Maharashtra CDC Review
The Nutrition Component of the Child Development Centre (CDC) Program in Maharashtra, India
Overview of Malnutrition Situation in Maharashtra
Maharashtra: The data below are from the National Family Healthy Survey 2005-2006.
Highlights: The nutrition situation in Maharashtra is slightly better than the national average with improvements from 1998-99 and 1992-93 except for an increase of anaemia prevalence among pregnant women.
The feeding practice for children aged 6-9 months shows an alarming pattern with only 48% of children aged 6-9 months receiving solid or semisolid food and breast milk. This is significantly lower than the national average of almost 56%. Furthermore, the prevalence drops to 40% for rural areas compared with the national average of 54% and as low as 23.3% for non-educated mothers compared with the national average of 49%.
The prevalence of overweight and obesity in Maharashtra is higher than the national average for both female and male with Mumbai reaching almost 35% of obesity among the female population.
Within Maharashtra, there are significant differences between rural and urban areas with the rural areas being more affected by malnutrition. However, the most outstanding gap in all indicators is between non-educated and well-educated respondents.
Malnutrition and Anaemia Rates Are High among Children
- Almost 38% of children under age three are stunted (India - 38.4%) and almost 40% are underweight (India 45.9%). Both indicators have slightly improved from 1998-99 and 1992-93.
- Wasting affects 14.6% of children under age (India 19%) with a steady improvement from 1998-99 and 1992-93.
- Compared with urban areas, under-nutrition is higher in rural areas and in Mumbai. Similar to the national picture, there is a strong correlation between child malnutrition and the level of maternal education showing a two-fold difference between non-educated and well-educated mothers. The stunting and underweight prevalence for children with illiterate mothers is 52.9% and 53.1% respectively contrasted with 22.9% and 25.9% for children with well educated mothers. The stark difference may be linked to access to nutritious diet and complementary feeding at 6-9 months.
- Almost 72% of children under age three are anaemic (India 79.2). There is a significant urban-rural divide with Mumbai having the lowest prevalence with 59.5% compared with 76.8% in rural areas. The non-educated versus educated mothers difference is not as strong with 75% and 71% relatively. This may be linked to a more general poor quality of nutrition and hygiene conditions and limited access to iron supplementation.
Improvements Needed in Infant and Child Feeding especially for the age 6-9 months
- 53% of children are fed only breast milk for the first 6 months (India 46%). Exclusive breastfeeding is significantly higher among the non-educated mothers, in rural areas and in Mumbai. Work factor and access to breast milk substitutes may have an impact among urban and better educated mothers. The positive deviance in Mumbai may be associated with an increased awareness among the female working class and better baby-friendly employment conditions.
- 51.8% of children under three years are breastfed within one hour of birth (India 23.4%) with no significant difference between urban and rural areas and between well-educated and non-educated mothers.
- Only 47.8% of children aged 6-9 months receive solid or semisolid food and breast milk. This is significantly lower than the national average of almost 56%. The prevalence drops as low as 40% in rural areas (India rural 54%) and 23.3% among non-educated mothers (India non-educated 49%) showing a high-priority gap. The prevalence in urban areas and in Mumbai is 58% and 56.6% respectively (India urban 62.1%).
- 32% of children age 12-35 months received vitamin A supplements in the six months before the survey (India 23%) with the highest prevalence in urban areas (34.2%) followed by rural areas (29.9%) and Mumbai (27%) with a significant difference between non-educated (26.2%) and well-educated mothers (32.2%).
A significant percentage of Women and Men Are Either Too Thin or Too Fat
- 32.6% of married women (India 33%) and almost 30% of men (India 28%) are too thin, according to the body mass index (BMI). Underweight is strikingly most common among the non-educated and the rural population compared with Mumbai and urban areas that show a similar prevalence.
- Overweight and obesity affects 17% of women (India 14.8%) and almost 16% of men (India 12%). Overweight and obesity are strikingly most common in urban areas and among the well-educated with Mumbai reaching almost 35% of obesity among the female population as compared with the national urban average of 29%.
Anaemia is Widespread
- 49% of women (India 56.2%) and 16.2% of men (India 24.3) suffer from anaemia. Among pregnant women, anaemia has increased from 52.6% to almost 58%.
- Only 30.5% of pregnant women consume Iron and Folic Acid supplementation for 90 days (India 22.3%) with 16.4% among the non-educated women compared to 45.2% among the well-educated ones. Rural and urban areas have the same prevalence of 30.5% with Mumbai reaching only 27.5% (India urban 34.5% respectively)
The bleakest numbers* at a glance:
*(NOTE: Figures have been rounded to the closest zero for easier understanding of the ratio)
For every ten children aged three or less, born to illiterate mothers, five children are stunted - too short for their age. This is a sign of chronic malnutrition.
For every ten children aged three or less, born to illiterate mothers, five children are underweight - too thin for their age. This is a sign of acute and chronic malnutrition.
For every ten children aged three or less, born to illiterate mothers, two children are wasted - too thin for his/her age. This is a sign of acute malnutrition. Wasted children are at highest risk of dying from malnutrition or from any common child diseases like diarrhoea or respiratory infections.
For every ten children aged 6-9 months, born to illiterate mothers, only two receive solid or semi-solid foods in addition to Breast-milk as recommended. This jeopardizes their chances of survival and irreversibly impairs their future growth and development.
For every ten children aged one to three years, born to illiterate mothers, only three children received Vitamin A supplementation in the last six months prior the survey.
For every ten illiterate women aged 15-49 years, four are too thin.
For every ten pregnant illiterate women, six are anaemic but only two take Iron and Folic Acid supplementation for 90 days as recommended.
The higher the education of the mother, the better the nutrition status of themselves and their child.
NOTE: In Maharashtra, for every ten women, 2 women are illiterate and 8 are educated
Among the educated women, 3 are well-educated (10 years complete and above), 2 have 8-9 years complete and 3 have less than 8 years complete.
Nutrition data (2005-2006 National Family Health Survey (NFHS-3) Maharashtra Fact Sheet)
11 April, 2013