PANEL 2.2 SOME NEW DATA FROM INDIA: WHAT IF? LAWRENCE HADDAD, KOMAL BHATIA, AND KAMILLA ERIKSEN
T
he Government of India is in the process of releasing its 2013–2014 Rapid Survey on Children (RSOC). This new national survey, covering all 29 states in India, relies on data collected by the Ministry of Women and Child Development in partnership with UNICEF India. The government has made preliminary estimates available for use in this Global Nutrition Report. Key summary statistics are reported below in comparison with the most recent national survey for India in the WHO
Global Database on Child Growth and Malnu- trition: the 2005–2006 National Family Health Survey (NFHS-3). Only data for children under age five are reported here.1 The average annual rate of reduction in stunting (47.9 percent to 38.8 percent in eight years) is 2.6 percent—below India’s target rate of 3.7 percent but well above the rate of 1.7 percent estimated on the basis of previ- ous surveys. Because India has such a large population and a high stunting prevalence,
SUMMARY STATISTICS ON CHILD NUTRITION IN INDIA FROM TWO SURVEYS Indicator
Under-five stunting (%) Under-five wasting (%)
Under-five stunting, total population affected (thousands) Under-five wasting, total population affected (thousands) Exclusive breastfeeding of infants under six months old (%)
this rate of change affects the global numbers significantly. Comparisons between the two surveys also show declines in wasting. The rise in exclusive breastfeeding rates from 46.4 per- cent to 71.6 percent in eight years represents an average annual rate of increase of 5.5 percent—far above the rate required to meet India’s WHA target by 2025 (1.5 percent). In fact, if the preliminary numbers hold, by 2025 India will have far surpassed its WHA exclu- sive breastfeeding target of 57 percent.
2005–2006 NFHS 47.9 20.0
58,167 24,287 46.4
2013–2014 RSOC 38.8 15.0
43,759 16,917 71.6
Change -9.1 -5.0
-14,408 -7,370 25.2
Source: Authors, based on data from India, Ministry of Health and Family Welfare (2009) and a personal communication from L.-G. Arsenault, UNICEF representative for India, August 27, 2014.
Maharashtra’s experience shows the importance of addressing child stunting by taking action across a wide range of levels and sectors.
Third, new projections based on a model linking stunting rates with underlying determinants also show that it should be possible to meet and even exceed WHA targets by achieving challenging but realistic increases in the levels of those determi- nants (Panel 2.4).
Fourth, in Africa south of the Sahara—the region where un-
dernutrition rates have declined most slowly—the International Monetary Fund reports in 2014 that economic growth prospects are expected to accelerate in 2014–2016 and the capacity to collect taxes is also increasing (IMF 2014). It is not clear wheth- er this growth will persist in the coming decade, but reducing undernutrition is easier in the context of economic growth and
TABLE 2.4 WHERE NUTRITION TARGETS CAN BE EMBEDDED WITHIN THE 169 SDG TARGETS Nutrition target
Reduce low birth weight (WHA target)
Reduce anemia in women of reproductive age (WHA target) Increase rate of exclusive breastfeeding (WHA target) Prevent increase in under-five overweight (WHA target)
Increase coverage of nutrition-specific interventions Increase coverage of nutrition-sensitive interventions
Where nutrition target can be embedded within the SDG targets Target 3.2: “by 2030 end preventable deaths of newborns and under 5 children”
Target 3.4: “by 2030 reduce by one-third pre-mature mortality from NCDs through prevention and treat- ment”
Target 3.8: “achieve universal health coverage”
Target 1.3: “implement nationally appropriate social protection measures for all and by 2030 achieve sub- stantial coverage of the poor and the vulnerable” Target 6.1: “by 2030 achieve universal and equitable access to safe and affordable drinking water for all” Target 6.2: “by 2030 achieve access to adequate and equitable sanitation and hygiene for all and end open defecation”
Improve the enabling environment
Target 5.5: “ensure women’s full and effective participation and equal opportunity for leadership at all levels of decision making in political, economic, and public life” Target 10.3: “ensure equal opportunity and reduce inequalities in outcome” such as stunting by wealth quintile.
Source: Open Working Group on the Sustainable Development Goals (2014) and the authors of this report. 12 GLOBAL NUTRITION REPORT 2014
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