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Trends in Outcomes, Determinants and Interventions between 2006 and 2016 : Uttar Pradesh and Tamil Nadu
Sneha Sarah Maniwith Phuong Hong Nguyen, Neha Kohli, Rasmi Avula and Purnima Menon
Poverty, Health and Nutrition Division, International Food Policy Research Institute
May 3, 2017
Objectives
§ Examine state-specific trends in nutrition outcomes, determinants and the coverage of interventions
§ District level variability in nutrition outcomes
§ Tamil Nadu and Uttar Pradesh used as examples
Data and Methods
§ Data sources:oNational Family Health Survey-4 (NFHS-4, 2015–16) factsheets oNational Family Health Survey-3 (2005–06) factsheets/reportoRapid Survey on Children (RSoC, 2013–2014) for indicators that are currently not available in NFHS-4 fact sheets.
§ Analysis – trends and levelsoOutcome indicatorso Immediate and underlying determinants oCoverage of nutrition-specific interventions
Trends in nutrition outcomes, 2006 and 2016
Uttar Pradesh Tamil Nadu
Sources : NFHS-‐3, NFHS-‐4 and RSoC
0
10
20
30
40
50
60
70
Stunting Anemia among women
Exclusive breastfeeding
Wasting Low birth weight
%
Uttar Pradesh 2006 Uttar Pradesh 2016 India 2006 India 2016
0
10
20
30
40
50
60
70
Stunting Anemia among women
Exclusive breastfeeding
Wasting Low birthweight
%
Tamil Nadu 2006 Tamil Nadu 2016 India 2006 India 2016
Inter district variability - Stunting
Uttar Pradesh Tamil Nadu
Source : NFHS-‐4
Inter district variability – Wasting and Severe WastingUttar Pradesh
Source : NFHS-‐4
Uttar Pradesh
Inter district variability – Wasting and Severe WastingTamil Nadu Tamil Nadu
Inter district variability – Exclusive BreastfeedingUttar Pradesh Tamil Nadu
Source : NFHS-‐4
Inter district variability – Anemia among womenUttar Pradesh Tamil Nadu
Source : NFHS-‐4
Changes in immediate determinants of nutrition, 2006 to 2016
0
10
20
30
40
50
60
70
80
90
2006 2016
%
Women with body mass index <18.5 Early initiation of breastfeeding Timely introduction of foods
Adequate diet Diarrhea in the last two weeks ARI in the last two weeks
0
10
20
30
40
50
60
70
80
90
2006 2016
%
Uttar Pradesh Tamil Nadu
Sources : NFHS-‐3 and NFHS-‐4
Changes in nutrition-specific interventions along the continuum of care, 2006 to 2016
0
10
20
30
40
50
60
70
80
90
100
2006 2016
%
ANC first trimester 4+ ANC visits Consumed 100+ IFA during pregnancyANC-‐ neonatal tetanus Supplementary food-‐ pregnancy Delivery in health facilitySkilled birth attendent Birth registration Supplementary food-‐ lactationFull immunization Received vitamin A in the last 6 months Supplementary food-‐ childrenORS during diarrhea
0
10
20
30
40
50
60
70
80
90
100
2006 2016
%
Uttar Pradesh Tamil Nadu
Sources : NFHS-‐4 and RSoC
0
10
20
30
40
50
60
70
80
90
100
2006 2016
%
Women who are literate Women with ≥10 years educationGirls married before age of 18 Households with access to improved drinking waterHouseholds with access to improved sanitation facility Households with electricityOpen defecation
0
10
20
30
40
50
60
70
80
90
100
2006 2016%
Uttar Pradesh Tamil Nadu
Changes in underlying determinants of nutrition, 2006 to 2016
Sources : NFHS-‐3 and NFHS-‐4
Levels of Non Communicable Diseases, 2006 to 2016
0
10
20
30
40
50
60
70
80
90
100
%
District average
India average
0
10
20
30
40
50
60
70
80
90
100
%
District average
India average
Uttar Pradesh Tamil Nadu
Implications and Recommendations : Uttar Pradesh
§ Strengthen coverage of antenatal care, IFA supplementation, food supplementation and other interventions related to maternal care during pregnancy.
§ Strengthen actions to support child healtho ImmunizationoORS and zincoAdequate infant and young child feeding practices (particularly complementary feeding practices).
§ Urgent attention needed to improve oAccess to electricity and oAccess to sanitation oWomen’s education oDelay age at marriage
Implications and Recommendations : Tamil Nadu
§ Urgent attention needed to reverse the decline in full immunization levels§ Strengthen coverage of antenatal care, IFA supplementation, food supplementation and other interventions related to maternal care during pregnancy and lactation
§ Improve access to sanitation facilities§ Strengthen actions to support child health especially complementary feeding practices
§ Sustain the current high coverage level for various interventions
POSHAN Policy Notes on States
Maharashtra Haryana UttarakhandJharkhand Goa PunjabKarnataka Delhi ChhattisgarhMadhya Pradesh Rajasthan
Upcoming policy notes:
