Malnutrition challenges in Northeast

(MainsGS2: Issues relating to poverty and hunger.)

Context:

• High incidence of child marriage and teenage pregnancies have been the major reasons for child undernutrition, with long term impact on health, education, and employment.

Severity in northeast:

• Looking at the National Family Health Survey (NFHS) 5 data, there is a stagnation in early marriage but a rise in teenage pregnancies, leading to complications at birth, including low birth weight and higher mortality rates. 
• The North Eastern states of Tripura and Assam show alarmingly high prevalence of teenage pregnancies and child marriage, more than the national average. 
• Data indicates a rise in prevalence of teenage pregnancies and child marriage since NFHS-4 (2015-16).

High Stunting:

• Stunting rates in children under the age of five are alarming for Meghalaya at 46.5 percent, the highest in the region and nation wide.
• Also alarming are Manipur, Sikkim, and Assam in the category of high-level stunting (30-< 40 percent) with more than half the districts presenting a public health concern. 
• Evidence indicates that children born to adolescent mothers have a 10 percent higher prevalence for stunting. 
• Poverty and gender discrimination further heighten the intergenerational cycle of undernutrition impacting cognitive and physical development.

Data on anaemia: 

• Data on anaemia in children under five, adolescent girls (15-19 years), and women (15-49 years) indicates a rise in anaemia in both children and women. Anaemia in children under five has increased in all states except Meghalaya. 
• Assam is the highest at 68.4 percent (32.7 percentage point increase from 2015-16), followed by Mizoram at 46.4 percent (27.1 percentage point increase from 2015-16), Manipur at 42.8 percent (18.9 percentage point increase from 2015-16), and Tripura at 64.3 percent (a 16-percentage point increase from 2015-16). Anaemia in women of reproductive age (15-49 years) shows an incline in Assam at 65.9 percent, that is higher than national average of 57 percent. 
• Looking at trends for anaemia in adolescent girls (15-19 years), a sharp rise can be observed in Assam at 67 percent (24.3 percentage points increase), and Tripura at 67.9 percent (15.3 percentage points increase). 

Child-feeding practices:

• Talking of indicators on infant and young child-feeding practices, exclusive breastfeeding rates witnessed a decline in six of the eight states, with Sikkim being the lowest at 28.3 percent. 
• Early initiation of breastfeeding has improved across states, with Meghalaya having highest prevalence at 78.8 percent. Only two states, Sikkim (33 percent) and Tripura (36.2 percent) showed lower prevalence than the national average (41.8 percent). 
• The practice of timely introduction of semi-solid food to a child was highest in Manipur at 78.9 percent, however, Tripura showed an increase of 39.5 percentage points, from 13.6 percent to 53.1 percent in 2015-16 to 2019-21 respectively.

Conclusion:

• Successful stories of change across India suggest investment in girls and women and heightened delivery of health and nutrition interventions in bringing down malnutrition. 
• The Mission Poshan 2.0 aims to contribute to human development by addressing the challenges of malnutrition in children, adolescent girls, and women through an inter-ministerial convergence and effective communication strategies.