The article analyses the data of NHFS-5 and try to factors responsible for the outcomes.

Analysing health and nutrition of child through NHFS-5

• The recently released fifth round of the National Family Health Survey (NFHS-5) provide insights into some dimensions of micro-development performance before COVID struck.
• The latest round only has data for 17 states and five Union territories.
• Madhya Pradesh, Uttar Pradesh, Punjab, Rajasthan and Tamil Nadu are notable exclusions.
• Many of the child-related outcomes are also determined by state-level implementation, therefore neither success nor failure can be attributed to state or the centre alone.

Let’s understand the data

• The NFHS has 42 indicators related to child’s health and nutrition.
• Indicators fall into nine categories and each of these can be divided into outcomes and inputs.
• For example, neonatal, infant and under-5 mortality rates can be thought of as outcomes.
• Similarly, all the nutrition indicators —stunting, wastage, excess wastage, underweight and overweight can also be classified as outcomes.
• In contrast, the post-natal care indicators relating to visits made by health workers and the extent and nature of feeding for the child can be classified as inputs.

Outcomes of the survey

• On the front of wasting (weight for height of children) these is an improvement because even though the gains were marginal, they reversed a negative trend between 2005 and 2015. 
• India continues to be successful in preventing child deaths, but the health and nutrition of the surviving, living child has deteriorated, somewhat worryingly.
• India continued to make progress in preventing child-related deaths (neonatal, infants and under-5).
• The pace of improvement in child mortality slowed down relative to the previous 10 years (Fig.1).
• Figure 2 shows the six indicators where outcomes have deteriorated. These all relate to what happens after survival:
• The health (anaemia, diarrhoea, and acute respiratory illness (ARI)) and nutrition (stunting, and overweight) of the child deteriorated between 2015 and 2019.
• The absolute deterioration in health and nutrition indicators must be seen against the fact that they reversed the historic trends of steady improvements.

What explains the outcomes

• Implementation capacity of individual states probably played an important role.
• Sector-specific factors such as changing diets are also implicated.
• A broader deterioration in outcomes hints at the likelihood of a common factor, namely the macro-economic growth environment, which determines employment, incomes and opportunities.
• At the least, it is safe to conjecture that some of these outcomes are inconsistent with the narrative of a rapidly growing economy.

Conclusion

As discussed in Chapter 5 of the Economic Survey of 2015-16, perhaps the next big welfare initiative of the government should be a mission-mode focus on the well-being of the early child (and of course the mother), from the womb to the first five years, which research shows is critical for realising its long run potential as an individual.

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