NEW DELHI: Many Indian districts continue to struggle with malnutrition, anaemia remains high among women and children, sex ratio is imbalanced, and disparity in coverage of routine immunization prevails among children, said a recent analysis by Harvard University experts.
Using NFHS-4 (2015-16) and NFHS-5 (2019-20) data from the National Family Health Survey (NFHS) Policy Tracker, Geographic Insights Lab experts, Harvard University analysed the performance of five major national programmes sponsored by the Centre on the basis of key performance indicators.
These include Anemia Mukt Bharat which aims to reduce anaemia prevalence to 32% by 2022, Beti Bachao Beti Padhao, Intensified Mission Indradhanush to ensure 90% child immunisation against vaccine-preventable diseases, POSHAN Abhiyaan and Pradhan Mantri Matru Vandana Yojana that provides financial subsidies to pregnant lactating women.
Anaemia among women and children has been seeing a rise which requires a continuum of care approach with a greater focus on curbing anaemia prevalence during pregnancy and its transmission to the next generation. Kerala, Manipur, and Goa top the rankings while Bihar, Tripura, and Jharkhand are at the bottom.
Most cases of anaemia are seen in certain endemic regions of Bihar, Jharkhand, Gujarat, Uttar Pradesh, and Chhattisgarh. The extremely high burden of anaemia prevalence in Ladakh and some districts of Jammu and Kashmir requires a focus on reviewing local dietary factors, as per the report. A large number of districts continue to reel under malnutrition. States like Manipur, Mizoram and Kerala have implemented the scheme the best while Gujarat, Bihar and Jharkhand are way behind.
Wide inter-state and inter-district variations of the programme are notable features in the report. Kerala, Goa and Mizoram are among the best performing states while Bihar, Jharkhand and Nagaland are at the bottom list. Among the best states, such as Kerala, almost one-fourth of females do not report enrolment matriculation (10+ years of schooling).
Any identified imbalances in sex ratio should be reviewed carefully, especially at the block and village levels. For instance, the highly female-biased sex ratio at birth in the Alappuzha district (1,485) of Kerala and the highly male-biased sex ratio at birth of Satna district (658) in Madhya Pradesh should be of equal concern in gender development.
More than 10% of the districts recorded more than 25% of home-based births and are thus lagging in covering institutional deliveries (women giving birth in hospitals) and the availability of skilled attendants at birth. The scheme should be targeted for strategies to better understand and improve these deficiencies.
The plan of action under IMI still needs comprehensive implementation. North-eastern states need to be targeted attention, as they are not only placed at the bottom of the KPI index rankings but have also not shown any improvement since the last survey round. The majority of the poorest performing districts are from the North-eastern states.
