Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 150
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Code Context


        trigger_error($message, E_USER_DEPRECATED);

    }
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 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.'
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deprecationWarning - CORE/src/Core/functions.php, line 311
Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421
App\Controller\ArtileDetailController::index() - APP/Controller/ArtileDetailController.php, line 150
Cake\Controller\Controller::invokeAction() - CORE/src/Controller/Controller.php, line 610
Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120
Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94
Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162
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Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 97
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51
Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98

Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 151
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Code Context


        trigger_error($message, E_USER_DEPRECATED);

    }
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 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.'
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deprecationWarning - CORE/src/Core/functions.php, line 311
Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421
App\Controller\ArtileDetailController::index() - APP/Controller/ArtileDetailController.php, line 151
Cake\Controller\Controller::invokeAction() - CORE/src/Controller/Controller.php, line 610
Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120
Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94
Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 97
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51
Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98

Warning (512): Unable to emit headers. Headers sent in file=/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php line=853 [CORE/src/Http/ResponseEmitter.php, line 48]
Code Context
            if (Configure::read('debug')) {

                trigger_error($message, E_USER_WARNING);

            } else {
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        NEWS ALERTS | NFHS data reveals that children in the Bundelkhand region suffer from double burden of malnutrition    </title>
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    <h1 class="cat-box-title">NFHS data reveals that children in the Bundelkhand region suffer from double burden of malnutrition</h1>
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                            <p style="text-align:justify">In the previous <a href="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html" title="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html">news alert</a>, we looked at the under-nutrition problem in the Bundelkhand region in terms of 3 indicators -- proportion of children under 5 years who are stunted <em>(height-for-age)</em>; proportion of children under 5 years who are wasted <em>(weight-for-height)</em>; and proportion of children under 5 years who are underweight <em>(weight-for-age)</em>. However, the&nbsp;<a href="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml" title="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml">National Family Health Survey (NFHS) data</a> also indicates that severe under-nutrition like severe wasting and anaemia among children co-exists alongside overweight among kids below 5 years of age in this region. According to the <a href="https://im4change.org/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf" title="https://im4change.org/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf">World Health Organisation (WHO)</a>, the phenomenon of double burden of malnutrition is characterised by the coexistence of undernutrition along with overweight and obesity, or diet-related non-communicable diseases, within individuals, households and populations, and across the life course.&nbsp;</p><p style="text-align:justify">In order to understand the malnutrition issue, which is troubling Bundelkhand, we have looked at the trends in three different indicators in the present news alert -- proportion of children under 5 years who are severely wasted <em>(weight-for-height)</em>; proportion of children under 5 years who are overweight <em>(weight-for-height)</em>; and proportion of children age 6-59 months who are anaemic <em>(&lt;11.0 g/dl)</em>.&nbsp;</p><p style="text-align:justify">It should be noted that the Bundelkhand region of Central India covers seven districts of Uttar Pradesh and six districts of Madhya Pradesh. The districts of Chitrakoot, Banda, Jhansi, Jalaun, Hamirpur, Mahoba and Lalitpur, which are part of the Bundelkhand region, lie in Uttar Pradesh. The districts of Madhya Pradesh that come under the Bundelkhand region are Chhatarpur, Tikamgarh, Damoh, Sagar, Datia and Panna.&nbsp;Regarded as one of the most backward regions, Bundelkhand, historically, has experienced <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">prolonged drought, low industrial growth</a>, <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">rampant poverty and apathy of the administration</a>. Due to the lack of livelihood opportunities, people are <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">compelled to migrate</a> from this region. &nbsp;</p><p style="text-align:justify"><strong>Prevalence of severe wasting among children under five years</strong></p><p style="text-align:justify">The recently released <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">data of the NFHS</a> shows that for the country as a whole, the percentage of children below 5 years who are severely wasted has marginally increased from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">7.5 percent to 7.7 percent</a> between 2015-16 and 2019-21 i.e., by +0.2 percentage points. While <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">for Madhya Pradesh</a>, the percentage of children below 5 years who are severely wasted has gone down from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">9.2 percent to 6.5 percent</a> between 2015-16 and 2020-21 <em>(i.e., by -2.7 percentage points)</em>, <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has increased from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">6.0 percent to 7.3 percent</a> between the two time points <em>(i.e., by +1.3 percentage points)</em>. Please see chart-1.</p><p style="text-align:justify">In Chhatarpur <em>(-1.4 percentage points)</em>, Damoh <em>(-2.8 percentage points)</em>, Datia <em>(-1.4 percentage points)</em>, Panna <em>(-2.1 percentage points)</em>, Sagar <em>(-0.5 percentage points)</em>, and Tikamgarh <em>(-0.3 percentage points)</em> districts the percentage of children below 5 years who are severely wasted has decreased between NFHS-4 and NFHS-5.</p><p style="text-align:justify">In Chitrakoot <em>(-2.7 percentage points)</em>, Hamirpur <em>(-3.9 percentage points)</em>, Jalaun <em>(-5.8 percentage points)</em>, Jhansi <em>(-0.6 percentage points)</em>, and Lalitpur <em>(-9.4 percentage points)</em> districts the percentage of children below 5 years who are severely wasted has gone down between NFHS-4 and NFHS-5, whereas in Banda <em>(+6.3 percentage points)</em> and Mahoba <em>(+5.3 percentage points) </em>districts the percentage of children below 5 years who are severely wasted has climbed up between the two time points.</p><p style="text-align:justify"><span style="background-color:#ffff00">In just two out of 13 districts that are part of Bundelkhand, the proportion of children under 5 years who are severely wasted has increased between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of severe wasting among children under five years in 2020-21 is higher in Datia <em>(6.8 percent)</em>, Panna <em>(7.9 percent)</em>, and Tikamgarh <em>(7.3 percent)</em> in comparison to Madhya Pradesh <em>(6.5 percent)</em>. The prevalence of severe wasting &nbsp;among children below five years in 2020-21 is higher in Banda <em>(13.0 percent)</em>, Chitrakoot <em>(12.0 percent)</em>, Hamirpur <em>(10.7 percent)</em>, Jalaun <em>(8.5 percent)</em>, Jhansi <em>(10.4 percent)</em>, Lalitpur <em>(7.5 percent)</em>, and Mahoba <em>(11.7 percent)</em> as compared to Uttar Pradesh <em>(7.3 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%201%20Percentage%20of%20children%20under%205%20years%20who%20are%20severely%20wasted.png" style="height:555px; width:831px" /></p><p style="text-align:justify"><em><strong>Note:</strong> Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a>&nbsp;to access the data of the above chart in a spreadsheet format</em></p><p><em><strong>Source:&nbsp;</strong>Madhya Pradesh --</em></p><p><em>District Factsheet: Chhatarpur, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Damoh, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Datia, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Panna, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Sagar, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access</em></p><p><em>***<br />District Factsheet: Tikamgarh, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />Madhya Pradesh Factsheet, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">click here</a>&nbsp;to access&nbsp;</em></p><p><em>---</em></p><p><em>Uttar Pradesh --&nbsp;</em></p><p><em>District Factsheet: Banda, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Chitrakoot, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Hamirpur, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Jalaun, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Jhansi, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Lalitpur, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;<br />***</em></p><p><em>District Factsheet: Mahoba, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;</em></p><p>***<br /><em>Uttar Pradesh Factsheet, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;</em></p><p><em>---</em></p><p><em>India Factsheet, NFHS-5, 2019-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;</em></p><p><strong>-----</strong></p><p style="text-align:justify">Severe wasting is <a href="https://im4change.org/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf" title="https://im4change.org/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf">characterised by a massive loss of body fat and muscle tissue</a>. Children who are severely wasted look almost elderly and their bodies are extremely thin and skeletal. A <a href="https://im4change.org/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf" title="https://im4change.org/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf">document</a> by the Ministry of Health and Family Welfare says that if the diet is deficient for a short duration, the body adapts its metabolism to compensate for the deficit to some extent. If the food deficit persists for a longer duration then the fat is utilised for energy and body metabolism and the&nbsp;muscle is depleted. A child with severe wasting has lost fat and muscle and appears like &ldquo;skin and bones&rdquo;. Another term used for this condition is marasmus. Any child who has following features are treated as severe acute malnutrition (SAM):<br /><strong>* </strong>Weight-for-height less than -3 SD and/or<br /><strong>*</strong> Visible severe wasting and/or<br /><strong>*</strong> Mid arm circumference (MUAC) &lt; 11.5 cm and/or<br /><strong>*</strong> Oedema of both feet; however, other causes of oedema e.g. nephrotic syndrome should be excluded.&nbsp;</p><p style="text-align:justify"><strong>Prevalence of anaemia among children aged 6-59 months</strong></p><p style="text-align:justify">For the country as a whole, the percentage of children aged 6-59 months who are anaemic has climbed up from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">58.6 percent</a> to <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">67.1 percent</a> between 2015-16 and 2019-21 i.e., by +8.5 percentage points. While for <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">Madhya Pradesh</a>, the percentage of children aged 6-59 months who are anaemic has increased from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">68.9 percent to 72.7 percent</a> between 2015-16 and 2020-21 <em>(i.e., by +3.8 percentage points)</em>, <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has gone up from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">63.2 percent to 66.4 percent</a> between the two time points <em>(i.e., by +3.2 percentage points)</em>. Please see chart-2.</p><p style="text-align:justify">In Chhatarpur <em>(+21.0 percentage points)</em>, Damoh <em>(+0.6 percentage points)</em>, Panna <em>(+6.3 percentage points)</em>, Sagar <em>(+15.9 percentage points)</em>, and Tikamgarh <em>(+0.4 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has increased between NFHS-4 and NFHS-5. However, in Datia district <em>(-0.4 percentage points)</em>, the percentage of children aged 6-59 months who are anaemic fell between 2015-16 and 2020-21.