General News
The Dynamics of Child Nutritional Status
by Priya Rampal
(Part of paper presented at Oxford University)
The first six years of life (and especially the first two years also called the window of opportunity) have a great and lasting influence on the quality of life of a human being.
Children for whom malnourishment has persisted deserve special attention. Who are these children and what are the factors that keep them malnourished? Is there any mobility in the nutritional status of children or persistence is observed? These are important questions and fairly little is known about the same child’s nutritional status at multiple points in time. This is because of lack of panel datasets on the same set of children. Mapping transitions across data points for the same child will help illuminate whether there is a persistent influence of early childhood status later in life or not.
There are a substantial number of studies on various aspects of malnutrition in India; aspects dealing with prevalence, consequences, trends across states and social groups. However, far less is known about the transition of a child into an adult in the life cycle of an individual. The first six years of life (and especially the first two years also called the window of opportunity) have a great and lasting influence on the quality of life of a human being. Martorell (Food Forum, 2001) has noted that the emphasis on under two is well placed if the objective is to prevent under nutrition and its consequences. This is because the age of active faltering is between six and twenty four months of age. Catch up growth i.e. resuming developmental progress despite suffering the impacts of malnutrition seems to taper off after three years of age.
In the Young Lives study, two cohorts of children, one born in 2001–02 and another who were born in 1994–95 are being followed in each of the four countries of Ethiopia, Peru, Vietnam and India. Three rounds of the surveys have been completed in 2002, 2006 and 2009. These groups provide insights into various phases of childhoods of the children being followed. We use data from the first three rounds in the state of Andhra Pradesh in India for the younger cohort to draw certain inferences.
At the outset, we discuss the prevalence of malnutrition, in terms of the three indices of stunting, wasting and underweight in the state of Andhra Pradesh. At the state level, 38% of the children are underweight, 39% are stunted and nine percent are wasted. In our sample, we observe that 32% of the children are stunted, 31% are underweight and 19% are wasted in the first round.
We observe that for underweight and stunting, more transitions are made in the younger age bracket than in the older age bracket while for wasting; the transitions made are similar in both age brackets. It is also observed that about 70% of the children show persistence in their nutritional status. In our study, we observe other castes do better than backward classes, scheduled castes and scheduled tribes in terms of the malnutrition indicators. Prevalence of stunting is highest amongst the scheduled tribes. Females are found to do better than males.
Location wise, urban sector does better than rural sector in terms of malnutrition indicators. This urban-rural differential has been observed at the aggregate level too (NFHS-3); with rural sector (50%) having higher prevalence of underweight than urban areas (38%). Twenty two to twenty four percent of children in urban while 30% in rural areas show transitions in the younger age bracket while 12-15% and 17% show transitions in older age bracket for urban and rural areas respectively. As we move to higher wealth quartiles, fewer percentage of children malnourished.
The persistence of nutritional status over the years confirms the fact that if a child starts off badly, it is very difficult for him to catch up in the later years.
