POSHAN District Nutrition Profile_Lakhisarai_Bihar
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Transcript of POSHAN District Nutrition Profile_Lakhisarai_Bihar
50.6
20.1
47.3
66.3
27.6
8.5
0.3
48.3
20.8
43.9
63.5
30.4
9.5
0.6
Children stunted(<5 yr) (%)
Children wasted(<5 yr) (%)
Childrenunderweight
(<5 yr) (%)
Children with anyanemia
(0-59 mo) (%)
Womenunderweight (BMI
<18.5)(15-49 yr) (%)
Children withbirthweight<2500gms
(0-2 mo) (%)
Adults who areobese in the
district(18-59 yr) (%)
Lakhisarai Bihar
15.3% 0.8% 83.9%
14.3% 85.7%
52.6% 47.4%
Lakhisarai, Bihar
DISTRICT NUTRITION PROFILE
Page 1
THE STATE OF NUTRITION IN LAKHISARAI3,4,5
DISTRICT DEMOGRAPHIC PROFILE1
Total Population 1,000,912
MALE FEMALE
RURALURBAN
SC ST OTHERS
CHANGES OVER TIME IN ANEMIA3,5,6,7
CHILDREN STUNTED
CHILDREN WASTED
CHILDREN UNDERWEIGHT
50.6%
20.1%
47.3%
Lakhisarai ranks 510th amongst 599 districts in India2
DISTRICT DEVELOPMENT INDEX (2015)
NFHS 4 (2015-2016)
99.8
98.2 66.3
97.6 78 80.7
63.5
DLHS 2 (2002-2004)^ NFHS 3 (2005-2006)^^ CAB (2014)^^ NFHS 4 (2015-2016)^^
Lakhisarai Bihar
No
Dat
a
CHHNS7 (2015) CAB (2014)NFHS 4 (2015-2016)
PREVALENCE OF ANEMIA AMONGST CHILDREN UNDER-SIX DECREASED IN THE DISTRICT BETWEEN 2002 AND 2016
!
NFHS 4 (2015-2016)
NFHS 4 (2015-2016) NFHS 4 (2015-2016)
^Children 0-71 months with <11 g/dl^^Children 0-59 months with <11 g/dl
37.3
57.5
100.0
34.6
58.3
99.2
Women who receivedANC in the first
trimester(15-49 yr) (%)
Anemia amongpregnant women
(15-49 yr) (%)
Anemia amongadolescent girls(10-19 yr) (%)
Lakhisarai Bihar
39.232.7
36.8
7.4
59.1 62.1
8.7
63.8
1.9
34.9
53.5
30.7
7.3
61.7 62.3
10.4
45.2
2.5
Children breastfedwithin one hour of
birth(<3 yr) (%)
Children exclusivelybreastfed
(0-6 mo) (%)
Children whoreceived any
solid/semi solidfood in the last 24
hours(6-8 mo) (%)
Children whoachieve minimum
diet diversity(6-23 mo) (%)
Children with fullimmunization
coverage(12-23 mo) (%)
Children who gotvitamin A
supplementation(9-59 mo) (%)
Children sufferingfrom diarrhoea inthe last 2 weeks
(<5 yr) (%)
Children withdiarrhoea treated
with ORS(<5 yr) (%)
Children showingsymptoms of ARI
(<5 yr) (%)
DISEASE BURDEN3
Page 2
Child undernutrition is caused by inadequacies in food, health and care for infants and young children, especially inthe first two years of life (immediate causes). Inadequate food, health and care arise from food insecurity, unsanitaryliving conditions, low status of women, and poor health care (underlying causes). These are, in turn, caused by socialinequity, economic challenges, poor political will and leadership to address these causes (basic causes). Interventionsto address undernutrition must address these multiple causes of undernutrition and do so in an equitable manner.
