Child malnutrition levels take a dip

By Our Staff Reporter

Bhopal, June 24:

India's tardy performance can be traced to the limited progress in providing basic health care. According to the recently released National Family Health Survey-3 for 2005-06, 46 per cent of children below the age of three are underweight - down from 47 per cent in 1998-99. It is disappointing that despite the acceleration in economic growth and the country's economic buoyancy, there has been only a one percentage point reduction in the proportion of underweight children at the end of seven years. NFHS-3 offers insights into some of the factors that account for the abysmal progress in reducing child malnutrition.

One, improvements in expanding the reach and coverage of public health services over the past seven years have been very limited. For instance, only 44 per cent of children aged 12 to 23 months were fully immunised in 2005-06 - up from 42 per cent in 1998-99 and 36 per cent in 1998-99. As a matter of fact, Two, access to critical components of treatment of childhood diseases has deteriorated over the past seven years. For instance, the proportion of children with diarrhoea who received oral rehydration salts (ORS) in the two weeks preceding the NFHS-3 survey had risen from 18 per cent in 1992-93 to 27 per cent in 1998-99; but since fell to 26 per cent in 2005-06.

Three, critical public health messages are simply not reaching families with children. Public health experts, for instance, have for long emphasised the importance of exclusive breastfeeding during the first six months of a baby's life. Despite this, in 2005-06, only 23 per cent of infants up to five months old were exclusively breastfed - up from 16 per cent in 1998-99, an increase of seven percentage points over seven years.

Four, levels of child malnutrition are closely linked to the care women receive during pregnancy and thereafter. NFHS-3 reveals very little progress in women's access to maternal health services. Between 1998-99 and 2005-06, the proportion of births assisted by a doctor, nurse, woman health worker, auxiliary nurse midwife or other health personnel went up marginally from 42 to 48 per cent; and institutional births went up from 36 to 41 per cent over the same period.

Finally, closely linked to the health and nutritional status of children is the health of mothers. In 1998-99, 36 per cent of married women aged 15 to 49 had a Body Mass Index (BMI) below normal. The proportion fell marginally to 33 per cent in 2005-06. Levels of anaemia, high in 1998-99, have risen further to 56 per cent among married women and to 58 per cent among pregnant women.

Some States have done better than others in terms of reducing child malnutrition. And there are lessons to be learned from the better performing States. For instance, between 1998-99 and 2005-06, Maharashtra, Orissa, Himachal Pradesh, Jammu and Kashmir, and Chhattisgarh recorded the maximum reductions in child malnutrition. At the other extreme are Bihar, Jharkhand, Assam, Madhya Pradesh, and Haryana where the proportion of underweight children has, in fact, gone up.

The nutritional well-being of newborn babies and children under the age of three deserves the topmost attention. It is not enough to talk about the demographic advantage that India enjoys; the real challenge lies in ensuring that the young in India do enjoy improved nutritional and other facilities.