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New Delhi: The malnutrition burden in India remains high despite some progress and there is tremendous inter-state and inter-district variability, the district wise nutrition profiles show.

The government’s flagship program National Nutrition Mission (NNM) has a clear picture of the challenges it faces in dealing with malnutrition after the International Food Policy Research Institute (IFPRI) recently  released nutrition profiles of all states and 640 districts of India.

The malnutrition burden in India remains high despite some progress and there is tremendous inter-state and inter-district variability, the district wise nutrition profiles show.

NITI Aayog officials said the district wise data would help the government in taking localized action to support the NNM’s target of bringing down stunting percentage from 38.4% to 25% by 2022, and reducing stunting, under-nutrition, and low birth weight by 2%, and anaemia by 3% per annum.

The nutrition profile generated using the National Family Health Survey 2015-16 (NFHS-4) explained that India achieved improvements in stunting between 2006 and 2016, with a decline from 48% to 38.4% among children below 5 years. A majority of districts across India, however, have a high stunting burden, with more than a third of children stunted in 441 districts.

“Inter-district and inter-state differences in stunting are not explained by any single factor, but rather by a set of maternal, economic, health, hygiene and demographic factors. Only 29 districts have stunting levels between 10 and 20%, and most of these are in South India. Five districts in Kerala, two districts in Odisha, and one each in Telengana, Meghalaya, and Tamil Nadu, are among the top ten districts with the lowest levels of stunting,” said Purnima Menon, research fellow at IFPRI.

The profiles highlighted that anaemia among women had remained stagnant over the last decade and more than a third of women were anaemic in over 550 districts. Several districts with extremely high prevalence are clustered across eastern areas. Districts with the lowest levels of anaemia are in Nagaland, Manipur, Jammu & Kashmir.

Similarly, wasting among children under five slightly increased over time at the national level. “The problem is extremely widespread across India, with 487 districts where more than 15% of children are wasted. However, most of this appears to be moderate wasting, as the map for severe wasting shows a smaller number of pockets across India that are clearly hotspots for severe wasting,” said Menon.

“Nearly 160 districts have levels of severe wasting above 10%. Among them, 37 districts, scattered across different states, have levels of wasting that are above 15%—these 37 districts need high priority attention. The ten districts with the lowest levels of severe wasting are in Nagaland, Assam, Mizoram, Jammu & Kashmir, Punjab and Manipur,” she said.

The nutritional profile report emphasized that it is important to rally stakeholders around data and evidence for nutrition and encourage state-level strategic investments where coverage has been lagging, like complementary feeding, immunization and vitamin A supplementation for children, and improving sanitation for households.

“States and districts should launch action for nutrition as the data will help them visualize the challenges and gaps in their programs. It is crucial to identify the key priorities for interventions and monitoring,” Alok Kumar, advisor (health and nutrition), NITI Aayog said.

“There is a real need for going a step further and supporting the districts by providing analytics even at a sub-district level using program data such as that available from the real-time monitoring systems within the Union health ministry and the Integrated Child Development Services,” he added.

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