STRENGTHENING DATA, ANALYTICS AND EVIDENCE FOR NUTRITION: AN OVERVIEW OF POSHAN-II
In 2012, India committed to achieving the six WHA targets for stunting, wasting, anemia, exclusive breastfeeding and overweight/obesity and then reaffirmed commitments to nutrition as part of the launch of the Sustainable Development Goals in 2016. Tracking India’s progress on these maternal, infant and young child nutrition targets has been challenging, due to lack of timely, representative, high-quality data on nutrition indicators. Recently released data from the National Family Health Survey (NFHS-4), however, finally offer an opportunity to undertake time-trend analyses for a majority of the globally agreed-upon nutrition indicators.
Data from the NFHS-4 show that levels of stunting, anemia, wasting, severe wasting and exclusive breastfeeding have improved in India between 2006 (NFHS-3) and 2016 (NFHS-4). Despite these improvements, 38.4 percent of Indian children remain stunted, and more than 15 percent wasted. Anemia among women has remained stagnant and exclusive breastfeeding (EBF) levels remain low at 55 percent. To add to the burden, new health challenges have emerged in the last decade. There has been an increase in prevalence of overweight/obesity, high blood pressure and high blood sugar, among men and women, in the country. It is therefore no surprise that substantial improvements are still required across all states, if India is to meet its WHA commitment by 2025.
With this in mind, POSHAN continues to support data and evidence informed policy, and program decisions, at the national and state-level in India. The team has already started documenting stories of change in nutrition at the state-level, and analytic work on these drivers of change, at both state and district levels, has also commenced. On May 3, 2017, POSHAN organized a stakeholder meeting to share early insights from these analyses. At this meeting, POSHAN released seven nutrition data products: A report on national trends in nutrition outcomes, determinants and interventions in India, four state-specific Policy Notes accompanying the report and providing a state-focused analysis of the same issues, and two Data Notes that provide insights on the burden of multiple forms of malnutrition – undernutrition and non-communicable diseases - at the district level in India.
At the meeting, Dr. Rasmi Avula (Research Fellow, IFPRI) shared insights on national-level trends in outcomes, determinants and interventions, Ms. Sneha Mani (Senior Research Assistant, IFPRI) on the variability of these outcomes at the state-level, and Dr. Phuong Nguyen (Research Fellow, IFPRI) on their variability at the district-level and on drivers of stunting at the district-level. The presentations revealed that no state is immune to nutrition challenges and that the nature, extent and distribution of the problem varies by state. The trends analyses highlighted that even high-performing states need to sustain coverage of health and nutrition interventions and adapt to changing nutrition challenges and needs. Within-state district analyses highlighted where states can focus action to accelerate change in outcomes and determinants, while the district-level analysis highlighted variability in the distribution of the problems and importance of multisectoral action for stunting.
Dr. P.K. Joshi (Director, IFPRI-South Asia), Mr. Alok Kumar (Advisor, NITI Aayog), Dr. Rajesh Kumar (Joint Secretary, Ministry of Women and Child Development, Government of India), and Mr. Arjan de Wagt (Chief, Nutrition and Child Development, UNICEF-India) were key panelists at the meeting. Dr. P.K. Joshi reaffirmed IFPRI’s commitment to using the best data and evidence to provide advice and policy support in India and other parts of South Asia. Mr. Alok Kumar stressed the importance of collecting timely, high-quality data to support nutrition action and was appreciative of POSHAN’s efforts to package data concisely. He noted that every Indian state is different– economically, geographically, and socially– so analyses using district data can help state governments prioritize certain actions. Mr. Rajesh Kumar also noted that importance of data investments to support nutrition action and also noted the value of building state capacity using diverse approaches, to help strengthen delivery of nutrition interventions by frontline functionaries.
Mr. Arjan de Wagt from UNICEF, in the closing session, highlighted the importance of examining data trends to identify successes and build on them. He emphasized the need for a multisectoral approach for nutrition, and of keeping a focus on delivering the full set of essential nutrition actions at scale, for improving nutrition in the country. Participants at the meeting voiced similar issues and suggested looking at challenges in poor-performing states, as well as lessons learnt from success stories not just in states but also in specific thematic areas. They also suggested looking into anemia, and the role of regional diet choices.
Dr. Purnima Menon concluded the meeting, noting that over the next few months, POSHAN will continue to work on state-focused Policy Notes, on diverse Data Notes, and will also analyze drivers of change in nutritional outcomes at the district-level. Once unit-level data are available the team will update the national trends report and conduct further analyses of distributions, determinants of levels and changes in nutritional outcomes. She affirmed POSHAN’s commitment to sharing more data and analytic work to support national and state-level nutrition stakeholders.
Written by Abhilasha Vaid and Purnima Menon, IFPRI
Presentations:
National-Level Trends in Outcomes, Determinants and Interventions (Rasmi Avula, IFPRI)
State-Level Variability in Outcomes and Trends (Sneha Mani, IFPRI)
District-Level Variability and Drivers of Stunting at the District Level (Phuong Nguyen, IFPRI)
Resources:
POSHAN Data Note: How Are India’s Districts Doing on Maternal, Infant and Young Child Nutrition? Insights from the National Family Health Survey-4
POSHAN Data Note: How Are India’s Districts Doing on Nutrition-Related Non-Communicable Diseases? Insights from the National Family Health Survey-4
POSHAN Policy Note: Working Multisectorally to Improve Nutrition: Current Status and Global Lessons
POSHAN Policy Note: Achieving the 2025 World Health Assembly Targets for Nutrition in India: What Will It Cost?
POSHAN Policy Note: Improving Nutrition in Gujarat: Insights from Examining Trends in Outcomes, Determinants and Interventions between 2006 and 2016
POSHAN Policy Note: Improving Nutrition in Uttar Pradesh: Insights from Examining Trends in Outcomes, Determinants and Interventions between 2006 and 2016
POSHAN Policy Note: Improving Nutrition in Bihar: Insights from Examining Trends in Outcomes, Determinants and Interventions between 2006 and 2016
POSHAN Policy Note: Improving Nutrition in Tamil Nadu: Insights from Examining Trends in Outcomes, Determinants and Interventions between 2006 and 2016
POSHAN Research Note: A Review of Evidence-Based Interventions in Indian Nutrition Programs
POSHAN Research Note: Understanding the Landscape of National Policies and Strategic Plans to Tackle Undernutrition in India: A Review
POSHAN Research Note: An Assessment of Data Sources to Track Progress on Nutrition in India
POSHAN Report: Trends in Nutrition Outcomes, Determinants and Interventions in India (2006-2016) [Email us at IFPRI-POSHAN@cgiar.org to request a copy]
