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Bihar Tops Stunting List, Says National Family Health Survey

On July 26, when Union Minister of Women and Child Development Smriti Irani submitted her written reply in the Lok Sabha, it revealed an alarming situation about malnutrition among children in India.

The minister’s reply quoted National Family Health Survey to conclude that as many as 48.3 per cent of Bihar’s children under five years — meaning half the number of children in the state — are ‘stunted’ owing to poor nutrition.

Seen as one of the most important indicators of children’s health, stunting is not just an issue of height, it is the opposite of wellbeing. Poor nutrition may leave them cognitively less capable. Worse still, the statistics confirm that Bihar is at the top of the tally when it comes to stunted children.

Inadequate feeding practices or absence of good food for children, alongside infection, are listed by the WHO as two of the main causes of stunting. The children need a rich diet for growth but poverty prevents them from eating three meals a day.


All skin and bones, Divya, 5, perfectly describes what malnourishment means. Asleep in her mother’s arm in one of the illegal hutments that have come up in Patna’s Rajeev Nagar locality, Divya is severely stunted and wasted — meaning she is both too short for her age and too thin for her height. She could well be the picture that the statistics tabled in the Lok Sabha point towards.

But Divya is not alone. According to the data tabled in the Lok Sabha, 38.4 per cent children in the country have stunted growth. It is worse in states like Bihar (48.3 per cent), Uttar Pradesh (46.3 per cent) Jharkhand (45.3 per cent), Meghalaya (43.8 per cent) Madhya Pradesh (42 per cent).

Globally, malnutrition has been identified as the cause of almost half of all deaths for under-fives.


According to experts, stunting makes a child increasingly vulnerable to, and five times more at risk to die of, diarrhoea. Worse still, it can also be a vicious cycle, as frequent episodes of diarrhoea before a child’s second birthday can even cause stunting.

“This is a silent emergency. Malnourishment has always been there among poor children. It is a medical condition largely triggered by poverty; multiple departments of the government must huddle to get our act together,” says Dr Ajay Kumar, vice-president of Indian Medical Association in Bihar.

Stunting, according to Muzaffarpur-based senior paediatrician Dr Arun Shah, can have scary and largely irreversible physical and cognitive consequences.

Studies have confirmed that long-term consequences of stunting can even be worse. Because of lack of nutrients, the process of brain development is adversely affected in a stunted child.


“This is not all. Stunting leaves a child with weaker immune systems with lower life expectancy and at greater risk of diseases like diabetes. Worse still, malnourishment travels across generations and a malnourished mother is more likely to give birth to a malnourished child,” said Dr Ajay Kumar.

In June this year, Bihar social welfare department drew its own nutrition strategy in line with the Centre’s Poshan Abhiyan scheme which is aimed at enhancing nutrition and reducing stunting in children. The Bihar government’s plan involves 16 departments, including health and social welfare, and seeks to establish a coordinated strategy to address malnutrition.

While this might not sound enough, the programme is surely a step in the positive direction. There is indeed a pressing need for immediate actions. A generation is left behind every two and half years, which is the time a child emerges free of stunting or gets caught for a life time. In fact the first 1,000 days in the life of a child is extremely crucial for healthy development for the rest of their lives. – India Today

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