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Public Investment for Addressing Childhood Wasting in Maharashtra and Karnataka
Maharashtra and Karnataka are among the most financially well-off states in India. Yet, they are home to 15% of all wasted children under five years of age in the country. Over the last decade (between National Family Health Survey-3 and NFHS-4), wasting levels among children in the two states have increased sharply. Investment by the two states in select nutrition interventions for addressing wasting remains low, with inconsistent budget outlays over the period between 2014–15 and 2018–19.
This article was presented at the conference “Towards Improving Nutrition Outcomes in India,” organised by the System of Promoting Appropriate National Dynamism for Agriculture and Nutrition during 8–10 November 2018, at the Indira Gandhi Institute of Development Research, Mumbai.
The World Health Organization (WHO) recently noted that more than half (27.6 million) of the 50.5 million wasted children in the world live in India (UNICEF et al 2018). Wasting is a symptom of acute malnutrition in children, which manifests as poor physical growth and susceptibility to disease and death. While the WHO finding is a cause for concern, the situation becomes more critical given the increase in the levels of wasting in India over the last decade. The report on the fourth round of the National Family Health Survey (NFHS-4), released in December 2017, revealed that the level of wasting (low weight-for-height) among children under five years of age has gone up from 19.8% to 21% between 2005–06 (NFHS-3) and 2015–16 (NFHS-4). This data represents an enigma since, during the same period, the number of stunted (low height-for-age) and underweight (low weight-for-age) children below five years of age went down significantly. The current trends indicate that India is far from achieving the global target set by the World Health Assembly of reducing wasting levels to below 5% and maintaining them there.
Moreover, there are significant inter-state and intra-state disparities in the prevalence of wasting. A comparison of the NFHS-3 and NFHS-4 data shows that Maharashtra and Karnataka, two economically well-off states, are home to almost 15% of India’s wasted children. These two states have also experienced the highest increases in wasting levels in the country during the last decade. The level of wasting in Maharashtra increased from 16.5% in 2005–06 to 25.6% in 2015–16. In Karnataka, it increased from 17.6% to 26.1% during the same period. This is despite the fact that both states have achieved noticeable reductions in levels of stunting during the period: Maharashtra managed to reduce stunting levels by 11.9 percentage points and Karnataka by 7.5 percentage points. Given this situation, there is a need to understand policy action on nutrition in these states in the recent past and analyse how it can be improved to protect children from malnourishment and premature death.
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