&nbsp;</p><p style="text-align:justify">In Chitrakoot<em> (-17.2 percentage points)</em>, Jalaun <em>(-29.6 percentage points)</em>, Jhansi <em>(-7.5 percentage points)</em>, Lalitpur <em>(-19.8 percentage points)</em>, and Mahoba <em>(-7.5 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has reduced between NFHS-4 and NFHS-5, whereas in Banda <em>(+19.5 percentage points)</em> and Hamirpur <em>(+13.0 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has climbed up between the two time points.</p><p style="text-align:justify"><span style="background-color:#ffff00">Therefore, in seven out of 13 districts that fall in Bundelkhand, the percentage of children aged 6-59 months who are anaemic has increased between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of anaemia among children aged 6-59 months in 2020-21 is higher in Chhatarpur <em>(87.2 percent)</em>, Damoh <em>(76.3 percent)</em>, Datia <em>(72.8 percent)</em>, Panna <em>(74.5 percent)</em>, and Sagar <em>(83.3 percent) </em>in comparison to Madhya Pradesh <em>(72.7 percent)</em>. The prevalence of anaemia among children aged 6-59 months in 2020-21 is higher in Banda <em>(82.2 percent)</em>, Hamirpur <em>(68.5 percent)</em>, Jhansi <em>(70.3 percent)</em>, and Mahoba <em>(70.1 percent)</em> as compared to Uttar Pradesh <em>(66.4 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%202%20Percentage%20of%20children%20age%206-59%20months%20who%20are%20anaemic.png" style="height:638px; width:1000px" /></p><p style="text-align:justify"><em><strong>Note:</strong> Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a> to access the data of the above chart in a spreadsheet format</em></p><p style="text-align:justify"><em>Haemoglobin in grams per decilitre (g/dl). Among children, prevalence is adjusted for altitude.</em></p><p style="text-align:justify"><em><strong>Source: </strong>Same as Chart-1</em></p><p style="text-align:justify"><strong>---</strong></p><p style="text-align:justify">In the absence of epidemiological data, haemoglobin (Hgb) of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">less than 11 g/dL</a> is considered abnormal in children up to the age of 59 months. Haemoglobin (Hgb) level is considered the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">gold standard for assessing anaemia</a> in preschool-age children. Anaemia in preschool-age children is responsible for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">non-fatal health outcomes</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">years lost due to disability</a> (YLD). The full effect of anaemia on morbidity and mortality is difficult to establish. However, it is well known that childhood anaemia is associated with impaired child growth and poor cognitive abilities. <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">Research</a> shows that <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">low birth weight</a> and <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">low maternal nutritional status</a>&nbsp;besides socioeconomic conditions of households also cause high prevalence of anaemia among children in India.</p><p style="text-align:justify"><strong>Prevalence of overweight among children below 5 years</strong></p><p style="text-align:justify">In the case of India, the percentage of children below 5 years who are overweight has increased from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">2.1 percent</a> to <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">3.4 percent</a> between 2015-16 and 2019-21 i.e., by +1.3 percentage points. For <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">Madhya Pradesh</a> the percentage of children below 5 years who are overweight has marginally risen from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">1.7 percent to 2.0 percent</a> between 2015-16 and 2020-21 <em>(i.e., by +0.3 percentage points)</em>, whereas <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has climbed up from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">1.5 percent to 3.1 percent</a> between the two time points <em>(i.e., by +1.6 percentage points)</em>. Please have a look at chart-3.</p><p style="text-align:justify">In Chhatarpur <em>(+0.2 percentage points)</em>, Damoh <em>(+0.5 percentage points)</em>, Datia <em>(+1.1 percentage points)</em>, Panna <em>(+1.0 percentage points)</em>, and Sagar <em>(+0.3 percentage points)</em> districts the percentage of children below 5 years who are overweight has gone up between NFHS-4 and NFHS-5, whereas in Tikamgarh district <em>(-0.5 percentage points) </em>the percentage of children below 5 years who are overweight has fallen between the two time points.</p><p style="text-align:justify">Although in Chitrakoot <em>(+5.7 percentage points)</em>, Hamirpur <em>(+7.1 percentage points)</em>, Jalaun <em>(+1.9 percentage points)</em>, Jhansi <em>(+2.6 percentage points)</em>, Lalitpur <em>(+6.2 percentage points)</em>, and Mahoba <em>(+3.2 percentage points)</em> districts the percentage of children below 5 years who are overweight has increased between 2015-16 and 2020-21, in Banda district <em>(-3.7 percentage points) </em>the percentage of children below 5 years who are overweight has fallen between the two time points. &nbsp;</p><p style="text-align:justify"><span style="background-color:#ffff00">In eleven out of 13 districts that belong to the Bundelkhand region, the proportion of children under 5 years who are overweight has grown between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of overweight among children under five years in 2020-21 is higher in Damoh <em>(2.4 percent)</em>, Datia <em>(2.8 percent)</em>, Panna <em>(2.4 percent)</em>, and Sagar <em>(2.3 percent)</em> in comparison to Madhya Pradesh <em>(2.0 percent)</em>. The prevalence of overweight among children below five years in 2020-21 is higher in Banda <em>(6.3 percent)</em>, Chitrakoot <em>(6.7 percent)</em>, Hamirpur <em>(9.1 percent)</em>, Jhansi <em>(3.3 percent)</em>, Lalitpur <em>(6.7 percent)</em>, and Mahoba <em>(5.0 percent)</em> as compared to Uttar Pradesh <em>(3.1 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%203%20Percentage%20of%20children%20under%205%20years%20who%20are%20overweight.png" style="height:608px; width:1000px" /></p><p style="text-align:justify"><em><strong>Note: </strong>Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a> to access the data of the above chart in a spreadsheet format</em></p><p style="text-align:justify"><em>Above +2 standard deviations, based on the WHO standard.</em></p><p style="text-align:justify"><em><strong>Source: </strong>Same as Chart-1</em></p><p style="text-align:justify"><strong>---</strong></p><p style="text-align:justify"><a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">Weight-for-height above +2 SD</a> <em>(standard deviation) </em>of the WHO Child Growth Standards median for children of the same height and sex is termed overweight in children aged 0 to 59 months. <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">Severe overweight</a> <em>(above +3 SD)</em> is referred to as obesity. According to the <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">United Nations Children&#39;s Fund (UNICEF)</a>, overweight, including its severe form <em>(obesity) </em>in children as well as adolescents is the result of the interaction between: 1) individual factors that regulate physiological processes, food preferences, and physical activity patterns over the life course; and 2) an obesogenic environment that promotes high energy intake and sedentary behaviour. Overweight affects children&rsquo;s immediate physical and emotional well-being. It also enhances the risk of being overweight later in life, a condition associated with non-communicable diseases, and considerable health and economic disadvantage for individuals, families and society. Overweight is a form of malnutrition. It does not happen in isolation and nor does it occur only in certain people or certain countries.&nbsp;In fact, <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">different forms of malnutrition</a> <em>(i.e., stunting, wasting, micronutrient deficiencies, overweight and diet-related non-communicable diseases)</em> <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">can coexist</a> in the same country <em>(or region)</em>, the same community and even in the same family or individual.&nbsp; &nbsp;</p><p style="text-align:justify"><strong>About NFHS-5</strong></p><p style="text-align:justify">Please note that the&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">fieldwork for the Phase-I</a>&nbsp;of the National Family Health Survey Fifth Round (NFHS-5) was conducted during&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">June 2019-January 2020</a>, and the results&nbsp;<em>(i.e., factsheets for 22 states/ UTs, and subsequently the detailed reports and the district level factsheets)</em>&nbsp;were released in&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">December 2020</a>. Those&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">22 states/ UTs</a>, which were&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">surveyed in Phase-I</a>, are Andhra Pradesh, Assam, Bihar, Goa, Gujarat, Himachal Pradesh, Karnataka, Kerala, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Telangana, Tripura, West Bengal, Andaman Nicobar Island, Dadra and Nagar Haveli and Daman and Diu, Jammu &amp; Kashmir, Ladakh and Lakshadweep.</p><p style="text-align:justify">The&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">fieldwork for Phase-II</a>&nbsp;of the NFHS-5 was conducted during&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">January 2020-April 2021</a>, and the results&nbsp;<em>(i.e., factsheets for 14 states/ UTs/ districts as well as the India factsheet)</em>&nbsp;were released in November 2021. The states and UTs, which were&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf">surveyed in the Phase-II</a>, are Arunachal Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, NCT of Delhi, Odisha, Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand.</p><p style="text-align:justify"><br /><strong><em>References</em></strong></p><p style="text-align:justify">The DHS (Demographic and Health Surveys) Program, National, State and Union Territory, and District Fact Sheets 2019-21 National Family Health Survey NFHS-5 (English), USAID, please click <a href="https://dhsprogram.com/publications/publication-OF43-Other-Fact-Sheets.cfm" title="https://dhsprogram.com/publications/publication-OF43-Other-Fact-Sheets.cfm">here</a> and <a href="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml" title="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml">here</a> to access &nbsp;</p><p style="text-align:justify">Participant Manual for Facility Based Care of Severe Acute Malnutrition (2013), Ministry of Health and Family Welfare, please <a href="/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf" title="/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Types of Acute Malnutrition, Action against hunger, please <a href="/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf" title="/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Double burden of malnutrition, World Health Organisation, please <a href="/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf" title="/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Haemoglobin cut-off values for the diagnosis of anaemia in preschool-age children -Ehab Hamed, Mohamed Ahmed Syed, Bayan Faleh Alemrayat, Syed Hammad Anwar Tirmizi, and Ahmed Sameer Alnuaimi (2021), American Journal of Blood Research, 11(3): 248&ndash;254, Published online 2021 Jun 15, please <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Prevalence of anaemia among 6- to 59-month-old children in India: the latest picture through the NFHS-4 -Susmita Bharati, Manoranjan Pal and Premananda Bharati (2019), Journal of Biosocial Science, Published online by Cambridge University Press: &nbsp;20 May 2019, please <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">click here</a> to access &nbsp;</p><p style="text-align:justify">UNICEF Programming Guidance: Prevention of Overweight and Obesity in Children and Adolescents, published in August 2019, please <a href="/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">click here</a> to access</p><p style="text-align:justify">Bundelkhand: Building on Partnership -Rakesh Singh, Pradan (NGO),&nbsp;NewsReach March&ndash;April 2015, please&nbsp;<a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">click here</a>&nbsp;to access&nbsp;</p><p>Union Health Ministry releases NFHS-5 Phase-II Findings, Press Information Bureau, Ministry of Health and Family Welfare, 24 November, 2021, please&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf">click here</a>&nbsp;to access&nbsp;</p><p>Phase-I Findings, National Family Health Survey-5, Press Information Bureau, Ministry of Health and Family Welfare, 15 December, 2020, please&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">click here</a>&nbsp;to access&nbsp;</p><p style="text-align:justify">News alert: The under-nutrition problem in Bundelkhand should receive equal attention of the policymakers, if not more, Inclusive Media for Change, Published on Dec 26, 2021, please <a href="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html" title="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html">click here</a> to access &nbsp;</p><p style="text-align:justify">A close reading of the NFHS-5, the health of India -Ashwini Deshpande, The Hindu, 27 November, 2021, please&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true">click here</a>&nbsp;to read&nbsp;more</p><p style="text-align:justify">&nbsp;</p><p style="text-align:justify"><strong>Image Courtesy: UNDP India</strong><br />&nbsp;</p>                                                           
