NFHS-6 and Child Nutrition in India: Progress, Gaps and the Road Ahead

Syllabus: GS2/Health

Context

• The recently released National Family Health Survey (NFHS)-6 by MoHFW highlights India’s advancements in child nutrition and maternal health, while also revealing persistent challenges related to infant feeding practices, dietary quality, maternal workload, and local-level implementation gaps.

About National Family Health Survey (NFHS)

• It was started in the early 1990s with the first NFHS conducted in 1992-93.
  • Since then, India successfully completed NFHS-2 in 1998-99, NFHS-3 in 2005-06, NFHS-4 in 2015-16 and NFHS-5 in 2019-21.
• Main Objectives:
  • To strengthen India’s demographic and health database by providing information that is both reliable and relied upon;
  • To strengthen the survey research capabilities of Indian institutions to provide, analyse, and disseminate high-quality data; and
  • To anticipate and meet the country’s needs for data on emerging health and family welfare issues.
• Major Indicators Covered: Maternal and child health; infant and child mortality; nutrition (stunting, wasting, underweight, and anemia); immunisation coverage; fertility and family planning; women’s empowerment and gender-related issues; and sanitation, drinking water, and household living conditions.
• NFHS-6 was conducted during 2023-24 by MoHFW with the International Institute for Population Sciences (IIPS), Mumbai, as the nodal agency.

Trends in Child Health and Nutrition (NFHS-6)

• Reduction in Stunting: Stunting prevalence among children under five years of age has decreased from 35.5% to 29.3%.
• Better Maternal & Child Healthcare: Currently, over 90% of deliveries are conducted in health facilities, 58% of births are delivered in public health centres, and 91% of deliveries are accompanied by competent health professionals.
• Immunisation: India has achieved nearly 87% complete immunisation coverage for children aged 12-23 months.
  • It helps Mission Indradhanush achieve its objectives of attaining universal immunisation.

Key Concerns and Issues Highlighted in NFHS-6

• Persistent Child Undernutrition: Nutrition is not improving fast enough to achieve SDG and National Nutrition Mission targets.
  • Stunting: 29.3% of children under five years old are still stunted.
  • Wasting: There is no or little improvement, indicating ongoing acute malnutrition. Overall wasting levels remain high and severe wasting has decreased.
• Poor Infant and Young Child Feeding Practices (IYCF):
  • Early breastfeeding: Only about half of newborns are breastfed within 1 hour of birth.

• Complementary feeding: Just about 60% of children aged 6–8 months receive solid or semi-solid foods on time.
• Only 15% of children aged 6–23 months receive an adequate diet.

• Dietary Quality and Nutritional Inadequacy: NFHS-6 data shows poor dietary diversity in India.
  • There is low consumption of pulses, fruits, vegetables, nuts, and animal-source foods.
  • Processed foods and sugary beverages are increasingly consumed.
  • Healthy diets are still unaffordable for many households.
• Maternal Time Poverty: The survey highlights the increasing work burden on women.
  • Women frequently balance agricultural work, livestock care, domestic duties, and both informal and unpaid labour.
• Weak Focus on the First 1,000 Days: The time from pregnancy to a child’s second birthday is vital for physical and cognitive development.
  • Key challenges include:
    • Limited data specific to children aged 0–2 years.
    • Growth faltering often starts before it can be identified.
    • Most programmes emphasise treatment over prevention.
• Other issues include regional and socioeconomic inequities, poor use of nutrition data, low capability of frontline workers such as ASHAs, AWWs, and ANMs, lack of multisectoral convergence, and lack of childcare facilities.

Related Government Initiatives & Strengthening Measures

• POSHAN Abhiyaan (National Nutrition Mission): It is a mission to minimise stunting, wasting, underweight and anaemia and enhance nutrition among children, pregnant women and breastfeeding mothers.
  • Key Features:
    • Real-time tracking and monitoring of growth in Anganwadi Centres;
    • Jan Andolan (Behaviour Change Communication);
    • Community-orientated management of malnutrition;
• Mission Saksham Anganwadi and POSHAN 2.0: The programme integrates the Supplementary Nutrition Programme (SNP), POSHAN Abhiyaan and Anganwadi Services.
  • It is intended for children under 6 years of age, pregnant women, nursing moms and adolescent females.
  • The focus areas include upgradation of Anganwadi infrastructure and promotion of Early Childhood Care and Education (ECCE).
• Other key schemes include the PM POSHAN Scheme (Mid-Day Meal), Anaemia Mukt Bharat (AMB), Mission Indradhanush, Pradhan Mantri Matru Vandana Yojana (PMMVY), Janani Suraksha Yojana (JSY) and the National Creche Scheme (Palna). 

Way Forward: Key Strengthening Measures Suggested by NFHS-6

• Nutrition-specific interventions: encourage breastfeeding within one hour of delivery, encourage timely supplemental feeding after six months, promote nutritional diversity through local foods, and increase counselling services for moms.
• Institutional measures: recruitment of district-level nutritionists and data analysts; improvement of the quality of anthropometric data collection; and use of digital tools for growth monitoring and counselling.
• Governance Measures:  Make child nutrition a regular topic in Gram Sabhas and Panchayats and improve coordination between health, ICDS, Jal Jeevan Mission, SBM-G and rural development departments.
• Gender-Sensitive Measures: Promote shared caring by males; increase community-based crèches; and lower the unpaid care burden for women.
• Reforms in the food system: Make pulses, millets, fruits, vegetables and protein-rich foods affordable; and control the use and marketing of ultra-processed meals.

Source: TH