INDIA’S DISTRICT-FOCUSED STRATEGY TO REDUCE CHILDHOOD STUNTING MUST ALSO ADDRESS WOMEN’S WELLBEING AND POVERTY REDUCTION, FINDS NEW STUDY
Purnima Menon and Rasmi Avula presenting a recent study results at a media briefing
May 24, 2018, New Delhi, India – Addressing women’s well-being and education are critical to any strategy focused on reducing child stunting in India, as nearly three-fourth of the differences in childhood stunting between low and high burden Indian districts can be explained by differences in women’s low body mass index (19%) and education (12%), according to a new study by the International Food Policy Research Institute (IFPRI). The study is the first to utilize district-level data to highlight spatial differences in stunting across 640 districts in India, providing the most comprehensive analysis of child stunting in the country at a granular level.
The study, authored by IFPRI researchers Purnima Menon, Rasmi Avula, Derek Headey, and Phuong Nguyen, analyzed the National Family Health Survey-IV district-level summary data to examine the differences in childhood stunting between low and high burden districts of India. This analysis comes at a time when Government of India’s POSHAN Abhiyan (or, National Nutrition Mission) has stated a clear district-level focus for action and has recently added 235 additional districts for inclusion in the second phase of POSHAN Abhiyan.
Welcoming the Indian government’s new nationwide initiative and district focused effort to reduce stunting, Purnima Menon, Senior Research Fellow at IFPRI, and lead author of the study, said, “Our study shows that additional determinants such as gender and poverty must also be addressed district-by‐district, to reduce these inequities and contribute to stunting reduction.” Co-author and Research Fellow at IFPRI, Phuong Nguyen added “The majority of India’s stunted children are in a subset of districts spread across the northern parts of India; the new Nutrition Mission must focus on addressing the major determinants we have identified in these districts to be able to close the gaps with other lower burden districts.”
According to this study, differences in stunting prevalence between low and high burden districts of India are explained by differences in women's low body mass index (19% of the difference), education (12%), children's adequate diet (9%), assets (7%), open defecation (7%), age at marriage (7%), antenatal care (6%), and household size (5%).
As POSHAN Abhiyan provides policy directions to address India’s nutrition challenges through coordinated inter-sectoral action, the efforts to address malnutrition are unfolding in districts across the country. NITI Aayog, the Government of India’s think-tank, will monitor progress on the roll-out of this new National Nutrition Mission, with support from IFPRI and the Tata Trusts. Alok Kumar, Health Advisor, NITI Aayog, said, “This new study from IFPRI supports our current efforts on the National Nutrition Mission, which is cross-sectoral and district-focused. The continued analytics support from IFPRI will support us in further refining the strategies needed to achieve our vision of a malnutrition free India.”
The study emphasizes that initiatives to address undernutrition in each district in the National Nutrition Mission will fall short without prioritized actions to improve the socioeconomic, nutritional and health status of girls and women — their nutrition, education, early marriage, and access to care during and after pregnancy — and improvements in sanitation and overall socioeconomic status of the household. The multisectoral nature of stunting, as shown by the study results, especially the focus on women’s conditions, suggests strongly that district-specific efforts to address stunting must also examine ways that will improve women’s health, women’s education and women’s access to antenatal care and other services.
Highlighting this result, Rasmi Avula, co-author of the IFPRI study, said, “There is an urgency to close equity gaps and address women's issues and other social determinants.” Derek Headey, co-author of this study, who has conducted similar studies in several other countries, emphasized, “Our study highlights, yet again, the importance of gender-related factors, especially in South Asia. Any efforts to address stunting in high burden districts in India that do not explicitly consider the multiple ways in which women’s status and poverty play out, will likely fall short.”
Underscoring the need for district-specific diagnostic assessments of major risk factors, Vinod Paul, member (Health) of the NITI Aayog, said “India’s National Nutrition mission is a beacon of hope for millions of children across India. Putting in place the conditions that support good nutrition – both health and nutrition programs, and favorable social and economic conditions – district-by-district - is crucial to ensure that the children born into the era of the Sustainable Development Goals get a good start in life. It is crucial that we help nutrition stakeholders in India use available district-level data, to diagnose risk factors and prioritize the best possible actions to support nutrition outcomes.”
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Press release shared at a media briefing on 24th May 2018 at the Press Club of India highlights findings from a recently published study on understanding the geographical burden of stunting in India.
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