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    <h1 class="cat-box-title">NFHS data reveals that children in the Bundelkhand region suffer from double burden of malnutrition</h1>
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                            <p style="text-align:justify">In the previous <a href="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html" title="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html">news alert</a>, we looked at the under-nutrition problem in the Bundelkhand region in terms of 3 indicators -- proportion of children under 5 years who are stunted <em>(height-for-age)</em>; proportion of children under 5 years who are wasted <em>(weight-for-height)</em>; and proportion of children under 5 years who are underweight <em>(weight-for-age)</em>. However, the&nbsp;<a href="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml" title="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml">National Family Health Survey (NFHS) data</a> also indicates that severe under-nutrition like severe wasting and anaemia among children co-exists alongside overweight among kids below 5 years of age in this region. According to the <a href="https://im4change.org/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf" title="https://im4change.org/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf">World Health Organisation (WHO)</a>, the phenomenon of double burden of malnutrition is characterised by the coexistence of undernutrition along with overweight and obesity, or diet-related non-communicable diseases, within individuals, households and populations, and across the life course.&nbsp;</p><p style="text-align:justify">In order to understand the malnutrition issue, which is troubling Bundelkhand, we have looked at the trends in three different indicators in the present news alert -- proportion of children under 5 years who are severely wasted <em>(weight-for-height)</em>; proportion of children under 5 years who are overweight <em>(weight-for-height)</em>; and proportion of children age 6-59 months who are anaemic <em>(&lt;11.0 g/dl)</em>.&nbsp;</p><p style="text-align:justify">It should be noted that the Bundelkhand region of Central India covers seven districts of Uttar Pradesh and six districts of Madhya Pradesh. The districts of Chitrakoot, Banda, Jhansi, Jalaun, Hamirpur, Mahoba and Lalitpur, which are part of the Bundelkhand region, lie in Uttar Pradesh. The districts of Madhya Pradesh that come under the Bundelkhand region are Chhatarpur, Tikamgarh, Damoh, Sagar, Datia and Panna.&nbsp;Regarded as one of the most backward regions, Bundelkhand, historically, has experienced <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">prolonged drought, low industrial growth</a>, <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">rampant poverty and apathy of the administration</a>. Due to the lack of livelihood opportunities, people are <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">compelled to migrate</a> from this region. &nbsp;</p><p style="text-align:justify"><strong>Prevalence of severe wasting among children under five years</strong></p><p style="text-align:justify">The recently released <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">data of the NFHS</a> shows that for the country as a whole, the percentage of children below 5 years who are severely wasted has marginally increased from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">7.5 percent to 7.7 percent</a> between 2015-16 and 2019-21 i.e., by +0.2 percentage points. While <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">for Madhya Pradesh</a>, the percentage of children below 5 years who are severely wasted has gone down from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">9.2 percent to 6.5 percent</a> between 2015-16 and 2020-21 <em>(i.e., by -2.7 percentage points)</em>, <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has increased from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">6.0 percent to 7.3 percent</a> between the two time points <em>(i.e., by +1.3 percentage points)</em>. Please see chart-1.</p><p style="text-align:justify">In Chhatarpur <em>(-1.4 percentage points)</em>, Damoh <em>(-2.8 percentage points)</em>, Datia <em>(-1.4 percentage points)</em>, Panna <em>(-2.1 percentage points)</em>, Sagar <em>(-0.5 percentage points)</em>, and Tikamgarh <em>(-0.3 percentage points)</em> districts the percentage of children below 5 years who are severely wasted has decreased between NFHS-4 and NFHS-5.</p><p style="text-align:justify">In Chitrakoot <em>(-2.7 percentage points)</em>, Hamirpur <em>(-3.9 percentage points)</em>, Jalaun <em>(-5.8 percentage points)</em>, Jhansi <em>(-0.6 percentage points)</em>, and Lalitpur <em>(-9.4 percentage points)</em> districts the percentage of children below 5 years who are severely wasted has gone down between NFHS-4 and NFHS-5, whereas in Banda <em>(+6.3 percentage points)</em> and Mahoba <em>(+5.3 percentage points) </em>districts the percentage of children below 5 years who are severely wasted has climbed up between the two time points.</p><p style="text-align:justify"><span style="background-color:#ffff00">In just two out of 13 districts that are part of Bundelkhand, the proportion of children under 5 years who are severely wasted has increased between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of severe wasting among children under five years in 2020-21 is higher in Datia <em>(6.8 percent)</em>, Panna <em>(7.9 percent)</em>, and Tikamgarh <em>(7.3 percent)</em> in comparison to Madhya Pradesh <em>(6.5 percent)</em>. The prevalence of severe wasting &nbsp;among children below five years in 2020-21 is higher in Banda <em>(13.0 percent)</em>, Chitrakoot <em>(12.0 percent)</em>, Hamirpur <em>(10.7 percent)</em>, Jalaun <em>(8.5 percent)</em>, Jhansi <em>(10.4 percent)</em>, Lalitpur <em>(7.5 percent)</em>, and Mahoba <em>(11.7 percent)</em> as compared to Uttar Pradesh <em>(7.3 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%201%20Percentage%20of%20children%20under%205%20years%20who%20are%20severely%20wasted.png" style="height:555px; width:831px" /></p><p style="text-align:justify"><em><strong>Note:</strong> Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a>&nbsp;to access the data of the above chart in a spreadsheet format</em></p><p><em><strong>Source:&nbsp;</strong>Madhya Pradesh --</em></p><p><em>District Factsheet: Chhatarpur, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Damoh, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Datia, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Panna, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Sagar, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access</em></p><p><em>***<br />District Factsheet: Tikamgarh, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />Madhya Pradesh Factsheet, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">click here</a>&nbsp;to access&nbsp;</em></p><p><em>---</em></p><p><em>Uttar Pradesh --&nbsp;</em></p><p><em>District Factsheet: Banda, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Chitrakoot, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Hamirpur, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Jalaun, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Jhansi, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Lalitpur, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;<br />***</em></p><p><em>District Factsheet: Mahoba, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;</em></p><p>***<br /><em>Uttar Pradesh Factsheet, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;</em></p><p><em>---</em></p><p><em>India Factsheet, NFHS-5, 2019-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;</em></p><p><strong>-----</strong></p><p style="text-align:justify">Severe wasting is <a href="https://im4change.org/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf" title="https://im4change.org/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf">characterised by a massive loss of body fat and muscle tissue</a>. Children who are severely wasted look almost elderly and their bodies are extremely thin and skeletal. A <a href="https://im4change.org/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf" title="https://im4change.org/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf">document</a> by the Ministry of Health and Family Welfare says that if the diet is deficient for a short duration, the body adapts its metabolism to compensate for the deficit to some extent. If the food deficit persists for a longer duration then the fat is utilised for energy and body metabolism and the&nbsp;muscle is depleted. A child with severe wasting has lost fat and muscle and appears like &ldquo;skin and bones&rdquo;. Another term used for this condition is marasmus. Any child who has following features are treated as severe acute malnutrition (SAM):<br /><strong>* </strong>Weight-for-height less than -3 SD and/or<br /><strong>*</strong> Visible severe wasting and/or<br /><strong>*</strong> Mid arm circumference (MUAC) &lt; 11.5 cm and/or<br /><strong>*</strong> Oedema of both feet; however, other causes of oedema e.g. nephrotic syndrome should be excluded.&nbsp;</p><p style="text-align:justify"><strong>Prevalence of anaemia among children aged 6-59 months</strong></p><p style="text-align:justify">For the country as a whole, the percentage of children aged 6-59 months who are anaemic has climbed up from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">58.6 percent</a> to <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">67.1 percent</a> between 2015-16 and 2019-21 i.e., by +8.5 percentage points. While for <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">Madhya Pradesh</a>, the percentage of children aged 6-59 months who are anaemic has increased from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">68.9 percent to 72.7 percent</a> between 2015-16 and 2020-21 <em>(i.e., by +3.8 percentage points)</em>, <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has gone up from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">63.2 percent to 66.4 percent</a> between the two time points <em>(i.e., by +3.2 percentage points)</em>. Please see chart-2.</p><p style="text-align:justify">In Chhatarpur <em>(+21.0 percentage points)</em>, Damoh <em>(+0.6 percentage points)</em>, Panna <em>(+6.3 percentage points)</em>, Sagar <em>(+15.9 percentage points)</em>, and Tikamgarh <em>(+0.4 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has increased between NFHS-4 and NFHS-5. However, in Datia district <em>(-0.4 percentage points)</em>, the percentage of children aged 6-59 months who are anaemic fell between 2015-16 and 2020-21.&nbsp;</p><p style="text-align:justify">In Chitrakoot<em> (-17.2 percentage points)</em>, Jalaun <em>(-29.6 percentage points)</em>, Jhansi <em>(-7.5 percentage points)</em>, Lalitpur <em>(-19.8 percentage points)</em>, and Mahoba <em>(-7.5 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has reduced between NFHS-4 and NFHS-5, whereas in Banda <em>(+19.5 percentage points)</em> and Hamirpur <em>(+13.0 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has climbed up between the two time points.</p><p style="text-align:justify"><span style="background-color:#ffff00">Therefore, in seven out of 13 districts that fall in Bundelkhand, the percentage of children aged 6-59 months who are anaemic has increased between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of anaemia among children aged 6-59 months in 2020-21 is higher in Chhatarpur <em>(87.2 percent)</em>, Damoh <em>(76.3 percent)</em>, Datia <em>(72.8 percent)</em>, Panna <em>(74.5 percent)</em>, and Sagar <em>(83.3 percent) </em>in comparison to Madhya Pradesh <em>(72.7 percent)</em>. The prevalence of anaemia among children aged 6-59 months in 2020-21 is higher in Banda <em>(82.2 percent)</em>, Hamirpur <em>(68.5 percent)</em>, Jhansi <em>(70.3 percent)</em>, and Mahoba <em>(70.1 percent)</em> as compared to Uttar Pradesh <em>(66.4 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%202%20Percentage%20of%20children%20age%206-59%20months%20who%20are%20anaemic.png" style="height:638px; width:1000px" /></p><p style="text-align:justify"><em><strong>Note:</strong> Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a> to access the data of the above chart in a spreadsheet format</em></p><p style="text-align:justify"><em>Haemoglobin in grams per decilitre (g/dl). Among children, prevalence is adjusted for altitude.