Commensurate with global and regional trends, India continues to show a reduction in stunting and recorded 1.6 crore fewer stunted children under five years in 2022 as compared to 2012, according to the Joint Malnutrition Estimates (JME) released by UNICEF, WHO and the World Bank.
However, wasting continues to remain a concern and so does growing levels of obesity.
Stunting among children under five years in India dropped from a prevalence rate of 41.6% in 2012 to 31.7% in 2022 — with the numbers dropping from 52 lakh to 36 lakh. This was accompanied by India’s share of the global burden of stunting declining from 30% to 25% in the past decade.
The overall prevalence of wasting in 2022 was 18.7% in India, with a share of 49% in the global burden of this malnutrition indicator. The prevalence of obesity marginally increased in a decade from 2.2% in 2012 to 2.8% in 2022 with the numbers growing to 31.8 lakh from 27.5 lakh thereby contributing to 8.8% of the global share. But the overall classification for obesity is low and much lower than the global prevalence of 5.6%.
Globally, stunting declined from a prevalence rate of 26.3% in 2012 to 22.3% in 2022. In South Asia, the decline was much sharper as it dropped from 40.3% to 30.5%.
There was no improvement in the weight issue worldwide, as its prevalence rate grew from 5.5% to 5.6%. There was a global prevalence of 6.8% in 2022, but there is no comparison available for past years as it is based on national-level country prevalence data.
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The JME report says there is insufficient progress to reach the 2025 World Health Assembly (WHA) global nutrition targets and the 2030 Sustainable Development Goal (SDG) 2 targets; only about one-third of all countries are ‘on track’ to halve the number of children affected by stunting by 2030. Even fewer countries are expected to achieve the 2030 target of 3% prevalence for overweight, with just one in six countries currently ‘on track’.
The decline in stunting in India is commensurate with National Family Health Survey (NFHS)-5 (2019-2021) data which estimated its prevalence at 35.5% as compared to 38% in NFHS-4 (2016) and 48% in NFHS-3 (2006).
“This is the first time I noted in a global report that the problem has started to shift from South Asia. The relative contribution of India’s global burden from 29 to 24 was interesting. NFHS-5 showed evidence of continued reduction of stunting and instances of underweight children, though anaemia was disappointing. It also showed an improvement in access to health services - family planning, ante-natal care, deworming, breastfeeding counselling,” said Arjan Wagt, Chief of Nutrition and Unicef India Deputy Representative, Programmes said adding that he remained hopeful of a further improvement in NFHS-6.
Wasting though is an outlier, Mr. Wagt explains. “In the past few years, we have learnt more about it. It is a challenging indicator that assesses acute malnutrition over short periods. It is probably more complex in South Asia and India. While in Africa it starts from four-six months, while in India, on the basis of our analysis of a small cohort, we have found that two-thirds of children at 12 or 24 months had wasting at birth or at one month of age. This means two-thirds of the wasting is caused by maternal malnutrition.” This meant that children were born with very low weight for height and didn’t recover even six months or 12 months later despite weight gain.
“There is a need to learn more and more of wasting and that is the big agenda and how the determinations are different for India and Asia,” the UNICEF official urged.
The JME estimates for stunting and obesity are based on country-level modelled estimates derived from primary sources, such as national household surveys based on a methodology developed by the JME Working Group. For wasting, the estimates are based on national-level country prevalence data.
