COVID-19’s Shadow on Undernourished Children (6–23 months): An Evidence-Based Study on Magnitude and its Determinants in Rajasthan

Abstract

The prevalence of child undernutrition in India is among the highest in the world, nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity and economic growth (HNP, World Bank). India is home to most malnourished people in the world (FAO, 2015). According to data tabled in the state assembly, 37% of children below 5 years of age are underweight in the state of Rajasthan. A total of 39% of children in Rajasthan under the age of 5 years are stunted, or too short for their age, which shows that they have been undernourished for quite a while (National Family Health Survey-4—Rajasthan factsheet). Region specific magnitude of under nutrition in young children (6–23 months) at the block level is scarce. The present study carried out by IIHMR University, supported by IPE Global could be of use to the Government, policy makers as well as to the development partners working towards the enhanced nutritional status of the children. The specific objectives of the study were to collect demographic and background information about enrolled children (6–23 months) and to assess the anthropometry based nutritional status as far as wasting, stunting and underweight for the children 6–23 months and its determinants. A cross-sectional survey was undertaken. Three stage sampling method was adopted. Three districts were randomly selected from total districts of Rajasthan and from each selected district, four rural blocks/urban slums based on systematic random sampling were enrolled for the study in Stage 1. For Stage 2, for each selected block 10 villages/urban slums primary sampling unit (PSU) were selected. In the third stage, from each PSU six children in the age group of 6–11 months and 12 children from the age group of 12–23 months based on systematic random sampling were enrolled for the study. It was done from the list available to Accredited Social Health Activist (ASHA)/Anganwadi workers in the respective PSU. Thus, from every district, a sample of 720 respondents comprising two groups of infants was enrolled in the study. Hence, the total sample size for the study was 2,160 for all three selected districts. Socio-demographic and economic indicators of the respondent’s household: Information on the family composition of the household, including age, religion, caste, occupation, income was elicited through pretested semi-structured questionnaire. Anthropometric measurements were taken adopting the standard procedure for the same. WHO Anthro form 3.2.2 programming was utilised for the anthropometric examination to evaluate the magnitude of wasting, stunting and underweight in the enrolled children. A total 92% of the households in the sampled population were the followers of Hinduism. Regarding caste/tribe, around 11% of the households belonged to general category, 16% of the scheduled caste group, while the remaining 28% households were found to be from the scheduled tribe group. The overall pervasiveness of wasting, stunting and underweight was 16.9%, 58.1% and 34.2%, respectively. In case of severe wasting, stunting and underweight among children, it was 6.4%, 36.7% and 12.9% individually. It was revealed that prevalence of undernutrition was higher in males as compared to females in all the three districts. In Rajasthan, existing nutritional status of children, including wasting, stunting and underweight is a cause of concern which may get aggravated due to the current pandemic of COVID-19. Some studied shows that ‘poorer households are much more likely to report much less income during April than richer households compare to income during January and February’. To protect the vulnerable groups, especially women and children, from the effects of this nutritional crisis, there is an urgent need for high-frequency surveillance of vulnerable populations and inter sectoral convergence across segments, including health, agriculture, education, water and sanitation, social protection, commerce and livelihood.