IMMEDIATE CAUSES OF UNDERNUTRITION
IMMEDIATE CAUSESBreastfeeding, nutrient rich foods, and eating routine
Feeding and caregiving practices, parenting stimulationLow burden of infectious diseases
Optimum fetal and child nutrition and development
WHAT FACTORS CAUSE UNDERNUTRITION?13
UNDERLYING CAUSESFood security: availability, economic access and use of foodFeeding and caregiving resources (maternal, household and
community level)Access to and use of health services, a safe and hygienic environment
BASIC CAUSESKnowledge and evidencePolitics and governance
Leadership, capacity and financial resourcesSocial, economic, political, and environmental context
(national and global)
The most crucial period for child nutrition is from pre-pregnancy to the second year of life2
HOW CAN NUTRITION IMPROVE?
ADOLESCENT & MATERNAL HEALTH3,5
INFANT AND YOUNG CHILD FEEDING3
0
10
20
30
40
50
60
70
80
90
100
Age of child (in months)
Per
cen
tage
of
child
stu
nti
ng
(%)
Window of opportunity
Too late
IMMUNIZATION & SUPPLEMENTATION3
DLHS 2 (2002-2004)NFHS 4 (2015-2016)
NFHS 4 (2015-2016)
NFHS 4 (2015-2016) NFHS 4 (2015-2016) NFHS 4 (2015-2016)
NFHS 4 (2015-2016)
NFHS 4 (2015-2016)NFHS 4 (2015-2016)NFHS 4 (2015-2016)
NFHS 4 (2015-2016)
NFHS 4 (2015-2016)
Areas for action: • Poor state of infant and young child feeding: Very few infants are
breastfed within on hour of birth, diet diversity rates are poor• Less than half of children suffering from diarrhoea receive ORS• Alarming levels of anaemia among adolescent girls• Less than half of women in the district report having received ANC in
the first trimester
Data challenges:• Where data are available, indicator definitions are non-standardized
and often differ from World Health Organisation recommendations
50.7
93.0 100.0
51.050.4
91.7
57.244.4
Adult literacy rate (%) Households with access to primary/middleschool (%)
Households who demanded and receivedwork through NREGA (%)
Households availing banking services (%)
Lakhisarai Bihar
58.6
41.1
55.7
29.6 33.1
57.9
27.1
49.4
34.8
53.2
34.1
50.9 48.1
16.4
Household share ofexpenditure on food
(%)
Household share offood expenditure on
cereals (%)
Households in thedistrict involved in
agriculture (%)
Households BelowPoverty Line (%)
Households ownershipof agricultural land (%)
Households living in apucca house (%)
Household access toelectricity (%)
Lakhisarai Bihar
52.4
25.3
42.8
12.4
21.9
93.8
36.8
66.8
12.1
49.6
22.8
39.1
12.221.2
98.2
25.2
75.8 73.3
20.8
Women who areliterate
(15-49 yr) (%)
Women whocompleted 10 or
more years ofschooling
(15-49 yr) (%)
Girls marriedwhen <18 years
old(20-24 yr) (%)
15-19 year oldwomen who are
mothers orpregnant
(%)
Total unmet needfor familyplanning
methods amongwomen
(15-49 yr) (%)
Households withaccess toimproved
drinking watersources (%)
Households withaccess toimprovedsanitation
facilities (%)
Householdspracticing opendefecation (%)
Householdsdisposing of childstool in a sanitary
manner (%)
Householdswashing hands
with soap beforemeals (%)^
NFHS 3 (2005-2006)
No
dat
a
Census (2011)
SOCIO ECONOMIC CONDITIONS 1,9,14,15
Page 3
UNDERLYING CAUSES OF UNDERNUTRITION
BASIC CAUSES OF UNDERNUTRITION 1,8,9
• Per capita gross district domestic product of Lakhisarai ranked 7th amongst 38 districts of Bihar in 2011-1215
• Bihar’s per capita income ranked last amongst 32 major States/UTs in India in 2011-1216
