NFHS Round 5 results show worrying trends on child growth & nutrition

~ by Trinanjan Chakraborty

The phase 1 results of the National Family Health Survey (NFHS) Round V, representing period 2019-20 was recently released by the Union Ministry of Health & Family Welfare (MoH&FW). The phase 1 results cover 22 states and UTs. For many of the relatively larger states/UTs, there is a worrying trend that can be observed on child growth/nutrition.

State: Andhra Pradesh

* Stunting, or low height for age, is caused by long-term insufficient nutrient intake and frequent infections | Wasting, or low weight for height, is a strong predictor of mortality among children under five. It is usually the result of acute significant food shortage and/or disease (UNICEF)

The stunting rate among children <5 years has remained almost unchanged from NFHS Rd IV and is high at close to 1/3rd of all children below 5. While wasting rate has witnessed a drop, severe wasting rate has gone up. Under-weight rate although having come down, in absolute terms remains quite high (~30%).


Assam is one of the prime concern states with wasting rate and underweight rate both witnessing a rise from round IV. Severely wasted rate has also gone up. Stunting rate has witnessed a marginal drop but is very high – more than a third of children below 5 years in Assam are found to be stunted (lower height than as warranted by age).


Bihar has one of the highest stunting and under-weight rates among children below 5 in the entire country. While it has made progress on these aspects, it still has a long way to go. In a worrying development, both wasted rate and severely wasted rate has gone up – the survey reports.


The levels of stunting rate, wasting rate and underweight rate all continue to be very high in Gujarat. Severely wasted rate has risen further and is in double digit now.

J&K :

Both wasted rate (including severely wasted rate) and underweight rate has gone up very sharply in the UT of J&K from round IV to the current round. Stunted rate has dropped a shade but still is on the higher side at > 1 out of 4.


Karnataka has witnessed a decline in all the metrics from round IV. Particularly impressive is the improvement achieved in wasting rate. Despite, both stunting and underweight rates stand at around 1/3rd of all children under 5 and needs significant work.


In a worrying development, Kerala – one of the best performing Indian states on human development parameters, witnesses a worsening of the scenario on both stunting and underweight rates among children <5 years.


Maharashtra, one of India’s largest and more affluent states reports a sad state of affairs as far as child growth/nutrition is concerned. More than a third of children below 5 years are stunted and same proportion is also underweight. More than 1/4th are wasted.


Telangana has witnessed a worsening of the situation across parameters. Stunting rate, Wasting rate (including severely wasted) and Underweight rate have all gone up in the state vis-à-vis the last round of surveying.

West Bengal:

NFHS round V levels in West Bengal across metrics remain almost at round IV levels – at an absolute level, stunting and under-weight rate is on the higher side.

The Global Hunger Index (GHI) 2020 report (ranked for 2019) placed India at 94 out of 107 nations and qualified the status of the “hunger” problem in India as “Serious.” The GHI is based on four key parameters: child wasting, undernourishment, child stunting, and child mortality.

While several large states like UP, MP, Rajasthan, Tamil Nadu as well as agriculturally prosperous states like Punjab & Haryana are part of phase II of the NFHS – V, the phase I results on child nutrition & growth when read in conjunction with the GHI 2020 certainly is a cause of major concern. Both NFHS round V and GHI 2020 represent pre-Covid19 levels. It can be surmised that the scenario would have only worsened due to the indirect effect of the pandemic.

The UN has already warned that globally, 130 million people are likely to be pushed into starvation due to the pandemic – South Asia and Africa being most vulnerable regions. Children are likely to be worse hit.

IPD hopes that the MoH&FW would initiate positive action basis the findings of NFHS-V to redress the worsening child growth/nutrition trend in many Indian states.

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