</em></p><p style="text-align:justify"><em><strong>Source: </strong>Same as Chart-1</em></p><p style="text-align:justify"><strong>---</strong></p><p style="text-align:justify">In the absence of epidemiological data, haemoglobin (Hgb) of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">less than 11 g/dL</a> is considered abnormal in children up to the age of 59 months. Haemoglobin (Hgb) level is considered the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">gold standard for assessing anaemia</a> in preschool-age children. Anaemia in preschool-age children is responsible for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">non-fatal health outcomes</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">years lost due to disability</a> (YLD). The full effect of anaemia on morbidity and mortality is difficult to establish. However, it is well known that childhood anaemia is associated with impaired child growth and poor cognitive abilities. <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">Research</a> shows that <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">low birth weight</a> and <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">low maternal nutritional status</a>&nbsp;besides socioeconomic conditions of households also cause high prevalence of anaemia among children in India.</p><p style="text-align:justify"><strong>Prevalence of overweight among children below 5 years</strong></p><p style="text-align:justify">In the case of India, the percentage of children below 5 years who are overweight has increased from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">2.1 percent</a> to <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">3.4 percent</a> between 2015-16 and 2019-21 i.e., by +1.3 percentage points. For <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">Madhya Pradesh</a> the percentage of children below 5 years who are overweight has marginally risen from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">1.7 percent to 2.0 percent</a> between 2015-16 and 2020-21 <em>(i.e., by +0.3 percentage points)</em>, whereas <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has climbed up from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">1.5 percent to 3.1 percent</a> between the two time points <em>(i.e., by +1.6 percentage points)</em>. Please have a look at chart-3.</p><p style="text-align:justify">In Chhatarpur <em>(+0.2 percentage points)</em>, Damoh <em>(+0.5 percentage points)</em>, Datia <em>(+1.1 percentage points)</em>, Panna <em>(+1.0 percentage points)</em>, and Sagar <em>(+0.3 percentage points)</em> districts the percentage of children below 5 years who are overweight has gone up between NFHS-4 and NFHS-5, whereas in Tikamgarh district <em>(-0.5 percentage points) </em>the percentage of children below 5 years who are overweight has fallen between the two time points.</p><p style="text-align:justify">Although in Chitrakoot <em>(+5.7 percentage points)</em>, Hamirpur <em>(+7.1 percentage points)</em>, Jalaun <em>(+1.9 percentage points)</em>, Jhansi <em>(+2.6 percentage points)</em>, Lalitpur <em>(+6.2 percentage points)</em>, and Mahoba <em>(+3.2 percentage points)</em> districts the percentage of children below 5 years who are overweight has increased between 2015-16 and 2020-21, in Banda district <em>(-3.7 percentage points) </em>the percentage of children below 5 years who are overweight has fallen between the two time points. &nbsp;</p><p style="text-align:justify"><span style="background-color:#ffff00">In eleven out of 13 districts that belong to the Bundelkhand region, the proportion of children under 5 years who are overweight has grown between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of overweight among children under five years in 2020-21 is higher in Damoh <em>(2.4 percent)</em>, Datia <em>(2.8 percent)</em>, Panna <em>(2.4 percent)</em>, and Sagar <em>(2.3 percent)</em> in comparison to Madhya Pradesh <em>(2.0 percent)</em>. The prevalence of overweight among children below five years in 2020-21 is higher in Banda <em>(6.3 percent)</em>, Chitrakoot <em>(6.7 percent)</em>, Hamirpur <em>(9.1 percent)</em>, Jhansi <em>(3.3 percent)</em>, Lalitpur <em>(6.7 percent)</em>, and Mahoba <em>(5.0 percent)</em> as compared to Uttar Pradesh <em>(3.1 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%203%20Percentage%20of%20children%20under%205%20years%20who%20are%20overweight.png" style="height:608px; width:1000px" /></p><p style="text-align:justify"><em><strong>Note: </strong>Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a> to access the data of the above chart in a spreadsheet format</em></p><p style="text-align:justify"><em>Above +2 standard deviations, based on the WHO standard.</em></p><p style="text-align:justify"><em><strong>Source: </strong>Same as Chart-1</em></p><p style="text-align:justify"><strong>---</strong></p><p style="text-align:justify"><a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">Weight-for-height above +2 SD</a> <em>(standard deviation) </em>of the WHO Child Growth Standards median for children of the same height and sex is termed overweight in children aged 0 to 59 months. <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">Severe overweight</a> <em>(above +3 SD)</em> is referred to as obesity. According to the <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">United Nations Children&#39;s Fund (UNICEF)</a>, overweight, including its severe form <em>(obesity) </em>in children as well as adolescents is the result of the interaction between: 1) individual factors that regulate physiological processes, food preferences, and physical activity patterns over the life course; and 2) an obesogenic environment that promotes high energy intake and sedentary behaviour. Overweight affects children&rsquo;s immediate physical and emotional well-being. It also enhances the risk of being overweight later in life, a condition associated with non-communicable diseases, and considerable health and economic disadvantage for individuals, families and society. Overweight is a form of malnutrition. It does not happen in isolation and nor does it occur only in certain people or certain countries.&nbsp;In fact, <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">different forms of malnutrition</a> <em>(i.e., stunting, wasting, micronutrient deficiencies, overweight and diet-related non-communicable diseases)</em> <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">can coexist</a> in the same country <em>(or region)</em>, the same community and even in the same family or individual.&nbsp; &nbsp;</p><p style="text-align:justify"><strong>About NFHS-5</strong></p><p style="text-align:justify">Please note that the&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">fieldwork for the Phase-I</a>&nbsp;of the National Family Health Survey Fifth Round (NFHS-5) was conducted during&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">June 2019-January 2020</a>, and the results&nbsp;<em>(i.e., factsheets for 22 states/ UTs, and subsequently the detailed reports and the district level factsheets)</em>&nbsp;were released in&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">December 2020</a>. Those&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">22 states/ UTs</a>, which were&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">surveyed in Phase-I</a>, are Andhra Pradesh, Assam, Bihar, Goa, Gujarat, Himachal Pradesh, Karnataka, Kerala, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Telangana, Tripura, West Bengal, Andaman Nicobar Island, Dadra and Nagar Haveli and Daman and Diu, Jammu &amp; Kashmir, Ladakh and Lakshadweep.</p><p style="text-align:justify">The&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">fieldwork for Phase-II</a>&nbsp;of the NFHS-5 was conducted during&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">January 2020-April 2021</a>, and the results&nbsp;<em>(i.e., factsheets for 14 states/ UTs/ districts as well as the India factsheet)</em>&nbsp;were released in November 2021. The states and UTs, which were&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf">surveyed in the Phase-II</a>, are Arunachal Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, NCT of Delhi, Odisha, Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand.</p><p style="text-align:justify"><br /><strong><em>References</em></strong></p><p style="text-align:justify">The DHS (Demographic and Health Surveys) Program, National, State and Union Territory, and District Fact Sheets 2019-21 National Family Health Survey NFHS-5 (English), USAID, please click <a href="https://dhsprogram.com/publications/publication-OF43-Other-Fact-Sheets.cfm" title="https://dhsprogram.com/publications/publication-OF43-Other-Fact-Sheets.cfm">here</a> and <a href="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml" title="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml">here</a> to access &nbsp;</p><p style="text-align:justify">Participant Manual for Facility Based Care of Severe Acute Malnutrition (2013), Ministry of Health and Family Welfare, please <a href="/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf" title="/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Types of Acute Malnutrition, Action against hunger, please <a href="/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf" title="/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Double burden of malnutrition, World Health Organisation, please <a href="/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf" title="/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Haemoglobin cut-off values for the diagnosis of anaemia in preschool-age children -Ehab Hamed, Mohamed Ahmed Syed, Bayan Faleh Alemrayat, Syed Hammad Anwar Tirmizi, and Ahmed Sameer Alnuaimi (2021), American Journal of Blood Research, 11(3): 248&ndash;254, Published online 2021 Jun 15, please <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Prevalence of anaemia among 6- to 59-month-old children in India: the latest picture through the NFHS-4 -Susmita Bharati, Manoranjan Pal and Premananda Bharati (2019), Journal of Biosocial Science, Published online by Cambridge University Press: &nbsp;20 May 2019, please <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">click here</a> to access &nbsp;</p><p style="text-align:justify">UNICEF Programming Guidance: Prevention of Overweight and Obesity in Children and Adolescents, published in August 2019, please <a href="/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">click here</a> to access</p><p style="text-align:justify">Bundelkhand: Building on Partnership -Rakesh Singh, Pradan (NGO),&nbsp;NewsReach March&ndash;April 2015, please&nbsp;<a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">click here</a>&nbsp;to access&nbsp;</p><p>Union Health Ministry releases NFHS-5 Phase-II Findings, Press Information Bureau, Ministry of Health and Family Welfare, 24 November, 2021, please&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf">click here</a>&nbsp;to access&nbsp;</p><p>Phase-I Findings, National Family Health Survey-5, Press Information Bureau, Ministry of Health and Family Welfare, 15 December, 2020, please&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">click here</a>&nbsp;to access&nbsp;</p><p style="text-align:justify">News alert: The under-nutrition problem in Bundelkhand should receive equal attention of the policymakers, if not more, Inclusive Media for Change, Published on Dec 26, 2021, please <a href="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html" title="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html">click here</a> to access &nbsp;</p><p style="text-align:justify">A close reading of the NFHS-5, the health of India -Ashwini Deshpande, The Hindu, 27 November, 2021, please&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true">click here</a>&nbsp;to read&nbsp;more</p><p style="text-align:justify">&nbsp;</p><p style="text-align:justify"><strong>Image Courtesy: UNDP India</strong><br />&nbsp;</p>                                                           
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        NEWS ALERTS | NFHS data reveals that children in the Bundelkhand region suffer from double burden of malnutrition    </title>
