61 million or one-third lived in India, Dr. Aguayo said.
The prevalence of stunting is about 48 per cent in India as compared to Sub-Saharan Africa (42 per cent), China (15 per cent) and Brazil (seven per cent). Defining stunting as children’s inability to achieve their growth and developmental potential because of persistent nutrition deprivation, Dr. Aguayo pointed out that there were long term consequences of stunting in early childhood. These affect a child’s very survival, physical growth, brain development, school achievement and economic productivity. The prevalence of low birth weight babies (below 2.5 kg at birth) in Maharashtra was also a cause for concern.
In Maharashtra, stunting happens early in life and the 1,000 day period from the child’s birth up to two years age was critical, he said. Ten interventions were needed in that window period, including essential nutrition interventions in the form of initiation of breast feeding, introduction of complementary foods, vitamin A supplementation, among other aspects. The final report of the study will be ready by the year end.
