New Delhi:Malnutrition continues to be the leading risk factor for death in children under-five years of age across India, according to comprehensive estimates of disease burden due to child and maternal malnutrition released by theIndian Council of Medical Research (ICMR)on Wednesday.
According to the study, the death rate attributable to malnutrition in under-5 children in India has dropped by two- thirds from 1990 to 2017, but still accounts for 68% of deaths in under-five children.
The study also highlighted that the disease burden rate attributable to malnutrition in children varies seven-fold across states, and is highest in Rajasthan, Uttar Pradesh, Bihar and Assam, followed by Madhya Pradesh, Chhattisgarh, Odisha, Nagaland, and Tripura.
Among malnutrition indicators, low birth weight is the biggest contributor to disease burden followed by ch ild growth failure which includes stunting, underweight, and wasting.
The estimates, part of the Global Burden of Disease Study 1990 – 2017, were also published in the Lancet Child & Adolescent Health on Wednesday. The study was conducted by the India State-Level Disease Burden Initiative – a joint initiative of the ICMR, Public Health Foundation of India, and Institute for Health Metrics and Evaluation in collaboration with the Ministry of Health and Family Welfare.
“Efforts are needed in each state to control malnutrition. State governments are being encouraged to intensify efforts to reduce malnutrition and undertake robust monitoring to track the progress, “said Vinod K. Paul, memberNITI Aayog.
“The National Institute of Nutrition, an ICMR institute, and other partners are setting in place mechanisms to ensure that there are more data available on malnutrition in the various states of India which will help monitor progress, “said Balram Bhargava, secretary in the department of health research in the ministry of health, and also director general ICMR.
According to the study, the prevalence of low birth weight was 21% in India in 2017, ranging from 9% in Mizoram to 24% in Uttar Pradesh.
The study highlighted that the prevalence of child stunting was 39% in India in 2017. This ranged from 21% in Goa to 49% in Uttar Pradesh, and was generally highest in the EAG states. The prevalence of child underweight was 33% in India in 2017, ranging from 16% in Manipur to 42% in Jharkhand. The prevalence of child anaemia was 60% in India in 2017, ranging from 21% in Mizoram to 74% in Haryana.
“While it is important to address the gaps in allmalnutrition indicators, low birth weight needs particular policy attention in India as it is the biggest contributor to child death among all malnutrition indications and its rate of decline is among the lowest, “said Lalit Dandona, Director of the India State-Level Disease Burden Initiative.
The study also captured the maternal health which found the prevalence of anaemia in women at 54% in India in 2017, ranging from 28% in Mizoram to 60% in Delhi.
“Focus on improving the overall nutritional status of girls and women during the preconcept ion and pregnancy period, providing quality antenatal care will positively influence low birth weight indicators and extend the benefits to next generation, “Paul said.
“ For substantial improvements across the malnutrition indicators, states will need to implement an integrated nutrition policy to effectively address the broader determinants of under nutrition across the life cycle, “said Soumya Swaminathan, chief scientist at the World Health Organization (WHO) and first author of the paper.
“Focus will be needed on major determinants like provision of clean drinking water, reducing rates of open defecation, improving women’s educational status, and food and nutrition security for the most vulnerable families. Also required is further enhancing agricultural productivity and food security, promoting nutrition-sensitive agriculture, “she said.
The study also highlighted that the prevalence of exclusive breastfeeding was 53% in India in 2017, ranging from 34% in Meghalaya to 74% in Chhattisgarh.
“Malnutrition in children is an outcome of inadequate maternal nutrition, poor sanitation and hygiene and suboptimal infant feeding practices. Improvement in nutrition, therefore, is linked not only with food availability and access, but also with food safety and environment,” said R. Hemalatha, director at National Institute of Nutrition, ICMR.
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