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                            <p style="text-align:justify">In the previous <a href="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html" title="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html">news alert</a>, we looked at the under-nutrition problem in the Bundelkhand region in terms of 3 indicators -- proportion of children under 5 years who are stunted <em>(height-for-age)</em>; proportion of children under 5 years who are wasted <em>(weight-for-height)</em>; and proportion of children under 5 years who are underweight <em>(weight-for-age)</em>. However, the&nbsp;<a href="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml" title="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml">National Family Health Survey (NFHS) data</a> also indicates that severe under-nutrition like severe wasting and anaemia among children co-exists alongside overweight among kids below 5 years of age in this region. According to the <a href="https://im4change.org/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf" title="https://im4change.org/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf">World Health Organisation (WHO)</a>, the phenomenon of double burden of malnutrition is characterised by the coexistence of undernutrition along with overweight and obesity, or diet-related non-communicable diseases, within individuals, households and populations, and across the life course.&nbsp;</p><p style="text-align:justify">In order to understand the malnutrition issue, which is troubling Bundelkhand, we have looked at the trends in three different indicators in the present news alert -- proportion of children under 5 years who are severely wasted <em>(weight-for-height)</em>; proportion of children under 5 years who are overweight <em>(weight-for-height)</em>; and proportion of children age 6-59 months who are anaemic <em>(&lt;11.0 g/dl)</em>.&nbsp;</p><p style="text-align:justify">It should be noted that the Bundelkhand region of Central India covers seven districts of Uttar Pradesh and six districts of Madhya Pradesh. The districts of Chitrakoot, Banda, Jhansi, Jalaun, Hamirpur, Mahoba and Lalitpur, which are part of the Bundelkhand region, lie in Uttar Pradesh. The districts of Madhya Pradesh that come under the Bundelkhand region are Chhatarpur, Tikamgarh, Damoh, Sagar, Datia and Panna.&nbsp;Regarded as one of the most backward regions, Bundelkhand, historically, has experienced <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">prolonged drought, low industrial growth</a>, <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">rampant poverty and apathy of the administration</a>. Due to the lack of livelihood opportunities, people are <a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">compelled to migrate</a> from this region. &nbsp;</p><p style="text-align:justify"><strong>Prevalence of severe wasting among children under five years</strong></p><p style="text-align:justify">The recently released <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">data of the NFHS</a> shows that for the country as a whole, the percentage of children below 5 years who are severely wasted has marginally increased from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">7.5 percent to 7.7 percent</a> between 2015-16 and 2019-21 i.e., by +0.2 percentage points. While <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">for Madhya Pradesh</a>, the percentage of children below 5 years who are severely wasted has gone down from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">9.2 percent to 6.5 percent</a> between 2015-16 and 2020-21 <em>(i.e., by -2.7 percentage points)</em>, <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has increased from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">6.0 percent to 7.3 percent</a> between the two time points <em>(i.e., by +1.3 percentage points)</em>. Please see chart-1.</p><p style="text-align:justify">In Chhatarpur <em>(-1.4 percentage points)</em>, Damoh <em>(-2.8 percentage points)</em>, Datia <em>(-1.4 percentage points)</em>, Panna <em>(-2.1 percentage points)</em>, Sagar <em>(-0.5 percentage points)</em>, and Tikamgarh <em>(-0.3 percentage points)</em> districts the percentage of children below 5 years who are severely wasted has decreased between NFHS-4 and NFHS-5.</p><p style="text-align:justify">In Chitrakoot <em>(-2.7 percentage points)</em>, Hamirpur <em>(-3.9 percentage points)</em>, Jalaun <em>(-5.8 percentage points)</em>, Jhansi <em>(-0.6 percentage points)</em>, and Lalitpur <em>(-9.4 percentage points)</em> districts the percentage of children below 5 years who are severely wasted has gone down between NFHS-4 and NFHS-5, whereas in Banda <em>(+6.3 percentage points)</em> and Mahoba <em>(+5.3 percentage points) </em>districts the percentage of children below 5 years who are severely wasted has climbed up between the two time points.</p><p style="text-align:justify"><span style="background-color:#ffff00">In just two out of 13 districts that are part of Bundelkhand, the proportion of children under 5 years who are severely wasted has increased between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of severe wasting among children under five years in 2020-21 is higher in Datia <em>(6.8 percent)</em>, Panna <em>(7.9 percent)</em>, and Tikamgarh <em>(7.3 percent)</em> in comparison to Madhya Pradesh <em>(6.5 percent)</em>. The prevalence of severe wasting &nbsp;among children below five years in 2020-21 is higher in Banda <em>(13.0 percent)</em>, Chitrakoot <em>(12.0 percent)</em>, Hamirpur <em>(10.7 percent)</em>, Jalaun <em>(8.5 percent)</em>, Jhansi <em>(10.4 percent)</em>, Lalitpur <em>(7.5 percent)</em>, and Mahoba <em>(11.7 percent)</em> as compared to Uttar Pradesh <em>(7.3 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%201%20Percentage%20of%20children%20under%205%20years%20who%20are%20severely%20wasted.png" style="height:555px; width:831px" /></p><p style="text-align:justify"><em><strong>Note:</strong> Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a>&nbsp;to access the data of the above chart in a spreadsheet format</em></p><p><em><strong>Source:&nbsp;</strong>Madhya Pradesh --</em></p><p><em>District Factsheet: Chhatarpur, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chhatarpur%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Damoh, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Damoh%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Datia, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Datia%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Panna, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Panna%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Sagar, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Sagar%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access</em></p><p><em>***<br />District Factsheet: Tikamgarh, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Tikamgarh%20Madhya%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />Madhya Pradesh Factsheet, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">click here</a>&nbsp;to access&nbsp;</em></p><p><em>---</em></p><p><em>Uttar Pradesh --&nbsp;</em></p><p><em>District Factsheet: Banda, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Banda%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Chitrakoot, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Chitrakoot%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Hamirpur, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Hamirpur%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Jalaun, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jalaun%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Jhansi, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Jhansi%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;<br />***<br />District Factsheet: Lalitpur, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Lalitpur%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;<br />***</em></p><p><em>District Factsheet: Mahoba, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="https://im4change.org/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf" title="/upload/files/District%20Factsheet%20Mahoba%20Uttar%20Pradesh%20NFHS-5.pdf">click here</a>&nbsp;to access&nbsp;</em></p><p>***<br /><em>Uttar Pradesh Factsheet, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;</em></p><p><em>---</em></p><p><em>India Factsheet, NFHS-5, 2019-21, Ministry of Health and Family Welfare, please&nbsp;<a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">click here</a>&nbsp;to access&nbsp;&nbsp;</em></p><p><strong>-----</strong></p><p style="text-align:justify">Severe wasting is <a href="https://im4change.org/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf" title="https://im4change.org/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf">characterised by a massive loss of body fat and muscle tissue</a>. Children who are severely wasted look almost elderly and their bodies are extremely thin and skeletal. A <a href="https://im4change.org/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf" title="https://im4change.org/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf">document</a> by the Ministry of Health and Family Welfare says that if the diet is deficient for a short duration, the body adapts its metabolism to compensate for the deficit to some extent. If the food deficit persists for a longer duration then the fat is utilised for energy and body metabolism and the&nbsp;muscle is depleted. A child with severe wasting has lost fat and muscle and appears like &ldquo;skin and bones&rdquo;. Another term used for this condition is marasmus. Any child who has following features are treated as severe acute malnutrition (SAM):<br /><strong>* </strong>Weight-for-height less than -3 SD and/or<br /><strong>*</strong> Visible severe wasting and/or<br /><strong>*</strong> Mid arm circumference (MUAC) &lt; 11.5 cm and/or<br /><strong>*</strong> Oedema of both feet; however, other causes of oedema e.g. nephrotic syndrome should be excluded.&nbsp;</p><p style="text-align:justify"><strong>Prevalence of anaemia among children aged 6-59 months</strong></p><p style="text-align:justify">For the country as a whole, the percentage of children aged 6-59 months who are anaemic has climbed up from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">58.6 percent</a> to <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">67.1 percent</a> between 2015-16 and 2019-21 i.e., by +8.5 percentage points. While for <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">Madhya Pradesh</a>, the percentage of children aged 6-59 months who are anaemic has increased from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">68.9 percent to 72.7 percent</a> between 2015-16 and 2020-21 <em>(i.e., by +3.8 percentage points)</em>, <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has gone up from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">63.2 percent to 66.4 percent</a> between the two time points <em>(i.e., by +3.2 percentage points)</em>. Please see chart-2.</p><p style="text-align:justify">In Chhatarpur <em>(+21.0 percentage points)</em>, Damoh <em>(+0.6 percentage points)</em>, Panna <em>(+6.3 percentage points)</em>, Sagar <em>(+15.9 percentage points)</em>, and Tikamgarh <em>(+0.4 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has increased between NFHS-4 and NFHS-5. However, in Datia district <em>(-0.4 percentage points)</em>, the percentage of children aged 6-59 months who are anaemic fell between 2015-16 and 2020-21.&nbsp;</p><p style="text-align:justify">In Chitrakoot<em> (-17.2 percentage points)</em>, Jalaun <em>(-29.6 percentage points)</em>, Jhansi <em>(-7.5 percentage points)</em>, Lalitpur <em>(-19.8 percentage points)</em>, and Mahoba <em>(-7.5 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has reduced between NFHS-4 and NFHS-5, whereas in Banda <em>(+19.5 percentage points)</em> and Hamirpur <em>(+13.0 percentage points)</em> districts the percentage of children aged 6-59 months who are anaemic has climbed up between the two time points.</p><p style="text-align:justify"><span style="background-color:#ffff00">Therefore, in seven out of 13 districts that fall in Bundelkhand, the percentage of children aged 6-59 months who are anaemic has increased between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of anaemia among children aged 6-59 months in 2020-21 is higher in Chhatarpur <em>(87.2 percent)</em>, Damoh <em>(76.3 percent)</em>, Datia <em>(72.8 percent)</em>, Panna <em>(74.5 percent)</em>, and Sagar <em>(83.3 percent) </em>in comparison to Madhya Pradesh <em>(72.7 percent)</em>. The prevalence of anaemia among children aged 6-59 months in 2020-21 is higher in Banda <em>(82.2 percent)</em>, Hamirpur <em>(68.5 percent)</em>, Jhansi <em>(70.3 percent)</em>, and Mahoba <em>(70.1 percent)</em> as compared to Uttar Pradesh <em>(66.4 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%202%20Percentage%20of%20children%20age%206-59%20months%20who%20are%20anaemic.png" style="height:638px; width:1000px" /></p><p style="text-align:justify"><em><strong>Note:</strong> Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a> to access the data of the above chart in a spreadsheet format</em></p><p style="text-align:justify"><em>Haemoglobin in grams per decilitre (g/dl). Among children, prevalence is adjusted for altitude.</em></p><p style="text-align:justify"><em><strong>Source: </strong>Same as Chart-1</em></p><p style="text-align:justify"><strong>---</strong></p><p style="text-align:justify">In the absence of epidemiological data, haemoglobin (Hgb) of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">less than 11 g/dL</a> is considered abnormal in children up to the age of 59 months. Haemoglobin (Hgb) level is considered the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">gold standard for assessing anaemia</a> in preschool-age children. Anaemia in preschool-age children is responsible for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">non-fatal health outcomes</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">years lost due to disability</a> (YLD). The full effect of anaemia on morbidity and mortality is difficult to establish. However, it is well known that childhood anaemia is associated with impaired child growth and poor cognitive abilities. <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">Research</a> shows that <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">low birth weight</a> and <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">low maternal nutritional status</a>&nbsp;besides socioeconomic conditions of households also cause high prevalence of anaemia among children in India.