NFHS-6 shows Madhya Pradesh has improved on institutional deliveries, vaccination and women’s internet access.
But nearly one in three children under five in the state is still stunted, while four in 10 are underweight.
The share of underweight children has risen from 33% to 39.7%, and wasting has increased from 18.9% to 23.8%.
Only 12% of children aged six to 23 months receive a minimum acceptable diet, while exclusive breastfeeding for the first six months has fallen.
The data also shows a double burden of malnutrition, with undernutrition and obesity now existing alongside rising diabetes risk.
Institutional deliveries of babies have increased in Madhya Pradesh, women’s access to the internet has more than doubled, and vaccination rates have improved. But the latest data from the National Family Health Survey-6 (NFHS-6) for 2023-24 reveals a picture that complicates this story of progress. Nearly one in three children under five in the state is still stunted, four in 10 are underweight, and acute malnutrition among children has increased compared with the previous survey.
According to NFHS-6, 31.4 per cent of children in Madhya Pradesh suffer from stunting. This is lower than the 35.7 per cent recorded in NFHS-5, and could be seen as an improvement. But the other side of the picture is far more worrying.
The percentage of underweight children in the state has increased from 33 per cent to 39.7 per cent. Similarly, wasting has risen from 18.9 per cent to 23.8 per cent. This raises the question of whether the state, once ranked number one in the country for malnutrition, has truly reversed its trend.
Both these indicators suggest that the acute nutritional crisis among children remains severe. The situation is particularly dire in rural areas, where 42 per cent of children are underweight and nearly a quarter are affected by wasting.
NFHS-6 data shows that the problem is not only about food availability, but also about its quality and variety. Only 12 per cent of children aged six to 23 months are receiving a minimum acceptable diet. This means that about 88 per cent of children in this age group are not receiving adequate and balanced food appropriate for their age, which is clearly affecting child nutrition.
The rate of exclusive breastfeeding for the first six months has also fallen to 56.4 per cent, compared with 74 per cent in the previous survey. Public health experts have long argued that the first 1,000 days of life are the most crucial for a child’s physical and mental development. A lack of breastfeeding and adequate complementary feeding during this period can contribute to malnutrition and affect learning abilities later in life.
Maternal health indicators have improved, but nutrition remains a weak link, the survey found. In Madhya Pradesh, 96.2 per cent of women received at least one antenatal check-up during pregnancy, and 89.8 per cent of deliveries took place in health institutions. At first glance, these appear to be significant achievements.
However, only 39.6 per cent of women took iron-folic acid tablets for 180 days or more during pregnancy. This indicates that maternal nutrition remains a weak link in the health system.
Health and nutrition experts have long said that the cycle of malnutrition between a malnourished mother and a low-birth-weight child is closely connected. If women’s nutrition does not improve, the desired improvement in children’s nutritional indicators will be difficult to achieve.
Another important finding of NFHS-6 is that Madhya Pradesh is no longer grappling with undernutrition alone. The state now faces the coexisting problem of undernutrition and obesity.
Among people aged 15 to 49, 26.5 per cent of women and 28.3 per cent of men have a body mass index below normal. At the same time, 22.2 per cent of women and 17.6 per cent of men are overweight or obese.
In public health, this is called the “double burden of malnutrition” — a situation where some people in the same society are deprived of adequate food and nutrition, while others face obesity and related diseases because of unhealthy diets and lifestyles. Survey data also shows that the risk of diabetes is increasing rapidly in the state.
Among people aged over 15, 14.5 per cent of women and 18.3 per cent of men have blood sugar levels above 140 or are taking diabetes medication. This is a significant increase compared with the previous survey. It indicates that Madhya Pradesh is now facing a growing burden of non-communicable diseases, in addition to traditional health challenges such as infections and malnutrition.
Positive changes have been recorded in indicators related to women’s empowerment. According to NFHS-6, 90.4 per cent of married women participate in household decision-making. About 92.1 per cent of women have bank accounts, and the percentage of women with internet access has increased from 26.9 per cent to 62 per cent.
However, despite these achievements, only 17.3 per cent of women own a house or land. This shows that women’s actual share of economic resources remains limited.
The rural-urban divide also remains deep. There are clear gaps between rural and urban areas in almost every key indicator, including child marriage, malnutrition, underweight children, maternal health and digital access. For example, 33.2 per cent of children in rural areas are stunted, compared with 24.5 per cent in urban areas.
The rate of child marriage among rural women is almost two-and-a-half times higher than among urban women. Similar gaps are visible in internet access and education, the survey underlined.