68% of under-5 mortality in India still due to malnutrition: Study
In India, the share of malnutrition in under-5 mortality continues to be high – it has only come down from 70.4% in 1990 to 68.2% in 2017.
Between 1990 and 2017, the number of under-5 deaths because of malnutrition in India fell from 2,336 per 100,000 to 801 per 100,000 children
However, the share of malnutrition in under-5 mortality continues to be high - it has only come down from 70.4% in 1990 to 68.2% in 2017
Of the 1.04 million under-5 deaths in India in 2017, 706 000 could be attributed to malnutrition
Malnutrition accounted for 68.2% of all deaths among children under 5 years in India in 2017, according to a Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), published Wednesday.
Under-5 mortality is an important measure of a country’s health and development status.
The GBD study, which collated data over 27 years from 1990 to 2017, was published online by The Lancet Child & Adolescent Health, a peer-reviewed journal. Several organizations around the world, including the Indian Council of Medical Research (ICMR), contributed to the study.
Between 1990 and 2017, the number of under-5 deaths because of malnutrition in India fell from 2,336 per 100,000 to 801 per 100,000 children. However, the share of malnutrition in under-5 mortality continues to be high – it has only come down from 70.4% in 1990 to 68.2% in 2017.
This is partly because overall under-5 mortality has decreased drastically in the world and India.
Data from the World Health Organization (WHO) show that under-5 mortality decreased globally from 93 deaths per 1000 live births in 1990 to 39 deaths per 1000 live births in 2017. In India, under-5 mortality in 2017 stood at 39.4 per 1000 live births according to UNICEF data.
One of the ways the study measured the impact of malnourishment on children’s health is in terms of disability-adjusted life years (DALY).
DALY is "years of healthy life lost to premature death and disability . . . the sum of years of life lost (YLLs) and years lived with disability (YLDs)".
On this metric, under-5s in Rajasthan, Uttar Pradesh, Bihar and Assam were the worst affected. Followed by children in Madhya Pradesh, Chhattisgarh, Odisha, Nagaland and Tripura, according to data from the India State-Level Disease Burden Initiative (which leads GBD studies in India).
India in 2017
“Of the 1.04 million under-5 deaths in India in 2017, 706 000 could be attributed to malnutrition,” the authors of the study wrote.
Despite advances in health and healthcare delivery, India continues to shoulder a “large and persistent burden of malnutrition, especially among children and women of reproductive age”, according to the study which identified malnutrition indicators to organize the data. Here’s a glimpse at what the study found:
- Low birth weight: Of all the indicators in the study, low birth weight emerged as the biggest contributor to malnutrition, followed by child growth failure which eventually leads to stunted growth, underweight children and child wasting. More than a fifth (21.4%) of all children were born underweight in India in 2017 -Mizoram with 8.7% had the best track record on this metric, Uttar Pradesh, at 24.2%, had the worst.
- Child stunting: Stunted growth was seen in up to 39.3% Indian children under 5 in 2017 - Goa had the lowest (21.3%) and Uttar Pradesh the highest (49%) prevalence. Stunting rates were highest among poorer families and in the socio-economically poorer states of Bihar, Chhattisgarh, Jharkhand, Odisha, followed by Rajasthan, Madhya Pradesh and Uttar Pradesh.
- Underweight children: A total of 32.7% Indian children under 5 years of age fell under this category in 2017, with most children (42.2%) from Jharkhand falling in this bracket. The lowest prevalence anywhere in the country was in Manipur (16.5%).
- Anaemia among children: 59.7% under-5 children in India had anaemia - low haemoglobin as a result of iron deficiency - in 2017. Haryana had the highest prevalence, at 74%, and Mizoram the lowest, with 21.1%. The study also collected data on anaemia in girls and women aged 15-49 (the so-called reproductive years) and found that more than half (54.4%) off all Indian women in this age group had anaemia.
- Childing wasting: Overall incidence across the country was 15.7%, with the highest prevalence in Gujarat (19.3%) and the lowest in Sikkim (6.3%).
In 2018, India had launched the National Nutrition Mission (NNM) to improve child health metrics such as birth weight and reduce the prevalence of stunted growth (the aim is to reduce prevalence from 39.3% now to 25% by 2022), among other signs of poor health and development.
Going by the GBD study, the absolute numbers tell a positive story compared with 1990 data. But there’s still a lot of room for improvement.
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