• Action needs to be taken to improve adult literacy which is low• No data available on indicators of governance and political will to address nutrition
WOMEN’S STATUS3 WATER, SANITATION AND HYGIENE1,4,7
FOOD SECURITY 9
CHHNS7 (2015)
Census (2011) Census (2011)NSS 68th round (2011-2012) NSS 68th round (2011-2012)
NSS 68th round (2011-2012)
Census (2011)Census (2011)
DLHS 3 (2007-2008)
NSS 68th round (2011-2012) NSS 68th round (2011-2012)NSS 68th round (2011-2012)
NFHS 4 (2015-2016)
NFHS 4 (2015-2016)
NFHS 4 (2015-2016)
NFHS 4 (2015-2016)
NFHS 4 (2015-2016)
NFHS 4 (2015-2016) NFHS 4 (2015-2016)
Areas for immediate action: • Very high rates of open defecation; critical need to increase awareness about washing hands with soap and ensuring
access to using improved sanitation facilities• Early marriage of girls less than 18 years is highly prevalent; early marriage is related to poor health and nutrition
outcomes for mothers and babies• Less than half of women in the district are literate• Very few households live in a ‘pucca’ house and have access to electricity
Data challenges:• Outdated data on open defecation• No district-level data on child stool disposal
64.1
4.5
76.5
90.7
25.6 28.4
83
2.99.4
86.8 91.7
32.7 31.0
Institutional deliveries(Women 15-49 yr) (%)
Home births attended byskilled health personnel(Women 15-49 yr) (%)
New born received check upwithin 24 hours ofbirth/delivery (%)
Households (with 12-23 mochild) with an
immunization/MCP card (%)
Households with access toAnganwadi worker (%)
Households with access to aSub-Health Centre (%)
Households that receivedfinancial assistance for
delivery and childcare (%)
46.5
28.640.3
21.7
43.9
Households that receive anytake home ration (%)
Women who received THRduring pregnancy (%)
Households with access toPDS (%)
Lakhisarai Bihar
No
Dat
a
This District Nutrition Profile was developed by Nitya George and Srabashi Ray for POSHAN. This version, dated 27-04-2016 is a draft intended for use in a district-level workshop in Lakhisarai, and will be revised following workshop discussions.
EVALUATION OF HEALTH AND NUTRITION SCHEMES3,4,8,9,12
NSS 68th round (2011-2012)
DLHS 3 (2007-2008) DLHS 3 (2007-2008)
NFHS 4 (2015-2016)
CHHNS7 (2015) RSOC (2013-2014)
No
Dat
a
CHHNS7 (2015)CHHNS7 (2015)
NFHS 4 (2015-2016) RSOC (2013-2014)
Data sources 1. Census of India. 2011. Primary Census Abstract. Accessed June 6, 2015, www.censusindia.gov.in/pca/default.aspx
Census of India. 2011. Houselisting and Housing Census Data. Accessed March 18, 2015, www.censusindia.gov.in/2011census/hlo/HLO_Tables.html2. Us-India Policy Institute. 2015. District Development and Diversity Index. Accessed July 2, 2015, http://www.usindiapolicy.org/updates/general-news/225-district-development-and-diversity-index-
report3. National Family Health Survey (NFHS-4), 2015-16, India. Mumbai: International Institute for Population Studies. 4. Concurrent Household Health and Nutrition Survey (Round-7), Concurrent Monitoring and Learning Unit, CARE India – Bihar5. Census of India. 2014. Clinical, Anthropometric & Bio-chemical (CAB) survey. http://www.censusindia.gov.in/2011census/hh-series/HH-2/Bihar%20CAB%20Sample%20Characteristics%202014.pdf 6. Author’s estimates based on District Level Household Survey on Reproductive and Child Health (DLHS-2), 2002-04, India.