</p><p style="text-align:justify"><strong>Prevalence of overweight among children below 5 years</strong></p><p style="text-align:justify">In the case of India, the percentage of children below 5 years who are overweight has increased from <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">2.1 percent</a> to <a href="https://im4change.org/docs/India_National_Fact_Sheet.pdf" title="https://im4change.org/docs/India_National_Fact_Sheet.pdf">3.4 percent</a> between 2015-16 and 2019-21 i.e., by +1.3 percentage points. For <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">Madhya Pradesh</a> the percentage of children below 5 years who are overweight has marginally risen from <a href="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Madhya%20Pradesh.pdf">1.7 percent to 2.0 percent</a> between 2015-16 and 2020-21 <em>(i.e., by +0.3 percentage points)</em>, whereas <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">for Uttar Pradesh</a> the same has climbed up from <a href="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf" title="https://im4change.org/docs/NFHS-5%20Uttar%20Pradesh.pdf">1.5 percent to 3.1 percent</a> between the two time points <em>(i.e., by +1.6 percentage points)</em>. Please have a look at chart-3.</p><p style="text-align:justify">In Chhatarpur <em>(+0.2 percentage points)</em>, Damoh <em>(+0.5 percentage points)</em>, Datia <em>(+1.1 percentage points)</em>, Panna <em>(+1.0 percentage points)</em>, and Sagar <em>(+0.3 percentage points)</em> districts the percentage of children below 5 years who are overweight has gone up between NFHS-4 and NFHS-5, whereas in Tikamgarh district <em>(-0.5 percentage points) </em>the percentage of children below 5 years who are overweight has fallen between the two time points.</p><p style="text-align:justify">Although in Chitrakoot <em>(+5.7 percentage points)</em>, Hamirpur <em>(+7.1 percentage points)</em>, Jalaun <em>(+1.9 percentage points)</em>, Jhansi <em>(+2.6 percentage points)</em>, Lalitpur <em>(+6.2 percentage points)</em>, and Mahoba <em>(+3.2 percentage points)</em> districts the percentage of children below 5 years who are overweight has increased between 2015-16 and 2020-21, in Banda district <em>(-3.7 percentage points) </em>the percentage of children below 5 years who are overweight has fallen between the two time points. &nbsp;</p><p style="text-align:justify"><span style="background-color:#ffff00">In eleven out of 13 districts that belong to the Bundelkhand region, the proportion of children under 5 years who are overweight has grown between 2015-16 and 2020-21.</span></p><p style="text-align:justify">The prevalence of overweight among children under five years in 2020-21 is higher in Damoh <em>(2.4 percent)</em>, Datia <em>(2.8 percent)</em>, Panna <em>(2.4 percent)</em>, and Sagar <em>(2.3 percent)</em> in comparison to Madhya Pradesh <em>(2.0 percent)</em>. The prevalence of overweight among children below five years in 2020-21 is higher in Banda <em>(6.3 percent)</em>, Chitrakoot <em>(6.7 percent)</em>, Hamirpur <em>(9.1 percent)</em>, Jhansi <em>(3.3 percent)</em>, Lalitpur <em>(6.7 percent)</em>, and Mahoba <em>(5.0 percent)</em> as compared to Uttar Pradesh <em>(3.1 percent)</em>.</p><p style="text-align:justify"><img alt="" src="/upload/images/Chart%203%20Percentage%20of%20children%20under%205%20years%20who%20are%20overweight.png" style="height:608px; width:1000px" /></p><p style="text-align:justify"><em><strong>Note: </strong>Please <a href="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true" title="https://docs.google.com/spreadsheets/d/17_mkowUg10bJthXjGC2epS6WP5mzKL-m/edit?usp=sharing&amp;ouid=112233925171588304692&amp;rtpof=true&amp;sd=true">click here</a> to access the data of the above chart in a spreadsheet format</em></p><p style="text-align:justify"><em>Above +2 standard deviations, based on the WHO standard.</em></p><p style="text-align:justify"><em><strong>Source: </strong>Same as Chart-1</em></p><p style="text-align:justify"><strong>---</strong></p><p style="text-align:justify"><a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">Weight-for-height above +2 SD</a> <em>(standard deviation) </em>of the WHO Child Growth Standards median for children of the same height and sex is termed overweight in children aged 0 to 59 months. <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">Severe overweight</a> <em>(above +3 SD)</em> is referred to as obesity. According to the <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">United Nations Children&#39;s Fund (UNICEF)</a>, overweight, including its severe form <em>(obesity) </em>in children as well as adolescents is the result of the interaction between: 1) individual factors that regulate physiological processes, food preferences, and physical activity patterns over the life course; and 2) an obesogenic environment that promotes high energy intake and sedentary behaviour. Overweight affects children&rsquo;s immediate physical and emotional well-being. It also enhances the risk of being overweight later in life, a condition associated with non-communicable diseases, and considerable health and economic disadvantage for individuals, families and society. Overweight is a form of malnutrition. It does not happen in isolation and nor does it occur only in certain people or certain countries.&nbsp;In fact, <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">different forms of malnutrition</a> <em>(i.e., stunting, wasting, micronutrient deficiencies, overweight and diet-related non-communicable diseases)</em> <a href="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="https://im4change.org/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">can coexist</a> in the same country <em>(or region)</em>, the same community and even in the same family or individual.&nbsp; &nbsp;</p><p style="text-align:justify"><strong>About NFHS-5</strong></p><p style="text-align:justify">Please note that the&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">fieldwork for the Phase-I</a>&nbsp;of the National Family Health Survey Fifth Round (NFHS-5) was conducted during&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">June 2019-January 2020</a>, and the results&nbsp;<em>(i.e., factsheets for 22 states/ UTs, and subsequently the detailed reports and the district level factsheets)</em>&nbsp;were released in&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">December 2020</a>. Those&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">22 states/ UTs</a>, which were&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">surveyed in Phase-I</a>, are Andhra Pradesh, Assam, Bihar, Goa, Gujarat, Himachal Pradesh, Karnataka, Kerala, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Telangana, Tripura, West Bengal, Andaman Nicobar Island, Dadra and Nagar Haveli and Daman and Diu, Jammu &amp; Kashmir, Ladakh and Lakshadweep.</p><p style="text-align:justify">The&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">fieldwork for Phase-II</a>&nbsp;of the NFHS-5 was conducted during&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece">January 2020-April 2021</a>, and the results&nbsp;<em>(i.e., factsheets for 14 states/ UTs/ districts as well as the India factsheet)</em>&nbsp;were released in November 2021. The states and UTs, which were&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf">surveyed in the Phase-II</a>, are Arunachal Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, NCT of Delhi, Odisha, Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand.</p><p style="text-align:justify"><br /><strong><em>References</em></strong></p><p style="text-align:justify">The DHS (Demographic and Health Surveys) Program, National, State and Union Territory, and District Fact Sheets 2019-21 National Family Health Survey NFHS-5 (English), USAID, please click <a href="https://dhsprogram.com/publications/publication-OF43-Other-Fact-Sheets.cfm" title="https://dhsprogram.com/publications/publication-OF43-Other-Fact-Sheets.cfm">here</a> and <a href="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml" title="http://rchiips.org/nfhs/factsheet_NFHS-5.shtml">here</a> to access &nbsp;</p><p style="text-align:justify">Participant Manual for Facility Based Care of Severe Acute Malnutrition (2013), Ministry of Health and Family Welfare, please <a href="/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf" title="/upload/files/Participant%20Manual%20for%20Facility%20Based%20Care%20of%20Severe%20Acute%20Malnutrition%202013.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Types of Acute Malnutrition, Action against hunger, please <a href="/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf" title="/upload/files/Types%20of%20Acute%20Malnutrition%20-%20Action%20Against%20Hunger.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Double burden of malnutrition, World Health Organisation, please <a href="/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf" title="/upload/files/WHO%20_%20Double%20burden%20of%20malnutrition.pdf">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Haemoglobin cut-off values for the diagnosis of anaemia in preschool-age children -Ehab Hamed, Mohamed Ahmed Syed, Bayan Faleh Alemrayat, Syed Hammad Anwar Tirmizi, and Ahmed Sameer Alnuaimi (2021), American Journal of Blood Research, 11(3): 248&ndash;254, Published online 2021 Jun 15, please <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months)." title="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303014/#:~:text=Background%3A%20The%20World%20Health%20Organisation,4%20years%20and%20eleven%20months).">click here</a> to access&nbsp;&nbsp;</p><p style="text-align:justify">Prevalence of anaemia among 6- to 59-month-old children in India: the latest picture through the NFHS-4 -Susmita Bharati, Manoranjan Pal and Premananda Bharati (2019), Journal of Biosocial Science, Published online by Cambridge University Press: &nbsp;20 May 2019, please <a href="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2" title="https://www.cambridge.org/core/journals/journal-of-biosocial-science/article/abs/prevalence-of-anaemia-among-6-to-59monthold-children-in-india-the-latest-picture-through-the-nfhs4/A472B96F3447D3F75D570C50E0350AC2">click here</a> to access &nbsp;</p><p style="text-align:justify">UNICEF Programming Guidance: Prevention of Overweight and Obesity in Children and Adolescents, published in August 2019, please <a href="/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf" title="/upload/files/UNICEF%20Programming-Guidance-Overweight-Prevention.pdf">click here</a> to access</p><p style="text-align:justify">Bundelkhand: Building on Partnership -Rakesh Singh, Pradan (NGO),&nbsp;NewsReach March&ndash;April 2015, please&nbsp;<a href="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf" title="https://im4change.org/upload/files/Bundelkhand-Building-on-Partnership-By-Rakesh-singh%20PRADAN.pdf">click here</a>&nbsp;to access&nbsp;</p><p>Union Health Ministry releases NFHS-5 Phase-II Findings, Press Information Bureau, Ministry of Health and Family Welfare, 24 November, 2021, please&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf" title="/upload/files/Press%20Release%20Phase%20II%20NFHS-5%2024%20Nov%202021.pdf">click here</a>&nbsp;to access&nbsp;</p><p>Phase-I Findings, National Family Health Survey-5, Press Information Bureau, Ministry of Health and Family Welfare, 15 December, 2020, please&nbsp;<a href="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="https://im4change.org/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf" title="/upload/files/Press%20Release%20Phase%20I%20NFHS-5%2015%20Dec%202020.pdf">click here</a>&nbsp;to access&nbsp;</p><p style="text-align:justify">News alert: The under-nutrition problem in Bundelkhand should receive equal attention of the policymakers, if not more, Inclusive Media for Change, Published on Dec 26, 2021, please <a href="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html" title="https://im4change.org/news-alerts-57/the-under-nutrition-problem-in-bundelkhand-should-receive-equal-attention-of-the-policymakers-if-not-more.html">click here</a> to access &nbsp;</p><p style="text-align:justify">A close reading of the NFHS-5, the health of India -Ashwini Deshpande, The Hindu, 27 November, 2021, please&nbsp;<a href="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true" title="https://www.thehindu.com/opinion/lead/a-close-reading-of-the-nfhs-5-the-health-of-india/article37711746.ece?homepage=true">click here</a>&nbsp;to read&nbsp;more</p><p style="text-align:justify">&nbsp;</p><p style="text-align:justify"><strong>Image Courtesy: UNDP India</strong><br />&nbsp;</p>                                                           
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NFHS data reveals that children in the Bundelkhand region suffer from double burden of malnutrition

