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Chart: Cause-specific disability-adjusted life-years attributable to malnutrition in children younger than five years of age in India, 2017. (Source: Lancet Child and Adolescent Health)[/caption]
Eastern Mirror Desk
Dimapur, Sep. 18: Malnutrition was adjudged a major contributor to diseases in India, with a predominant risk factor for death in children younger than five years in every state in India in 2017, a study published by the Lancet Child and Adolescent Health informed on September 18.
According to the study, out of the 1.04 million deaths of children under five years in 2017, a total of 7, 06,000 were attributed to malnutrition. “Although all-cause under-5 death rate in India decreased from 2336 per 1,00, 000 (2271–2405) in 1990 to 801 per 1,00, 000 (759–850) in 2017, the proportion of under-5 deaths attributable to malnutrition changed only modestly from 70.4% (67.0-74.0) in 1990 to 68.2% (65.8-70.7) in 2017,” it said.
The study also suggested that malnutrition contributed to 17.3% to the disability-adjusted life years (DALYs) in India and 25.4% of the total global DALY.
DALY is a measure of the per person disease burden. The highest proportion of the malnutrition DALYs was from low birth weight and short gestation followed by child growth failure. The largest proportions were from neonatal disorders (54.9%) followed by lower respiratory infections (22.6%) and diarrhoeal diseases (13.3%). The highest proportion of DALYs attributable to low birth weight and short gestation were from neonatal disorders (84.7%). The highest proportion of DALYs attributable to child growth failure were from lower respiratory infections (47•0%) followed by diarrhoeal diseases (35•3%). The DALYs attributable to suboptimal breastfeeding were from diarrhoeal diseases (62•1%) and lower respiratory infections (37.9%). (Refer chart)
In Nagaland, there was a gap of 9.2% from prevalence and projected low birth weight. There was a 2.9 % gap in stunting and 14.6% in breastfeeding. Anaemia and child under weight had a gap of 20.2% and 8.2% respectively, the study indicated.
The study suggested that the “burden of child and maternal malnutrition has declined in India since 1990, but it remains the predominant risk factor for health loss in children younger than 5 years of age in every state of the country and the leading risk factor for health loss across all ages in the majority of state,” it said.
India has been trying to address child malnutrition for many decades through various policy initiatives, such as the Integrated Child Development Scheme launched in 1975, the National Nutrition Policy 1993, the Mid Day Meal Scheme for school children 1995, and the National Food Security Act 2013, but the prevalence of stunting and underweight remains high, the study said.
Interventions such as the National Iron Plus Initiative in 2013 to comprehensively address anaemia and improve nutrition of girls, starting at a young age, has been launched for better pregnancy-related and early child health outcomes and for a beneficial long-term effect on future generations, it informed.
“Substantial improvements across the malnutrition indicators in the states of India would require an integrated nutrition policy to effectively address the broader determinants of under nutrition across the life cycle. These improvements include providing clean drinking water, reducing rates of open defecation, improving women’s status, enhancing agricultural productivity and food security, promoting nutrition sensitive agriculture, coupled with harmonisation of efforts across ministries and sectors, political will and good governance, and strategic investments in a multi-sectoral approach,” the study suggested.