NFHS5 is a mixed bag of pluses and minuses for India under the NDA government 

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The latest nutritional indicators released in the National Family Health Survey (NHFS) 5 report are a miscellany of pluses and minuses.

In four out of five years of the National Democratic Alliance (NDA) government’s first term, India slipped on some malnutrition parameters for young children and women, including prevalence of anaemia, reversing gains made previously. On some other indicators, the country appears to have improved. The incidence of stunting (low height for age) and wasting (low weight for height) has declined, for instance.

NFHS5 shows that the incidence of anaemia in young children has increased alarmingly; more than one in three children up to five years of age suffer from anaemia. Under-five anaemia was prevalent among 58.6 percent of children in 2015-16, 67.1 percent are now anaemic. Anaemia refers to deficiency of haemoglobin, resulting in fatigue and pallor.

Also, the proportion of women (15-49 years of age) who are anaemic has grown — from 53.1 percent to 57 percent — during this five-year period. The percentage of pregnant women (15-49 years) who are anaemic has increased to 52.2 percent from 50.4 percent.

In some states, incidence of anaemia and stunting have both increased during these five years. Take the example of Assam, a state with alarming parameters. Every third woman between 15 and 49 years is now anaemic versus 49 percent earlier; every fifth child under five is wasted versus 17 percent earlier.

During the same five-year period, however, some other child malnutrition indicators have improved at the national level. A lower percentages of children are now stunted or wasted although the number of severely wasted has risen.

Impact of the pandemic 

The global COVID-19 pandemic and consequent losses to the economy were widely expected to exacerbate hunger in 2019-21. But the Union Budget for 2021-22 did not enhance allocations for flagship central schemes to address child malnutrition as well as for schemes promoting nutrition for pregnant and lactating mothers. Instead, the Budget merged some flagship schemes, making it near impossible to determine scheme-wise allocations. Allocations for some of these schemes were cut.

Dipa Sinha, assistant professor of economics at Ambedkar University and also associated with the Right to Food Campaign (RFC), said that even the improved nutrition indicators (stunting and wasting) are no cause for celebration.

“The target under the government’s Poshan Abhiyan was to reduce stunting by two percentage points per annum. That has clearly not happened. Even the pace of reduction seen in NFHS5 has slowed compared to NFHS 3 and NFHS4. Will have to look at state-wise data for further analysis,” she noted.

An earlier analysis by RFC had shown that the combined budget for nutrition schemes – Umbrella Integrated Child Development Scheme (ICDS), Aanganwadi Services, Poshan Abhiyan, Scheme for Adolescent Girls and the National Crèche Scheme – for 2021-22 had been slashed by more than a fifth to Rs 20,105 crore from Rs 24,557.4 crore in 2020-21.

All these schemes have been clubbed under Saksham, making year wise allocation comparisons tough.

Worrying trends 

The ICDS, for example, is a flagship scheme to provide health, nutrition and education to children under six years of age and lactating women through Aanganwadis.

Another flagship scheme, the Pradhan Mantri Matru Vandana Yojana (PMMVY), entitles pregnant and lactating women to Rs 5,000 for their first born.

The reduction in budgetary allocations after the pandemic happened as a worrying trend in actual utilisation of the monies in 2020-21 was evident. The revised estimates for ICDS-Aanganwadi Services, for example, show that utilisation was about 16 percent less; utilisation under the Poshan Abhiyan has been less than a sixth of the allocation at just Rs 600 crore (Rs 3,700 crore) and just a fifth of the Rs 250 crore allocated for adolescent girls has been used. Ditto for PMMVY, where just about 50 percent of the Rs 2,500 crore allocation in 2020-21 has been used.

Sinha said that in many ways, the Poshan Abhiyan has not taken off as spending remains below par.

“Only two aspects under this Abhiyan have actually happened. One, a campaign towards behaviour change for eating healthier diets and two, introduction of smart phones to Aanganwadi workers for monitoring the progress under the programme. Smart phones are a good idea but because of software glitches, real -time data gathering is still not happening,” Sinha said.

Yet another worrying trend seen in NFHS5 is the rising proportion of women, men and children who are overweight. At an all-India level, nearly every fourth women was found to be overweight or obese against every fifth earlier; nearly 23 percent men were also overweight or obese versus just about 19 percent earlier. Children under five who were overweight accounted for 3.4 percent against 2.1 percent earlier.