International Institute for Population Studies. (IIPS). 2006. District Level Household Survey on Reproductive and Child Health (DLHS-2), 2002-04, India: Nutritional Status of Children and Prevalence of Anemia among Children, Adolescent Girls and Pregnant Women. Mumbai: IIPS. March 18, 2015, www.rchiips.org/pdf/rch2/National_Nutrition_Report_RCH-II.pdf
7. Author’s estimates based on National Family Health Survey (NFHS-3), 2005-06, India. Mumbai: International Institute for Population Studies. 8. International Institute for Population Studies (IIPS). 2010. District Level Household Survey and Facility Survey (DLHS-3), 2007-08, India, Bihar. Mumbai: IIPS. Accessed June 28, 2015,
http://rchiips.org/pdf/rch3/report/BH.pdf9. Author’s estimates based on Household Consumption Expenditure, National Sample Survey Office (NSSO) 68th Round, 2011-12. Ministry of Statistics and Program Implementation. Government of
India Author’s estimates based on Employment and Unemployment, National Sample Survey Office (NSSO) 68th Round, 2011-12. Ministry of Statistics and Program Implementation. Government of India
10. Finance Department, Government of Bihar. Economic Survey Report 2011-12: Gross District Domestic Product at Constant Prices (2005-06). Accessed March 18, 2015, http://finance.bih.nic.in/Documents/Reports/Economic-Survey-2012-EN.pdf
11. Government of India. 2014. State-wise Per Capita Income and Gross Domestic Product at current prices. Accessed July 2, 2015, http://pib.nic.in/archieve/others/2014/aug/d2014070801.pdf12. UNICEF. 2013-2014. Rapid Survey on Children (RSoC). http://wcd.nic.in/RSOC/21.RSOC_Bihar.pdf 13. Robert E Black, Cesar G Victora, Susan P Walker, Zulfiqar A Bhutta, Parul Christian, Mercedes de Onis, Majid Ezzati, Sally Grantham-McGregor, Joanne Katz, Reynaldo Martorell, Ricardo Uauy, and
the Maternal and Child Nutrition Study Group. 2013. “Maternal and Child Undernutrition and Overweight in Low-Income and Middle-Income Countries”. The Lancet 382 (9890), 427-451.14. Planning Commission. 2013. Press note on poverty estimates, 2011-12. Government of India. Accessed March 18, 2015. http://planningcommission.nic.in/news/pre_pov2307.pdf15. Government of Bihar. 2015. Economic Survey 2014-15. Accessed July 2,2015, http://finance.bih.nic.in/Documents/Reports/Economic-Survey-2015-EN.pdf16. Government of India. 2014. State-wise Per Capita Income and Gross Domestic Product at current prices. Accessed July 2, 2015, http://pib.nic.in/archieve/others/2014/aug/d2014070801.pdf17. Photo Credit: Stephan Rebernik. 2012. https://www.flickr.com/photos/stephanrebernik/7316902886/in/photolist-c9z3j3-84jAhD-dBqB49-bvwZKN-r9S16m-7hbFtw-ww5wR-k32J4Y-9EU6Yp-aMYGun-
qRTqtX-ecqSzg-gqsndt-dgcPVa-rir84x-e7rvKp-4W6FEL-b4cBSB-5Fobvq-gkNLN6-97MFur-52bDg-aE6CHE-5CWZqw-89D8Wg-C2Xyr-5JVCfB-8HyAVb-95jZH-96TGaG-89Daqn-hZXBgK-btaPQj-d4x1D9-kF5uPx-97MTqk-89D9ia-pSsahb-3fr98n-47wCFN-5dVprx-zfuF1-dB9Zrp-ww5c6-sq8LAW-8kUfxq-9ydJB-kqG1vB-aashk1-7a41P1
Last Trimester^ Within 1 week of delivery*Within 24 hours of delivery
Less than recommended
Equal to recommended
More than recommended
Less than recommended
Equal to recommended
More than recommended
Bihar 4.1% 6.7% 22.5% 26.4% 5.7% 5.4% 34.1%
Lakhisarai 10.3% 10.6% 16.3% 31.5% 8.3% 3.4% 36.7%
FLW visits4
^2 recommended visits; *3 recommended visits
Areas for immediate action: • Access to skilled health personnel and Sub-Health Centres is
very limited • Less than half of eligible households receive any take home
ration• Poor access to financial assistance for delivery and child care• Majority of households do not have PDS accessData challenges:• Lack of data on assessing the implementation of government
schemes