MUMBAI, India 7 August 2014 - A new report launched jointly by UNICEF and the Institute of Development Studies, UK is calling for effective public action to tackle childhood stunting by citing the case of Maharashtra, a state which has achieved an unprecedented decline of 15% within a span of six years- faster than any recent country-level trend.
Child stunting is the phenomenon of children being too short for their age, which is a measure of profound physical and cognitive underdevelopment. It is a manifestation of child undernutrition, which affects an estimated 165 million children globally. It is believed to be responsible for almost half of all deaths of children under the age of 5 years.
The report titled, “Maharashtra’s Child Stunting Declines: What is Driving Them? Findings of a Multidisciplinary Analysis” by Lawrence Haddad, Nick Nisbett, Inka Barnett and Elsa Valli examines the success of Maharashtra in tackling child stunting.
The research followed a multidisciplinary approach to understand the driving force behind Maharashtra’s success. The authors reviewed available evidence and undertook statistical analysis of survey data collated between 2006 and 2012. They combined this with qualitative interviews with a broad range of key stakeholders in the state.
What sets this report apart is that it has actually undertaken a rigorous analysis of individual cases, something that most ‘success stories’ often pushed forward by the nutrition world are lacking in.
Why the decline is significant
The report says, “A comparison of stunting rates for children under the age of two years, using the data from the 2005-06 National Family Health Survey and the 2012 Maharashtra Comprehensive Nutrition Survey, shows that rates declined from 39% to 24% - a decline of almost 3 percentage points per year. This is faster than any recent country level trend. Bangladesh comes closest to this performance with declines of 2 percentage points over a similar period.
The decline is even more remarkable given that Maharashtra’s performance in reducing stunting between 1992 and 2006 was lower than the all-India average. To put the recent decline in a national context, if India posted a 10-percentage-point decline in stunting over the same period, the number of stunted children under 5 years would decline from 60 million to 45 million. Global stunting numbers would be reduced from 165 million to 150 million, well on the way to the World Health Assembly targets of 100 million by 2025.”
In Maharashtra, this decline itself is pro-poor and broad-based, benefitting lower income quintiles. “The analysis suggests that the declines are broadly based: they are rural as well as urban; largest for the bottom wealth quintile; larger for those who are not literate, those with no improved water source or no improved sanitation
facilities; strongest for younger mothers and those who are younger at the age of their first birth. Some of the larger declines are also seen by those who avail themselves of interventions, such as those who have more antenatal care visits and those who do not give birth at home.”
Maharashtra’s winning formula
Leadership on undernutrition reduction is particularly important given the lack of an institutional home and the multisectorality of action required. When leadership in government and civil society join forces within a reasonably supportive socioeconomic context, as Maharashtra shows us, public action can reduce undernutrition—fast.
To quote IDS, “The report concludes that the case of Maharashtra shows what can be achieved when modest progress on a number of fronts - economic growth, empowering women and improving their maternal health, a committed government and improving services - combine.” It says the state provides a new example of leadership in nutrition that will serve as a future example of what can drive success in tackling the global crisis of child and maternal undernutrition.