In India, minimum diet diversity failure (MDDF) in children aged 6-23 months has decreased, there are eight states, mostly in the north, central and western parts, where 80 per cent experienced this condition, a new study showed.
Uttar Pradesh (86.1 per cent), Rajasthan (85.1 per cent), Gujarat (84 per cent), Maharashtra (81.9 per cent) and Madhya Pradesh (81.6 per cent) had the highest MDDF prevalance, it found.
The report was published in the National Medical Journal of India published by All India Institute of Medical Sciences. Scientists Dhruvi Bagaria, Sudeshna Roy and this author, who wrote the report and are trained in population and health studies, used National Family and Health Survey (NFHS) datasets from rounds 3, 4 and 5 to examine MDDF among children longitudinally, regionally and across population groups having diverse background characteristics.
Minimum dietary diversity is a reliable and widely used indicator approved by World Health Organization (WHO) that reflects the access and consumption of diverse food groups and essential micronutrient availability to the children. As per the WHO, nutrition-related factors lead to approximately 35 per cent of child deaths and contribute to 11 per cent of the total disease burden globally.
Poor levels of nutrition augment the risk of children to delayed motor and cognitive development, translates into low immunity, vulnerability to infections and deficiency diseases as well as a host of poor health conditions.
Since diet diversity failure is one of the reasons for stunting and wasting among children under five years of age, it is crucial to understand the dietary consumption pattern of young children to ensure minimum adequate diet is being consumed and align public budgetary policy to meet the need-gap.
District-wise prevalence of MDDF according to NFHS-5 (2019-21)
NFHS is conducted under the guidance of the Union Ministry of Health and Family Welfare and provides a reliable cross-sectional data covering a nationally representative sample. NFHS-3 (2005-06) survey collected data from India’s 29 states and Union territories (UT), while NFHS-4 and NFHS-5 surveys covered 36 states and UTs during 2015–16 and 2019–21, respectively.
Bagaria, Roy and this author used multivariate and descriptive statistical analysis and graphical representation, to study the prevalence, determinants of MDDF and identify trends of MDDF across India’s regions.
Only 95 out of the 707 districts that were part of the analysis, primarily in the southern, eastern, northeastern and northern parts of India, recorded MDDF prevalence below 60 per cent as per NFHS-5.
Overall, the country's MDDF reduced from 87.4 per cent (2005-06) to 77.1 per cent (2019-21) and, regionally speaking, the central region (84.6 per cent) of the country reported the highest prevalence of MDDF in 2019–21.
The trend of dietary diversity and MDDF among children under two years of age by consumption of food items within eight food groups was computed. Consumption of eggs, Vitamin A rich foods and vegetables and flesh foods increased between NFHS-3 and NFHS-5 reports.
Further, using logistic modelling, the new report showed that the likelihood of higher prevalence of MDDF was more among children born to younger and illiterate mothers, female children, children belonging to poor households, anaemic children and those having low birth-weight, children who were not attended to with regular health-checkups and counselling at the anganwadis / integrated child development services (ICDS) centres.
The implication of the study is large as it underlines the need for intensive policy interventions in nutrition resource deliverance, beneficiary population counselling for screening of malnutrition and diet consumption and strengthening of local self-governance systems for programme implementation.
National nutrition programmes like Poshan Abhiyaan, ICDS system, Public Distribution System among others have been implemented by the Indian government to improve the holistic nutritional status yet much scope for convergence remains to be done.
Gaurav Gunnal has an MSc in biostatistics and demography, International Insitute of Population Sciences, Mumbai. Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth.