New Delhi, January 10
Prime Minister Manmohan Singh today described child malnutrition as “national shame” and said health, education and sanitation sectors must collaborate to shape national response to the problem.

“These sectors can no longer work in isolation. Health professionals cannot solely concentrate on curative care. Drinking water providers cannot be oblivious to the externality of their actions. School teachers need to be aware of the nutritional needs of adolescent girls,” he said after releasing a new research by Hyderabad-based Naandi Foundation on the status child malnutrition in India.

The study reveals shocking results for all three standard indices used to measure children’s nutritional status - stunting (height for age); wasting (weight for height) and underweight (weight for age). The researchers, after surveying 1,09,093 children aged 0 to 5 in 100 most backward districts of six states - Bihar, Jharkhand, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh - found 59 per cent children were stunted; 42 per cent underweight and 11.4 per cent wasted.

The Prime Minister said 42% children being underweight in the country which was witnessing a high growth was a matter of concern. “This is unacceptably high occurrence,” he said.

Pointing to some positives highlighted by the survey, Manmohan Singh said: “The study reports high levels of malnutrition but also indicates that one child in five has reached an acceptable healthy weight during the last 7 years in 100 focus districts. This 20 per cent decline in malnourishment is better than the rate of decline reported in NFHS- 3,” the PM said, adding that the Integrated Child Development Scheme could not be solely depended upon and district-wise focus was needed.

Led by Rohini Mukherjee, the study is the first since the 2006 National Family Health Survey generated national nutritional data.

Although it says prevalence of underweight children decreased from 53 per cent (2004 District Level Health Survey) to 42 per cent now, it adds that this is very low rate of decline - 2.9 per cent a year. “Underweight incidence declined 20.3 per cent in seven years,” the study finds.

A major revelation of the study titled HUNGama (Fighting Hunger and Malnutrition) is that child malnutrition sets in early where the 37-year-old ICDS fails to work. It shows that the prevalence of stunting peaks among children aged 24 to 35 months. Comparing 100 most backward districts, alongside six best in the states under study and six best nationwide, the research finds that across all three clusters, children’s underweight incidence was the highest at early ages and wasting was the highest for children aged 12 to 23 months.

The new study finds that child stunting among uneducated mothers is 62.9 pc as against 42.6 for mothers who have passed Class X. Malnutrition also increases for a child born with low birth weight (less than 2.5 kg). In 100 districts (selected from UNICEF’s 2010 rankings), prevalence of underweight children among those with low birth weight is 49.9 as against 33.5 pc for children with normal weight. Child wasting, underweight and stunting are higher for children in households with no toilets.

The PM also noted, “We have believed that a mother’s education level, economic status of the family, provision of sanitation, status of women and breastfeeding affect children’s nutrition. The survey validates it.”

Naandi survey further reveals several chinks in ICDS. It says half of the 74,020 mothers covered never gave their first milk to the child after birth; 58 per cent did not exclusively feed him. “While 96 per cent anganwari workers knew what malnutrition is, 92 per cent mothers said they had never heard of the term. Anganwari workers are not counseling mothers. ICDS messaging is not reaching the targets,” Rohini Mukherjee said. She said the mid-day meal scheme was helping children above five years of age but by then, the damage is done.