NFHS-6 Reveals Progress Amid Persistent Nutrition Challenges
Subject: Polity & Governance (Mains)
The National Family Health Survey-6 (NFHS-6) presents a mixed picture of India’s progress in child nutrition, maternal health, and healthcare access. While significant improvements have been recorded in several health indicators, challenges related to child feeding practices, maternal workload, and dietary quality continue to impede faster progress.
Improvement in Child Nutrition Indicators
1. Decline in Stunting
- Stunting among children under five years has declined from 35.5% to 29.3%.
- Stunting is an indicator of chronic undernutrition, resulting from prolonged inadequate nutrition, recurrent infections, and socio-economic deprivation.
- The decline reflects improvements in children’s long-term nutritional status.
2. Wasting Remains a Concern
- Wasting (low weight-for-height) has remained largely unchanged.
- However, the prevalence of severe wasting has declined.
- This indicates that acute malnutrition continues to be a challenge despite overall progress.
Factors Driving Nutritional Improvements
The improvements in child nutrition can largely be attributed to:
- Better access to healthcare services.
- Increased immunisation coverage.
- Improved maternal education levels.
- Enhanced housing conditions.
- Greater access to safe drinking water and sanitation facilities.
However, poor infant and young child feeding practices and inadequate access to nutritious diets continue to limit progress.
Progress in Maternal and Child Healthcare
Institutional Deliveries
- 90% of births now take place in health institutions.
- Around 58% of institutional deliveries occur in public healthcare facilities.
- Approximately 91% of births are attended by skilled health personnel.
- Nearly 95% of mothers receive at least one antenatal care visit from health professionals.
Significance
Higher institutional deliveries have contributed to:
- Reduced maternal and infant mortality.
- Improved neonatal care.
- Better monitoring of pregnancy-related complications.
Improved Immunisation Coverage
- 87% of children aged 12–23 months are fully immunised.
Contribution of Frontline Health Workers
The success of immunisation programmes reflects the efforts of:
- Accredited Social Health Activists (ASHAs)
- Anganwadi Workers (AWWs)
- Auxiliary Nurse Midwives (ANMs)
Despite regional disparities, access to healthcare services has improved across most states.
Persistent Challenges in Child Nutrition
Inadequate Infant Feeding Practices
Despite high institutional delivery rates:
- Only 50% of newborns are breastfed within one hour of birth.
- Around 60% of children aged 6–8 months receive solid or semi-solid foods.
- Only 15% of children aged 6–23 months receive a minimum acceptable and nutritionally adequate diet.
Implications
Delayed breastfeeding and complementary feeding can result in:
- Growth faltering.
- Micronutrient deficiencies.
- Poor cognitive development.
- Long-term health consequences.
Cultural Dimension
In India, complementary feeding is often linked to the Annaprasana ritual, traditionally performed between six and twelve months of age. Delays in this practice may affect timely nutritional supplementation.
Maternal Time Poverty: An Emerging Concern
NFHS-6 highlights the issue of maternal time poverty, an often-overlooked determinant of child nutrition.
Key Findings
- Nearly 30% of women were engaged in paid work during the previous year.
- Many women simultaneously perform:
- Unpaid family labour.
- Agricultural activities.
- Livestock care.
- Household chores.
Impact on Child Nutrition
- Lack of childcare facilities and crèches forces many mothers to leave children with older siblings or relatives.
- This negatively affects:
- Breastfeeding practices.
- Timely feeding.
- Childcare quality.
The Processed Food Trap
Changing Consumption Patterns
Recent trends indicate:
- Declining expenditure on cereals.
- Rising expenditure on:
- Dairy products.
- Processed foods.
- Packaged beverages.
Concern
Dietary diversity does not automatically translate into nutritional adequacy.
Affordability Challenge
The ICMR–National Institute of Nutrition (NIN) recommends diets rich in:
- Pulses
- Millets
- Fruits
- Vegetables
- Nuts
- Animal-source foods
However, nutritious diets remain unaffordable for many households.
Why Processed Foods Dominate
Processed foods are:
- Cheap.
- Easily available.
- Aggressively marketed.
- Sold in small affordable packets.
This encourages unhealthy dietary habits and increases the risk of malnutrition and non-communicable diseases.
Way Forward
Focus on the First 1,000 Days
The period from pregnancy to a child’s second birthday is the most critical phase for physical and cognitive development.
Strengthening POSHAN Abhiyaan
The programme should move beyond identifying and rehabilitating severely malnourished children and place greater emphasis on:
- Prevention of growth faltering.
- Early intervention.
- Behavioural change.
Early Detection and Counselling
- Regular monitoring of weight and height.
- Early identification of growth stagnation.
- Timely counselling of mothers and caregivers.
Capacity Building of Frontline Workers
- Strengthen AWWs’ skills in anthropometric measurements.
- Use digital tools for nutrition monitoring and counselling.
- Conduct joint training programmes for:
- AWWs
- ASHAs
- ANMs
Community-Based Interventions
- Behaviour Change Communication (BCC) rooted in local cultural practices.
- Improved Anganwadi infrastructure.
- Community crèches to reduce maternal time poverty.
- Better drinking water and sanitation facilities.
- Greater convergence through Gram Sabhas and Panchayats.
Conclusion
NFHS-6 demonstrates that India has made notable progress in reducing stunting, improving maternal healthcare, and expanding immunisation coverage. However, persistent challenges related to infant feeding practices, maternal time constraints, dietary quality, and affordability continue to hinder optimal nutritional outcomes. A preventive, community-centred, and multi-sectoral approach focused on the first 1,000 days of life is essential to achieve sustainable improvements in child nutrition and human development.
