Despite various initiatives, childhood stunting remains a major public health challenge in India.
“In recent decades, public health interventions in India have effectively tackled previously prevalent nutritional problems, such as iodine deficiency, which are associated with living at higher altitudes,” said Professor Sumantra Ray, Executive Director of the NNEdPro Global Institute for Food, Nutrition and Health.
Children
under 5 years of age in India, living at higher altitudes—over 2,000 metres
above sea level—may be at about 40 per cent higher risk of stunted growth,
according to a study on Friday.
The study, published in
BMJ Nutrition Prevention & Health, showed that despite various initiatives,
childhood stunting, caused by chronic malnutrition, remains a major public
health challenge in India, affecting over a third of five-year-olds.
“In
recent decades, public health interventions in India have effectively tackled
previously prevalent nutritional problems, such as iodine deficiency, which are
associated with living at higher altitudes,” said Professor Sumantra Ray,
Executive Director of the NNEdPro Global Institute for Food, Nutrition and
Health, a think tank.
“But this study
highlights the complexities of malnutrition in hilly regions where wider
determinants of malnutrition among the under-fives require further study to
elucidate the relative contributions of heredity, environment, lifestyle, and
socioeconomic factors,” Ray added.
To explore further, the researchers drew on data from the 2015-16 National Family
Health Survey on 1,67,555 children under the age of five. About 1.4 per cent of
kids lived between 1,000 and 1,999 m above sea level, and 0.2 per cent lived at
or above 2,000 m.
Overall, stunting was
seen among 36 per cent children, with a higher prevalence among those aged
18-59 months (41 per cent) than among those under 18 months of age (27 per
cent).
Stunting was also found
to be more common among children of third or higher birth order (44 per cent)
than it was among firstborns (30 per cent).
Stunting rates were even higher among those children who had been small or very
small (45 per cent) at birth.
However, the study is
“observational” and cannot confirm “altitude as a cause of stunting”, said the
researchers.
According to them,
chronic exposure to high altitudes which can reduce appetite, restrict oxygen
delivery to tissues, and limit nutrient absorption are reasons for stunted
growth.
“Food insecurity also tends to be greater at higher elevations where crop
yields are lower and the climate is harsher. Similarly, health care provision,
including implementing nutritional programmes, and health care access are also
more challenging,” they said.
The study showed that the
mother’s education, proper antenatal care, such as clinic visits, tetanus vaccination,
and iron and folic acid supplements; and proximity to health facilities acted
as protective factors against stunting.
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