Improving household-level nutrition-specific and nutrition-sensitive conditions key to reducing child undernutrition in India

Since the publication of our study, the Government of India has released
preliminary estimates from the on-going latest round of National Family
Health Surveys (2015–2016) on the prevalence of stunting, underweight
and wasting for a limited number of states in India (International Institute
for Population Sciences, 2016). We compared the prevalence from the most
recent data for 13 states to the corresponding states from 2005–06 (Fig. 3).
Declines in undernutrition between 2005–06 and 2015–16 averaged 1.3%/
year for stunting, 1.6%/year for underweight and 0.4%/year for wasting since
2015 (International Institute for Population Sciences, 2016). The sluggish
pace of decline suggests that undernutrition continues to be a major disease
burden among Indian children. It also suggests that macroeconomic growth
experienced by India in recent years has not contributed to any meaningful
reductions in child undernutrition in India (Subramanian et al., 2016,
Subramanian and Subramanyam, 2015, Subramanyam et al., 2011). As we
observed in our original study (Corsi et al., 2015), and elsewhere (Subramanian
et al., 2016), there is an urgent need to consider direct investments in
conditions that more generally are reflective of the upstream and structural
determinants of undernutrition. Specifically, policies and interventions that
aim to provide and sustain nutritional security at the household level are
critical to eliminating child undernutrition in India. Pursuing interventions in
proximal risk factors without any improvements to broader socioeconomic
and structural conditions, to put it bluntly, is likely to be waste of time and
resources with little impact on reducing the burden of undernutrition among
children in India.