Published on Jan 19, 2022   Modified on Jan 20, 2022

In the previous news alert, we looked at the under-nutrition problem in the Bundelkhand region in terms of 3 indicators -- proportion of children under 5 years who are stunted (height-for-age); proportion of children under 5 years who are wasted (weight-for-height); and proportion of children under 5 years who are underweight (weight-for-age). However, the National Family Health Survey (NFHS) data also indicates that severe under-nutrition like severe wasting and anaemia among children co-exists alongside overweight among kids below 5 years of age in this region. According to the World Health Organisation (WHO), the phenomenon of double burden of malnutrition is characterised by the coexistence of undernutrition along with overweight and obesity, or diet-related non-communicable diseases, within individuals, households and populations, and across the life course.  In order to understand the malnutrition issue, which is troubling Bundelkhand, we have looked at the trends in three different indicators in the present news alert -- proportion of children under 5 years who are severely wasted (weight-for-height); proportion of children under 5 years who are overweight (weight-for-height); and proportion of children age 6-59 months who are anaemic (<11.0 g/dl).  It should be noted that the Bundelkhand region of Central India covers seven districts of Uttar Pradesh and six districts of Madhya Pradesh. The districts of Chitrakoot, Banda, Jhansi, Jalaun, Hamirpur, Mahoba and Lalitpur, which are part of the Bundelkhand region, lie in Uttar Pradesh. The districts of Madhya Pradesh that come under the Bundelkhand region are Chhatarpur, Tikamgarh, Damoh, Sagar, Datia and Panna. Regarded as one of the most backward regions, Bundelkhand, historically, has experienced prolonged drought, low industrial growth, rampant poverty and apathy of the administration. Due to the lack of livelihood opportunities, people are compelled to migrate from this region.   Prevalence of severe wasting among children under five years The recently released data of the NFHS shows that for the country as a whole, the percentage of children below 5 years who are severely wasted has marginally increased from 7.5 percent to 7.7 percent between 2015-16 and 2019-21 i.e., by +0.2 percentage points. While for Madhya Pradesh, the percentage of children below 5 years who are severely wasted has gone down from 9.2 percent to 6.5 percent between 2015-16 and 2020-21 (i.e., by -2.7 percentage points), for Uttar Pradesh the same has increased from 6.0 percent to 7.3 percent between the two time points (i.e., by +1.3 percentage points). Please see chart-1. In Chhatarpur (-1.4 percentage points), Damoh (-2.8 percentage points), Datia (-1.4 percentage points), Panna (-2.1 percentage points), Sagar (-0.5 percentage points), and Tikamgarh (-0.3 percentage points) districts the percentage of children below 5 years who are severely wasted has decreased between NFHS-4 and NFHS-5. In Chitrakoot (-2.7 percentage points), Hamirpur (-3.9 percentage points), Jalaun (-5.8 percentage points), Jhansi (-0.6 percentage points), and Lalitpur (-9.4 percentage points) districts the percentage of children below 5 years who are severely wasted has gone down between NFHS-4 and NFHS-5, whereas in Banda (+6.3 percentage points) and Mahoba (+5.3 percentage points) districts the percentage of children below 5 years who are severely wasted has climbed up between the two time points. In just two out of 13 districts that are part of Bundelkhand, the proportion of children under 5 years who are severely wasted has increased between 2015-16 and 2020-21. The prevalence of severe wasting among children under five years in 2020-21 is higher in Datia (6.8 percent), Panna (7.9 percent), and Tikamgarh (7.3 percent) in comparison to Madhya Pradesh (6.5 percent). The prevalence of severe wasting  among children below five years in 2020-21 is higher in Banda (13.0 percent), Chitrakoot (12.0 percent), Hamirpur (10.7 percent), Jalaun (8.5 percent), Jhansi (10.4 percent), Lalitpur (7.5 percent), and Mahoba (11.7 percent) as compared to Uttar Pradesh (7.3 percent). Note: Please click here to access the data of the above chart in a spreadsheet format Source: Madhya Pradesh -- District Factsheet: Chhatarpur, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Damoh, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Datia, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Panna, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Sagar, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access *** District Factsheet: Tikamgarh, Madhya Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** Madhya Pradesh Factsheet, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  --- Uttar Pradesh --  District Factsheet: Banda, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Chitrakoot, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Hamirpur, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Jalaun, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Jhansi, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** District Factsheet: Lalitpur, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access   *** District Factsheet: Mahoba, Uttar Pradesh, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access  *** Uttar Pradesh Factsheet, NFHS-5, 2020-21, Ministry of Health and Family Welfare, please click here to access   --- India Factsheet, NFHS-5, 2019-21, Ministry of Health and Family Welfare, please click here to access   ----- Severe wasting is characterised by a massive loss of body fat and muscle tissue. Children who are severely wasted look almost elderly and their bodies are extremely thin and skeletal. A document by the Ministry of Health and Family Welfare says that if the diet is deficient for a short duration, the body adapts its metabolism to compensate for the deficit to some extent. If the food deficit persists for a longer duration then the fat is utilised for energy and body metabolism and the muscle is depleted. A child with severe wasting has lost fat and muscle and appears like “skin and bones”. Another term used for this condition is marasmus. Any child who has following features are treated as severe acute malnutrition (SAM): * Weight-for-height less than -3 SD and/or * Visible severe wasting and/or * Mid arm circumference (MUAC) < 11.5 cm and/or * Oedema of both feet; however, other causes of oedema e.g. nephrotic syndrome should be excluded.  Prevalence of anaemia among children aged 6-59 months For the country as a whole, the percentage of children aged 6-59 months who are anaemic has climbed up from 58.6 percent to 67.1 percent between 2015-16 and 2019-21 i.e., by +8.5 percentage points. While for Madhya Pradesh, the percentage of children aged 6-59 months who are anaemic has increased from 68.9 percent to 72.7 percent between 2015-16 and 2020-21 (i.e., by +3.8 percentage points), for Uttar Pradesh the same has gone up from 63.2 percent to 66.4 percent between the two time points (i.e., by +3.2 percentage points). Please see chart-2. In Chhatarpur (+21.0 percentage points), Damoh (+0.6 percentage points), Panna (+6.3 percentage points), Sagar (+15.9 percentage points), and Tikamgarh (+0.4 percentage points) districts the percentage of children aged 6-59 months who are anaemic has increased between NFHS-4 and NFHS-5. However, in Datia district (-0.4 percentage points), the percentage of children aged 6-59 months who are anaemic fell between 2015-16 and 2020-21.  