The data from NFHS-5 indicates that while Mortality Rates have decreased, Child Nutrition did not register progress in most Key States. Here is a review.
Mortality rates and nutritional data were provided in the NFHS-5 (National Family Health Survey) (Phase I) (2019-20) report. We compare it with the previous rounds of NFHS (2015-16; 2005-06) and compare the trends. In the context of an overall decreasing trend of mortality but an overall increasing trend of malnutrition, we will try to understand the challenges that surround the development of children’s nutritional status in developing countries.
(Note: the figures are based on the comparison of 17 states that feature in NFHS-5 (Phase I) factsheet, which does not include all states/UTs).
Mortality Rates register an overall decrease
- Neonatal Mortality Rates (NMR) shows an overall decrease with some exceptions
Neonatal Mortality Rate (NMR) refers to the death of a live-born baby within the first 28 days of life. Most states have recorded a decrease in their NMR except for Maharashtra and some northeastern states like Manipur, Mizoram, Meghalaya, and Tripura, which have shown an increase in the NMR figures.
- Infant Mortality Rates (IMR) show an overall decrease but negligible progress in key states
Infant Mortality Rate (IMR) is the number of deaths per 1,000 live births of children under one year of age. Most states have recorded a decrease in their IMR as compared to the previous rounds of NFHS with the exception of some northeastern states like Manipur, Meghalaya, and Tripura which have shown an increase in the IMR figures. Key states like Maharashtra, Karnataka, Bihar, and Telangana although register a decrease in IMR figures, there is no substantial change in the figures from the last NFHS round in 2015-16.
The average rate of decline from NFHS-3 to NFHS-4 figures (27.69%) was much higher as compared to the average rate of decline from NFHS-4 to NFHS-5 figures (17.15%).
(c) Under-five Mortality Rates (U5MR) show an overall decrease but negligible progress in key states
The under-five mortality rate is the probability per 1,000 that a new-born baby will die before reaching age five, if subject to current age-specific mortality rates. Most states have recorded a decrease in their U5MR as compared to the previous rounds of NFHS figures except for some northeastern states like Manipur, Meghalaya, and Tripura which have shown an increase in the IMR figures. Key states like Maharashtra, Karnataka, Bihar, and Telangana although register a decrease in IMR figures, there is no substantial change in the figures from the last NFHS round in 2015-16.
The average rate of decline from NFHS-3 to NFHS-4 figures (34.53%) was much higher as compared to the average rate of decline from NFHS-4 to NFHS-5 figures (16.19%).
Children Under 5 who are Stunted, Wasted, Underweight, and Anaemic – register an overall increase
Stunting, based on a child’s height and age, is a measure of chronic nutritional deficiency. Wasting, based on a child’s weight and height, is a measure of acute nutritional deficiency. Underweight, based on weight and age, is a composite measure of both acute and chronic statuses. Anaemia refers to a condition in which there is a deficiency of red cells or of haemoglobin in the blood, resulting in pallor and weariness.
The percentage of children under five who are stunted shows an increase in majority of the states including Kerala, Maharashtra, Gujarat, Meghalaya, Nagaland and Telangana, among others. Few states like Sikkim, Jammu and Kashmir, Andhra Pradesh, and Karnataka among others register a decrease.
The percentage of children under five who are wasted also registered an increase or remained almost the same in majority of the states including Kerala, Telangana, Nagaland, Assam, Jammu & Kashmir and Maharashtra, among others. Few states like Andhra Pradesh, Sikkim, Karnataka and Gujarat, among others register a decrease.
The percentage of children under five who are underweight also registered an increase or remained almost the same in majority of the states including Jammu & Kashmir, Nagaland, Kerala, and Telangana, among others. Few states like Sikkim, Manipur, Meghalaya, Bihar, Andhra Pradesh, and Karnataka among others register a decrease.
The percentage of children under five who are anaemic registered an overall increase in all states with the only exception of Meghalaya. The average rate of increase in anaemia from NFHS-4 to NFHS-5 is about 30.71%.
What are the challenges around improving child nutrition in developing countries?
A Case Study of six developing countries (2006) from FAO highlights the pattern of “epidemiologic transition” that constitutes a shift from high mortality and fertility patterns to lower mortality followed by lower fertility. Improvements in water and sanitation, and more effective public health services such as immunization result in an associated shift in disease burden from high rates of infectious disease to increasing non-communicable disease (NCD). In tandem with this shift, life expectancy increases, and the demographic profile shifts becoming more predominant as longevity increases. There is increasing documentation of slow progress in reducing undernutrition, particularly in children under five years of age.
However, at the same time, children’s nutritional status is dependent on a host of inter-related factors. The current burden of malnutrition seen in many developing countries is brought about by a coupling of risk factors. The low status of women, poor maternal nutrition, inadequate prenatal care, and the disproportionate burden of physical labour borne by mothers are some of the greatest impediments to improving nutritional status. When discrimination against women is prevalent, so is poor nutrition, regardless of economic growth. Both maternal undernutrition and maternal overweight affect children’s development, including that of their metabolism, ‘fuelling an intergenerational cycle of malnutrition’, according to the UNICEF’s Report titled ‘The State of World’s Children’ 2019.
Featured Image: NFHS 5 on Mortality Rates
