60% children in India are Anemic, Malnutrition still remains major killer of Under-5 : ICMR study in Lancet

New Delhi: While the mortality from malnutrition fell by two-third from 1990 to 2017 in children under five years of age, it still remains the leading risk factor for death in 68% of the children of same age group and 60% of the children of this age-group are anaemic, revealed a study published by scientists of India State-Level Disease Burden Initiative of Indian Council of Medical Research (ICMR) in Lancet.

The study came as a collaborative effort of the Indian Council of Medical Research (ICMR), Public Health Foundation of India (PHFI), and Institute for Health Metrics and Evaluation in collaboration with the Ministry of Health and Family Welfare, Government of India, along with experts and stakeholders associated with over 100 Indian institutions, involving many leading health scientists and policymakers from India. The scientific paper involved a large number of collaborators, including many leading malnutrition experts from India.

The study showed that among the malnutrition indicators, low birth weight is the biggest contributor to disease burden followed by child growth failure which includes stunting, underweight and wasting. The DALY rate attributable to malnutrition in children varies 7-fold between the states and is highest in Rajasthan, Uttar Pradesh, Bihar and Assam, followed by Madhya Pradesh, Chhattisgarh, Odisha, Nagaland, and Tripura.

The authors analyzed the disease burden attributable to the child and maternal malnutrition, and the trends in the malnutrition indicators from 1990 to 2017 in every state of India using all accessible data from multiple sources, as part of Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. The states were categorized into three groups using their Socio-demographic Index (SDI) calculated by GBD on the basis of per capita income, mean education, and fertility rate in women younger than 25 years. The authors projected the prevalence of malnutrition indicators for the states of India up to 2030 on the basis of the 1990–2017 trends for comparison with India National Nutrition Mission (NNM) 2022 and WHO and UNICEF 2030 targets which are as follows

Key findings of the study include

• The death rate attributable to malnutrition in under-5 children in India has dropped by two-thirds from 1990 to 2017.


• Malnutrition is however still the underlying risk factor for 68% of the deaths in under-five children in India, and is the leading risk factor for disease burden in persons of all ages considered together contributing 17% of the total DALYs.


• The major disease conditions through which malnutrition results in disease burden and death in under-five children in India are neonatal disorders, lower respiratory infections, and diarrhoeal diseases.


• The DALY rate attributable to malnutrition in children varies 7-fold between the states and is highest in Rajasthan, Uttar Pradesh, Bihar and Assam, followed by Madhya Pradesh, Chhattisgarh, Odisha, Nagaland and Tripura.


• Among the malnutrition indicators, low birth weight is the largest contributor to child deaths in India, followed by child growth failure which includes stunting, underweight and wasting.


• The prevalence of low birth weight was 21% in India in 2017, ranging from 9% in Mizoram to 24% in Uttar Pradesh. The annual rate of reduction was 1.1% in India between 1990 and 2017, ranging from 3.8% in Sikkim to 0.3% in Delhi.


• The prevalence of child stunting was 39% in India in 2017. This ranged from 21% in Goa to 49% in Uttar Pradesh, and was generally highest in the EAG states. The annual rate of reduction was 2.6% in India between 1990 and 2017, which varied from 4% in Kerala to 1.2% in Meghalaya.


• The prevalence of child underweight was 33% in India in 2017, ranging from 16% in Manipur to 42% in Jharkhand. The annual rate of reduction was 3.2% in India between 1990 and 2017, ranging from 5.4% in Meghalaya to 1.8% in Delhi.


• The prevalence of child anaemia was 60% in India in 2017, ranging from 21% in Mizoram to 74% in Haryana. The annual rate of reduction was 1.8% in India between 1990 and 2017, which varied from 8.3% in Mizoram to no significant reduction in Goa.


• The prevalence of anaemia in women was 54% in India in 2017, ranging from 28% in Mizoram to 60% in Delhi. The annual rate of reduction was 0.7% in India between 1990 and 2017, varying from 3.4 % in Nagaland to no significant reduction in Himachal Pradesh.


• The prevalence of exclusive breastfeeding was 53% in India in 2017, ranging from 34% in Meghalaya to 74% in Chhattisgarh. The annual rate of increase in India between 1990 and 2017 was 1.2%, ranging from 4% increase in Gao to a slight reduction in Uttar Pradesh.


• The prevalence of child overweight was 12% in India in 2017. It was highest in the more developed states, but it is rapidly increasing in all states of India. This annual rate of increase between 1990 and 2017 was 5% in India, which varied from 7.2% in Madhya Pradesh to 2.5% in Mizoram.

For more details, click on the link

India State-Level Disease Burden Initiative Malnutrition Collaborators. The burden of child and maternal malnutrition and the trends in its indicators in the states of India: the Global Burden of Disease Study 1990–2017. Lancet Child & Adolescent Health. 18 September 2019.

Available from: http://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(19)30273-1/fulltext