In Chitrakoot (-17.2 percentage points), Jalaun (-29.6 percentage points), Jhansi (-7.5 percentage points), Lalitpur (-19.8 percentage points), and Mahoba (-7.5 percentage points) districts the percentage of children aged 6-59 months who are anaemic has reduced between NFHS-4 and NFHS-5, whereas in Banda (+19.5 percentage points) and Hamirpur (+13.0 percentage points) districts the percentage of children aged 6-59 months who are anaemic has climbed up between the two time points. Therefore, in seven out of 13 districts that fall in Bundelkhand, the percentage of children aged 6-59 months who are anaemic has increased between 2015-16 and 2020-21. The prevalence of anaemia among children aged 6-59 months in 2020-21 is higher in Chhatarpur (87.2 percent), Damoh (76.3 percent), Datia (72.8 percent), Panna (74.5 percent), and Sagar (83.3 percent) in comparison to Madhya Pradesh (72.7 percent). The prevalence of anaemia among children aged 6-59 months in 2020-21 is higher in Banda (82.2 percent), Hamirpur (68.5 percent), Jhansi (70.3 percent), and Mahoba (70.1 percent) as compared to Uttar Pradesh (66.4 percent). Note: Please click here to access the data of the above chart in a spreadsheet format Haemoglobin in grams per decilitre (g/dl). Among children, prevalence is adjusted for altitude. Source: Same as Chart-1 --- In the absence of epidemiological data, haemoglobin (Hgb) of less than 11 g/dL is considered abnormal in children up to the age of 59 months. Haemoglobin (Hgb) level is considered the gold standard for assessing anaemia in preschool-age children. Anaemia in preschool-age children is responsible for non-fatal health outcomes and years lost due to disability (YLD). The full effect of anaemia on morbidity and mortality is difficult to establish. However, it is well known that childhood anaemia is associated with impaired child growth and poor cognitive abilities. Research shows that low birth weight and low maternal nutritional status besides socioeconomic conditions of households also cause high prevalence of anaemia among children in India. Prevalence of overweight among children below 5 years In the case of India, the percentage of children below 5 years who are overweight has increased from 2.1 percent to 3.4 percent between 2015-16 and 2019-21 i.e., by +1.3 percentage points. For Madhya Pradesh the percentage of children below 5 years who are overweight has marginally risen from 1.7 percent to 2.0 percent between 2015-16 and 2020-21 (i.e., by +0.3 percentage points), whereas for Uttar Pradesh the same has climbed up from 1.5 percent to 3.1 percent between the two time points (i.e., by +1.6 percentage points). Please have a look at chart-3. In Chhatarpur (+0.2 percentage points), Damoh (+0.5 percentage points), Datia (+1.1 percentage points), Panna (+1.0 percentage points), and Sagar (+0.3 percentage points) districts the percentage of children below 5 years who are overweight has gone up between NFHS-4 and NFHS-5, whereas in Tikamgarh district (-0.5 percentage points) the percentage of children below 5 years who are overweight has fallen between the two time points. Although in Chitrakoot (+5.7 percentage points), Hamirpur (+7.1 percentage points), Jalaun (+1.9 percentage points), Jhansi (+2.6 percentage points), Lalitpur (+6.2 percentage points), and Mahoba (+3.2 percentage points) districts the percentage of children below 5 years who are overweight has increased between 2015-16 and 2020-21, in Banda district (-3.7 percentage points) the percentage of children below 5 years who are overweight has fallen between the two time points.   In eleven out of 13 districts that belong to the Bundelkhand region, the proportion of children under 5 years who are overweight has grown between 2015-16 and 2020-21. The prevalence of overweight among children under five years in 2020-21 is higher in Damoh (2.4 percent), Datia (2.8 percent), Panna (2.4 percent), and Sagar (2.3 percent) in comparison to Madhya Pradesh (2.0 percent). The prevalence of overweight among children below five years in 2020-21 is higher in Banda (6.3 percent), Chitrakoot (6.7 percent), Hamirpur (9.1 percent), Jhansi (3.3 percent), Lalitpur (6.7 percent), and Mahoba (5.0 percent) as compared to Uttar Pradesh (3.1 percent). Note: Please click here to access the data of the above chart in a spreadsheet format Above +2 standard deviations, based on the WHO standard. Source: Same as Chart-1 --- Weight-for-height above +2 SD (standard deviation) of the WHO Child Growth Standards median for children of the same height and sex is termed overweight in children aged 0 to 59 months. Severe overweight (above +3 SD) is referred to as obesity. According to the United Nations Children's Fund (UNICEF), overweight, including its severe form (obesity) in children as well as adolescents is the result of the interaction between: 1) individual factors that regulate physiological processes, food preferences, and physical activity patterns over the life course; and 2) an obesogenic environment that promotes high energy intake and sedentary behaviour. Overweight affects children’s immediate physical and emotional well-being. It also enhances the risk of being overweight later in life, a condition associated with non-communicable diseases, and considerable health and economic disadvantage for individuals, families and society. Overweight is a form of malnutrition. It does not happen in isolation and nor does it occur only in certain people or certain countries. In fact, different forms of malnutrition (i.e., stunting, wasting, micronutrient deficiencies, overweight and diet-related non-communicable diseases) can coexist in the same country (or region), the same community and even in the same family or individual.    About NFHS-5 Please note that the fieldwork for the Phase-I of the National Family Health Survey Fifth Round (NFHS-5) was conducted during June 2019-January 2020, and the results (i.e., factsheets for 22 states/ UTs, and subsequently the detailed reports and the district level factsheets) were released in December 2020. Those 22 states/ UTs, which were surveyed in Phase-I, are Andhra Pradesh, Assam, Bihar, Goa, Gujarat, Himachal Pradesh, Karnataka, Kerala, Maharashtra, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Telangana, Tripura, West Bengal, Andaman Nicobar Island, Dadra and Nagar Haveli and Daman and Diu, Jammu & Kashmir, Ladakh and Lakshadweep. The fieldwork for Phase-II of the NFHS-5 was conducted during January 2020-April 2021, and the results (i.e., factsheets for 14 states/ UTs/ districts as well as the India factsheet) were released in November 2021. The states and UTs, which were surveyed in the Phase-II, are Arunachal Pradesh, Chandigarh, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, NCT of Delhi, Odisha, Puducherry, Punjab, Rajasthan, Tamil Nadu, Uttar Pradesh and Uttarakhand. References The DHS (Demographic and Health Surveys) Program, National, State and Union Territory, and District Fact Sheets 2019-21 National Family Health Survey NFHS-5 (English), USAID, please click here and here to access   Participant Manual for Facility Based Care of Severe Acute Malnutrition (2013), Ministry of Health and Family Welfare, please click here to access   Types of Acute Malnutrition, Action against hunger, please click here to access   Double burden of malnutrition, World Health Organisation, please click here to access   Haemoglobin cut-off values for the diagnosis of anaemia in preschool-age children -Ehab Hamed, Mohamed Ahmed Syed, Bayan Faleh Alemrayat, Syed Hammad Anwar Tirmizi, and Ahmed Sameer Alnuaimi (2021), American Journal of Blood Research, 11(3): 248–254, Published online 2021 Jun 15, please click here to access   Prevalence of anaemia among 6- to 59-month-old children in India: the latest picture through the NFHS-4 -Susmita Bharati, Manoranjan Pal and Premananda Bharati (2019), Journal of Biosocial Science, Published online by Cambridge University Press:  20 May 2019, please click here to access   UNICEF Programming Guidance: Prevention of Overweight and Obesity in Children and Adolescents, published in August 2019, please click here to access Bundelkhand: Building on Partnership -Rakesh Singh, Pradan (NGO), NewsReach March–April 2015, please click here to access  Union Health Ministry releases NFHS-5 Phase-II Findings, Press Information Bureau, Ministry of Health and Family Welfare, 24 November, 2021, please click here to access  Phase-I Findings, National Family Health Survey-5, Press Information Bureau, Ministry of Health and Family Welfare, 15 December, 2020, please click here to access  News alert: The under-nutrition problem in Bundelkhand should receive equal attention of the policymakers, if not more, Inclusive Media for Change, Published on Dec 26, 2021, please click here to access   A close reading of the NFHS-5, the health of India -Ashwini Deshpande, The Hindu, 27 November, 2021, please click here to read more   Image Courtesy: UNDP India

Tagged with: Anaemia Anemia Bundelkhand Region Double Burden of Malnutrition Madhya Pradesh Malnutrition National Family Health Survey NFHS NFHS-4 NFHS-5 Obesity Overweight SAM Severe Acute Malnutrition Severe Wasting Uttar Pradesh

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"Session 2: Farmer Centric Digitalisation in Agriculture" in Exploring...

"Session 3: Future of Digitalisation in Agriculture" in Exploring...

• Public Spending on Agriculture in India (Source: Foundation for...
• Agrarian Change Seminar: 'Protests against the New Farm Laws...
• Webinar: Ramrao - The Story of India's Farm Crisis...
• Water and Agricultural Transformation in India: A Symbiotic Relationship...
• More...

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