NFHS: The good and bad news
Though it is not complete, there is enough data to frame positive intervention policies
The first phase of the fifth National Family Health Survey (NFHS-5), results of which have just been released, brings both good and bad news. First, the good news. Several of the 22 states and Union Territories (UTs), for which findings have been released, showed an increase in childhood immunisation. There has been a drop in neonatal mortality in 15 states, a decline in infant mortality rates in 18 states and an increase in the female population (per 1,000 males) in 17 states. Fertility rate decline and increase in contraceptive use were registered in almost all the states surveyed. The bad news is that there has been an increase in stunting and wasting among children in several states, a rise in obesity in women and children, and an increase in spousal violence. In several other development indicators, the needle has hardly moved since the last NFHS.
While the results of the remaining states and UTs will be required to work out national averages, the available data provides a glimpse into challenges. There has been a severe disruption in the midday meal scheme in areas due to the pandemic. Several states have take-home meal arrangements for outof-school children but they have no way of ensuring that in situations where resources are stretched, the intended beneficiary will get the food. The government must begin identifying areas where malnutrition and anaemia among children are severe and work with communities and civil society to improve nutrition and food security policies. Stunting and wasting have long-term effects which include lower abilities in school, increased child mortality, vulnerability to diseases, and chronic illness in adulthood among others.
The paradox, in a sign of glaring inequality, is that this is accompanied with a rise in obesity, especially among women and children. Even before the pandemic, the trend towards obesity was driven by the lack of awareness of good food habits resulting in greater consumption of high-fat, highsugar foods and sedentary lifestyles. Increasing obesity will exacerbate conditions such as cardiovascular disease, diabetes and hypertension. Though NFHS-5 is not complete, there is enough data to frame positive intervention policies. Community health workers have been in the frontline of the fight against Covid-19. For a start, better nutrition, health and awareness programmes can be mainstreamed into their efforts to begin the process of reversing some of the problems identified in NFHS-5.