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Drivers of Child Nutritional Change in India
A trend analysis is undertaken to account for the child nutritional change in India by covering 25 years of the National Family Health Surveys from 1992–93 to 2015–16. The 34% overtime decline in child undernutrition has been possible mainly because of the improvement in parental education, household economic status, coverage in immunisation, and reproductive healthcare. However, the onus has shifted towards education and economic status. The combined share of contribution to the nutritional change has increased from 48.4% to 71% between 1992–93 to 2005–06 and 2005–06 to 2015–16. While there has been a saturation of persistent government interventions for immunisation, antenatal care, and institutional delivery, education and economic status have become stronger predictors. They ensure better childcare practices, sanitation, proper diet, and access to healthcare. Therefore, the future of child nutrition lies largely in the improvement of quality education and inclusive economic development.
Child undernutrition remains one of the major public health challenges of the 21st century. Children who suffer from chronic undernutrition in the early stages of life fail to grow and develop to their full potential, both mentally and physically (Black et al 2013). It has a negative impact on economic outcomes, including productivity, occupational status, and wages (McGovern et al 2017). The challenges are more serious in India given the large number of undernourished children. India is home to around one-third of the world’s undernourished children. The number of stunted children accounts for 46.6 million of the 150 million worldwide statistics (Development Initiatives 2018). The stunting rate of children below five years is as high as 38.4%. The other measures of undernutrition like wastage and being underweight depict similar pictures. The rates of wastage and underweight are 21% and 35.8%, respectively (IIPS and ICF 2017).
The prevailing rates of child undernourishment in India upholds important questions and paradoxes like—why has India failed to contain child undernutrition rates despite its high economic growth? And why has the reduction rate been slower as compared to many similar neighbouring countries, which were coined as Asian enigma? (Ramalingaswami et al 1996) For example, Bangladesh and Nepal record greater yearly reduction rates with 2.9% and 4.1%, respectively, as compared to 1.3% for India in the last two decades
(Krishna et al 2018).
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