Week 1 : Lecture 1 : NFHS 5 data

Summary of NFHS 5 Data Lecture 1

This lecture analyzes the National Family Health Survey 5 (NFHS-5) data to understand the problem of undernutrition in India, focusing on age-wise distribution of wasting, underweight, and stunting. The data reveals significant growth faltering in the first six months of life and a critical need for improvements in breastfeeding practices and complementary feeding. The lecture also highlights regional disparities, gender differences, and alarming rates of anemia among children.

Key Takeaways

* **High Undernutrition Rates:** NFHS-5 data reveals concerning rates of wasting, underweight, and stunting, especially in the first two years of life.

* **Critical First Six Months:** Growth faltering is most prevalent in the first six months, emphasizing the importance of maternal nutrition and breastfeeding.

* **Breastfeeding Challenges:** Early initiation and exclusive breastfeeding rates are low, particularly in the context of institution delivery.

* **Complementary Feeding Issues:** The introduction and support for complementary feeding are inadequate, leading to increased malnutrition in older infants and young children.

* **Anemia Prevalence:** Anemia affects a significant portion of children, and early intervention is critical to prevent lasting impacts on brain development.

* **Regional and Gender Disparities:** Undernutrition varies significantly across states and is slightly higher in males for stunting and underweight.

Detailed Notes

**I. Introduction (0:00:15 - 0:00:33)**

* Welcome and introduction to the session.

* Focus: Understanding undernutrition in India using NFHS-5 data.

**II. Age-Wise Distribution of Nutritional Indicators (0:00:36 - 0:03:02)**

* **Indicators:** Wasting (blue), Underweight (yellow), Stunting (red)

* **0-2 Months:**

* High rates of wasting (30%), underweight (30%), and stunting (28%).

* Impact of maternal nutrition and breastfeeding during pregnancy.

* Need for good milk transfer.

* Significant growth faltering.

* **3 Months:**

* Slight improvement in stunting.

* **4-5 Months and 6 Months:**

* Wasting, underweight, and stunting levels remain relatively unchanged.

* Growth faltering persists.

* Up to six months, breastfeeding is the primary factor.

* Possible issues with milk transfer.

* Cow's milk and diarrhea.

* **7-12 Months:**

* Introduction of complementary feeding.

* Slight improvement in wasting.

* Underweight and stunting increase due to a lack of appropriate complementary feeding support.

* **1-2 Years:**

* Stunting dramatically increases to almost 40%.

* Failure of IYCF (Infant and Young Child Feeding).

* Impact of maternal nutrition, breastfeeding, and complementary feeding rates.

* Underweight also increases.

* Wasting may be masked by the child being shorter.

* **2-3 Years:**

* Not much decrease in stunting.

* Underweight increases.

* **3-5 Years**

* Stunting and underweight are high.

* Wasting is lingering around.

**III. Undernutrition by Residence (0:08:23 - 0:08:57)**

* **Stunting:** Higher in rural areas.

* **Underweight:** Higher in rural areas.

* **Wasting:** No significant difference between urban and rural areas.

**IV. Undernutrition by Gender (0:08:57 - 0:09:28)**

* **Stunting and Underweight:** Slightly higher in males.

* **Wasting:** No significant difference.

**V. Prevalence of Undernutrition Categories (0:10:09 - 0:13:32)**

* **Normal:** 47.8% of children under five are normal for wasting, stunting, and underweight.

* **Only Stunted:** 15%

* **Only Wasted:** 6.5%

* **Only Underweight:** 2.3%

* **Stunted & Underweight:** 15.5%

* **Underweight & Wasted:** 7.5%

* **All Three (Stunted, Wasted, Underweight):** 5.2% - children at high risk.

**VI. Prevalence of Stunting by State (0:13:48 - 0:15:25)**

* India's average: 36%

* High stunting rates across many states (e.g., Bihar, Gujarat).

**VII. Prevalence of Underweight by State (0:15:26 - 0:16:12)**

* India's average: 32%

* Similar states as stunting are affected.

* Some states are doing a bit better (e.g. Mizoram).

**VIII. Prevalence of Wasting by State (0:16:51 - 0:17:46)**

* India's average: 19%

* Wasting often linked with acute malnutrition.

* Economically advanced states also show issues.

**IX. Anemia Prevalence (0:19:36 - 0:20:28)**

* **Overall:** Affects about 65% of children.

* **Higher in Rural Areas:**

* Impact on brain development, especially during 9-12 months.

* **Urban-Rural Split (approx.):**

* Mild: 30%

* Moderate: Rural - 35%, Urban - 32%

* Severe: 2-3%

**X. Anemia by Gender (0:21:19 - 0:21:43)**

* No significant difference between genders in under-5 children.

* Caused primarily by diet.

**XI. Breastfeeding Practices (0:22:41 - 0:23:04)**

* **Early Initiation:** Institutional delivery rates are very high, yet early initiation (within one hour) is only at about 40%.

**XII. Early Initiation of Breastfeeding by Region (0:23:04 - 0:23:59)**

* Early initiation rates are significantly poor.

* Meghalaya has a good breastfeeding rate.

* Bihar and Uttar Pradesh need improvement.

**XIII. Exclusive Breastfeeding (0:23:59 - 0:24:33)**

* India's average: 60-64%.

* Breastfeeding failure and the need for support for exclusive breastfeeding.

**XIV. Other Feeds (0:24:33 - 0:25:02)**

* Plain Water: 4-5%

* Non-Milk Liquids (Honey, Tea):

* Other Milk (Cow's Milk, Formula):

* Complementary Feeding: High risk of infection.

**XV. Status of Complementary Feeding (0:29:06 - 0:29:19)**

* 52% of children in urban areas get complementary feeding by 6-8 months.

* Rurals are less.

* The red zone states need improvement.

**XVI. Minimum Acceptable Diet (MAD) (0:29:50 - 0:30:39)**

* Only 10-12% of babies are getting enough dietary diversity and frequency.

**XVII. Conclusion (0:30:57 - 0:31:02)**

* Emphasis on next session: strategies for improving indicators.