Peer-reviewed article
Prevalence of severe and moderate anthropometric failure among children in India, 1993-2021.
Menaka Narayanan, Omar Karlsson, Akhil Kumar, Thomas W Pullum, Rockli Kim et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines malnutrition trends among children under 2 years old across India from 1993 to 2021 using national household survey data. While moderate and severe stunting, underweight and wasting generally declined nationally over the period, the rate and direction of change varied significantly between states and regions. Severe wasting showed a concerning increase from 8% to 9%, and since 2016 both moderate underweight and severe wasting have worsened in many regions. The findings highlight the need for context-specific nutrition interventions tailored to regional patterns.
Key points
- Nationwide moderate stunting decreased from 20% to 16%, moderate underweight from 23% to 18%, and moderate wasting from 15% to 12% between 1993 and 2021
- Severe stunting declined from 23% to 16% and severe underweight from 18% to 11%, but severe wasting marginally increased from 8% to 9%
- From 2016 to 2021, moderate underweight showed the highest rate of change across regions, with 15 of 36 regions experiencing increases
- Severe wasting increased in 13 of 36 regions during 2016-2021, indicating emerging concern in specific areas
- State and regional variation is substantial, with inconsistent patterns of improvement across different types of malnutrition
Limitations
This is a descriptive epidemiological study documenting prevalence trends; it does not evaluate specific interventions or explain the causes of regional variation in malnutrition patterns. The analysis is restricted to children under 2 years and cannot assess nutritional status in older children or identify causal factors driving the observed trends.
Abstract
Though child anthropometric failure (CAF) is a persistent problem in India, previous studies have often neglected state-level variance and aggregated moderate and severe CAF categories. This study addresses this gap by examining moderate and severe malnutrition across India's states and union territories (UTs) from 1993 to 2021. Data of children under 2 years old from five waves of National Family Health Surveys, a representative cross-sectional survey of Indian households, were analysed. Outcomes included prevalence of moderate and severe stunting, underweight and wasting, as per the 2006 World Health Organization growth standards. Percentage prevalence and standardized absolute change (SAC) were calculated nationally and by region for each wave. From 1993 to 2021, there was a notable reduction in the nationwide prevalence of moderate stunting, underweight and wasting, with rates dropping from 20% to 16%, 23% to 18%, and 15% to 12%, respectively. Severe stunting and underweight declined considerably from 23% to 16% and 18% to 11%, respectively; severe wasting marginally increased from 8% to 9%. From 2016 to 2021 moderate underweight was noted to have the highest SAC across all regions, although 15 regions saw an increase in the prevalence of moderate underweight. In the 2016-2021 period, severe wasting has increased in 13 of the 36 regions. While there has been a nationwide reduction in most indicators of CAF since 1993, the rate and direction of change vary widely among states and UTs and between moderate and severe categories within each of the states and UTs. Understanding these patterns of change can direct context-specific interventions for improving child nutrition and health. A greater focus on reducing severe wasting, which has increased since 1993, is also crucial.