Stunting

A trend analysis is undertaken to account for the child nutritional change in India by covering 25 years of the National Family Health Surveys from 1992–93 to 2015–16. The 34% overtime decline in child undernutrition has been possible mainly because of the improvement in parental education, household economic status, coverage in immunisation, and reproductive healthcare. However, the onus has shifted towards education and economic status. The combined share of contribution to the nutritional change has increased from 48.4% to 71% between 1992–93 to 2005–06 and 2005–06 to 2015–16. While there has been a saturation of persistent government interventions for immunisation, antenatal care, and institutional delivery, education and economic status have become stronger predictors. They ensure better childcare practices, sanitation, proper diet, and access to healthcare. Therefore, the future of child nutrition lies largely in the improvement of quality education and inclusive economic development. 

The number of "poor" derived by applying price adjustment to an old consumption basket, which is largely what official poverty measures have done, are very different from estimates based on actual consumption baskets that have changed over time. For instance, the share of cereals in household expenditure halved between 1993-94 and 2011-12 in rural areas. In the light of this, we ask if all expenditure would be on food, what percentage of the population would be unable to meet the prescribed calorie requirement? Adding a "minimum" level of expenditure on clothing-bedding-footwear, fuel and light, and conveyance to the "derived" sum of food expenditure provides a second counterfactual. Similarly, the cumulative addition of expenditure on other consumer goods and services provides further counterfactual scenarios.

The nutritional performance of adult women in India, at present, parallels a situation referred to famously as The Asian Enigma. Ramalingaswami, Jonsson and Rohde (1996) deployed this term to refer to the prevalence of higher levels of child undernutrition in south Asia, despite its much better performance in economic and social spheres, than Sub-Saharan Africa. The analysis established that the Asian enigma was essentially a “low birth weight enigma”, as the exceptionally high level of low birth weight was found to be the primary reason for the much higher incidence of under-nutrition, especially stunting, in south Asia than Sub-Saharan Africa (Osmani and Bhargava 1998). The low birth weight of babies relates essentially to the poor nutritional status of women (mothers, to be specific), which in itself has become a source for yet another enigmatic situation.