Bihar’s Burden of Child Stunting

The prevalence of child stunting in Bihar is as high as 48%. This study of the immediate and underlying causes of stunting reveals that only 15 of Bihar’s 38 districts are on course to reach the global target of 40% reduction in child stunting by 2025, with some districts likely to take over 25 years to reach the target. The data disaggregation at the district level presented here can help district managers use publicly available data to design and strengthen nutrition-specific and nutrition-sensitive programmes to lower the incidence of stunting.

N C Saxena reviewed the background paper for this article. District disaggregated data from the National Sample Survey 68th round was provided by the International Food Policy Research Institute. Sutapa Agarwal, Dimple Kondal and Surbhi Bhalla provided data collation and analysis support.

In Bihar, the burden of stunting among children under five years of age is high, with serious and lifelong consequences, involving irreversible adverse changes to children’s physical, cognitive and productive capacity. As state averages mask disparities at lower administrative levels, a disaggregated analysis of the causes of child stunting is important for strategising specific interventions to address child stunting.

Bihar is the third most populous state in India, with an estimated 100 million people and 12.7 million children under five years of age (Registrar General and Census Commissioner[RGCC] 2011). Despite a fast-growing economy, the state has the highest rural poverty concentration at 2,160 poor people per square kilometre (Shah 2016) and high prevalence of child stunting at 48% (International Institute for Population Sciences[IIPS] 2016). Estimates suggest that 6.1 million children under five years of age are stunted or short for their age in Bihar (RGCC 2011; IIPS 2016). While the proportion of stunted children has declined over the last 10 years, from 56% in 2005–06 to 48% in 2015–16, the rate of decline has been slow, at less than 1.5% per year (IIPS 2016, 2007). Stunting or linear growth failure begins early in life, from conception until two years of age, and is largely irreversible, affecting the child’s survival, health, development, learning capacity, school performance and productivity in adulthood (Black et al 2008; Victora et al 2008; Dewey and Begum 2011; Martorell and Zongrone 2012).