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Indian Pediatr 2017;54: 686-687 |
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Undernutrition Amongst Under-five Children
Belonging to High Income Group Communities in India
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Aakriti Gupta and *Umesh
Kapil
Department of Human Nutrition, All India Institute of
Medical Sciences, New Delhi, India.
Email: [email protected]
Published online: June 04, 2017. PII:S097475591600065
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According to RSOC (2013-2014) data,
high prevalence of stunting (26.7%) and wasting (13.0%) exists amongst
under-five children belonging to highest wealth index communities. India
possibly cannot achieve the 2025 Global nutrition targets for reducing
the rate of stunting and wasting amongst Under-five children, unless
efforts are also directed towards this group.
Keywords: National Family Health Survey,
Global Nutrition targets, Stunting, Wasting, Undernurition.
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T he World Health Assembly in
the year 2012, adopted the 2025 Global nutrition targets, to which India
is a signatory. These targets are aimed to achieve: (i) 40%
reduction in the number of U5 who are stunted (target I) i.e.
from the present level of 38.7% [1] to 23%; and (ii) reduction
and maintenance in childhood wasting to less than 5% (target VI) from
the present level of 15.1% [1] by 2025. In order to achieve these
targets, the Government of India is strengthening the nutrition and
health interventions directed towards low income group communities. This
is due to the common belief that undernutrition is a result of the
cumulative effects of inadequate food intake, lack of safe drinking
water, poor sanitation and hygiene practices, low parental education
status, poor infant and young child feeding (IYCF) practices, monetary
constraints and other related detrimental factors present in the poor
households [2,3]. Since these common etiological factors of
undernutrition are possibly missing in the highest wealth index (HWI)
communities, the rate of undernutrition is expected to be low.
We conducted a secondary analysis of National
Family Health survey-3 (NFHS-3) (2005-2006) [4] and Rapid Survey of
Children (RSOC) (2013-2014) [1] data to assess the prevalence of
stunting and wasting amongst Under-five children belonging to the HWI
families. Socioeconomic status as defined by highest and lowest wealth
index was compared with the prevalence of stunting and wasting as
defined by Z score below -2SD score amongst under-five children. We
further assessed the trend in reduction of stunting and wasting over a
decade (2005-2014).
We found high prevalence of stunting (27%) and
wasting (13%) amongst the HWI families as per RSOC. No reduction in the
prevalence of stunting and wasting was seen amongst under-five children
belonging to HWI families during the decade of 2005-2014 (Table
I).
TABLE I Prevalence of Stunting and Wasting Amongst Under-five Children
Indicators of
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NFHS-3 |
RSOC |
%
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Undernutrition |
(2005-2006) |
(2013-2014) |
reduction |
Stunting
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|
|
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Highest Wealth Index |
25.3 |
26.7 |
-1.4 |
Lowest Wealth Index |
59.9 |
50.7 |
9.2 |
Wasting |
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|
|
Highest Wealth Index |
12.7 |
13 |
-0.3 |
Lowest Wealth Index |
25 |
17 |
8 |
Inadequate IYCF practices, being an important
determinant of stunting and underweight amongst under-five children, may
have resulted in high undernutrition amongst HWI families. According to
RSOC, only 62% mothers belonging to HWI families practiced exclusive
breastfeeding for 6 months. Complementary foods were provided to only
62.1% children aged 6-8 months, and only 26.5% children aged 6-23 months
consumed complementary foods with minimum dietary diversity (four or
more food groups). Although the rate of decline in under nutrition
amongst under-five children have accelerated since 2006 (Table
I), with high rates of stunting and wasting in HWI families, India
is unlikely to achieve the WHO Global Nutrition targets. There is a need
to direct health and nutritional education based interventions on
optimal IYCF practices [5-7] to HWI communities also, to reduce the
prevalence of undernutrition in the country.
References
1. Ministry of Women & Child Development, UNICEF.
Rapid Survey on Children (RSOC). 2014. Available from :
http://wcd.nic.in/issnip/National_Fact%20sheet_ RSOC%20_02-07-2015.pdf.
Accessed July 9, 2016.
2. Corsi DJ, Mejía-Guevara I, Subramanian SV.
Risk factors for child chronic undernutrition in India: Estimating
relative importance, population attributable risk and fractions. Soc Sci
Med. 2016;157:165-85.
3. Patel A, Pusdekar Y, Badhoniya N, Borkar J, Agho
KE, Dibley MJ. Determinants of inappropriate complementary feeding
practices in young children in India: secondary analysis of National
Family Health Survey 2005–2006. Mater Child Nutr. 2012;8:28-44.
4. International Institute for Population Sciences:
National Family Health Survey (NFHS-3): India (Mumbai: IIPS), 2005-06.
Available from : http://rchiips.org/nfhs/. Accessed July
9, 2016.
5. Bhandari N, Mazumder S, Bahl R, Martines J, Black
RE, Bhan MK, et al. An educational intervention to promote
appropriate complementary feeding practices and physical growth in
infants and young children in rural Haryana, India. Journal Nutr.
2004;134:2342-8.
6. Kilaru A, Griffiths PL, Ganapathy S, Shanti G. Community-based
nutrition education for improving infant growth in rural Karnataka.
Indian Pediatr. 2005;42:425-32.
7. Penny ME, Creed-Kanashiro HM, Robert RC, Narro MR,
Caulfield LE, Black RE. Effectiveness of an educational intervention
delivered through the health services to improve nutrition in young
children: A cluster-randomised controlled trial. Lancet.
2005;365:1863-72.
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