More than 30 per cent children under the age of five years in Himachal Pradesh are stunted and more than 1/4th are underweight, according to the fifth National Family Health Survey (NFHS) released recently. The health of children in the state has taken a turn for the worse in terms of all three crucial indicators of nutrition — stunting, wasting (low weight for height) and underweight, the survey has shown.
Stunting is impaired growth and development in children due to poor nutrition, repeated infection and inadequate opportunities to play and learn, according to the World Health Organization, and it can be prevented but not cured.
The survey, conducted in 2019-20 in nearly 11,000 households in Himachal, found that 30.8 per cent children aged below five years are stunted in terms of their height-for-age, i.e. their height is low in relation to their age as per WHO’s standards of normal child growth.
The proportion of stunted children is more in rural areas as compared to urban areas, and has increased by 4.5 per cent since the last such survey held five years ago.
The WHO says that stunting in early life, particularly in the first 1,000 days from conception until the age of two, has negative consequences for the child’s physical and mental development. Poor maternal nutrition and health, inadequate breastfeeding and infections are the main causes of stunting.
Chamba HP’s worst-affected district
The worst-affected district in Himachal is Chamba where 42.6 per cent children are stunted, followed by Bilaspur (40 per cent) and Kullu (36 per cent), the survey said.
Even in the least-affected district of Una, 25 per cent children are stunted.
Furthermore, a total of 25.5 per cent children in the state are underweight and 17.4 per cent are wasted, including 7 per cent who are severely wasted, according to the survey. Child wasting means a child is too thin for his/her height. Wasted children have an increased risk of death, the WHO says, but treatment is possible.
Less than one-fifth children receiving adequate diet
Dr Piyush Gautam, an associate professor at a medical college in Tanda, said that after attaining the age of six months, a child needs complimentary feed in addition to being breast-fed. “Sometimes, this practice is neglected by parents and the child continues to be only breast-fed, or there is a lack of adequate calories, proteins and nutrients in the diet. This results in malnutrition and wasting, which may further be aggravated by underlying infections such as tuberculosis and chronic diarrhea,” he added.
The survey found that only 19 per cent children in Himachal aged 6 to 23 months are receiving an adequate diet. The situation is alarming in urban areas of the state, where only 14.4 per cent children are receiving an adequate diet, the survey said.
Dr Gautam said that in children aged less than six months, lack of breast-feeding or feeding diluted cow milk is also a contributory factor towards malnutrition. The survey said that 70 per cent children in the state aged under 6 months are exclusively breastfed.
Child health and nutrition in Himachal
Children under 5 years are stunted: 30.8%
Children under 5 years are wasted (low weight for height): 17.4 %
Children under 5 years are underweight: 25.5%
Children aged 6-23 months are receiving adequate diet: 19%
Children aged 12-23 months are fully vaccinated: 89.3%
Source: National Family Health Survey-5, 2019-20