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The fifth National Family Health Survey has some good news —greater vaccination, rising agency of women, reflected in falling fertility rates, better sanitation. However, India’s battle with malnutrition is far from over. Some of the richest states have failed to stem the problem of stunting and wasting.
The survey provides state-level information on fertility, infant and child mortality, maternal and child health, reproductive health, nutrition, anaemia, utilisation and quality of health and family planning services, inputs for better policy and implementation. The data from this round defies easy generalisations. For instance, a relatively prosperous state like Kerala has show a dramatic rise in stunting but maintains a stable rate for wasting. Bihar, a poor state, has shown sizeable improvement in terms of stunting but lost some of the gains made in wasting. Maharashtra and West Bengal have not shown any improvement, with a slight deterioration in stunting. Comparing the third (2005-06), fourth (2015-16) and fifth (2019-20) surveys presents a more complex picture. There is a need for greater analysis to understand trends, and to ascertain why malnutrition persists despite improvements in key parameters of vaccination, reproductive health, total fertility ratio, sanitation, infant and child mortality. There is a need to identify whether these are state-wide trends or limited to particular districts or regions for effective policymaking.
Further analysis of data must take into account the impact of climate change and environmental degradation, which alter the nutritional value of crops and the incidence of vector-borne diseases, besides creating pollution, heat stress and water scarcity, and impair mental development.
This piece appeared as an editorial opinion in the print edition of The Economic Times.