54.8

95.2

39.56

50.56

16.87

96.2

Children aged <5years underweight

(%)2,4

Children aged <5years stunted

(%)2,4

Children aged <5years wasted

(%)2,4

Children aged <6years anemic (%)3

Chronic energydeficiency inwomen (%)

Mothers with lowbirthweightchildren (%)

Adults who areobese in thedistrict (%)

Lucknow Uttar Pradesh

Lucknow, Uttar Pradesh

DISTRICT NUTRITION PROFILE

Page 1

THE STATE OF NUTRITION IN LUCKNOW

DISTRICT DEMOGRAPHIC PROFILE

Total Population 4589838

MALE FEMALE

RURALURBAN

SC ST OTHERS

CHANGES OVER TIME

**2002 (DLHS-2) for the district level indicators; no data for comparison of trends*2002 (DLHS-2) to 2005-06 (NFHS-3)

Uttar Pradesh (2002 to 2005-06)*(Children aged <5 years)

Lucknow 2002-2011**(Children aged <5years)

2002 2005-06 2002 No latest data

Underweight 52.1% 39.6% 54.8% No data

Stunting No data 50.6% No data No data

Wasting No data 16.9% No data No data

NO DATA ON CHILDREN STUNTED

NO DATA ON CHILDREN WASTED

NO DATA ON WOMEN UNDERWEIGHT

CHILDREN UNDERWEIGHT4

54.8%

52.2% 47.8%

20.7% 0.2% 79.1%

66.2% 33.8%

NO

DA

TA

NO LATEST DATA AT THE DISTRICT LEVEL TO UNDERSTAND TRENDS IN NUTRITION

NO

DA

TA

NO

DA

TA

NO

DA

TA

NO

DA

TA

NO

DA

TA

NO

DA

TA

NO

DA

TA

6.0%9.9%

52.4%

42.5%

8.8%

60.5%

7.1%

46.9%

56.2%

11.2%

30.3%

11.5%16.2% 17.4%

58.1%

Early initiation ofbreastfeeding

Exclusivebreastfeeding

Children between6-8 mo whoreceived any

solid/semi solidfood in the last 24

hours

Children whoachieve minimum

diet diversity

Full immunizationcoverage

Children (12-35mo) who got

vitamin Asupplementation

Acute diarrhoeain children <2

years in previous2 weeks

Children <5 yearswith diarrhoeatreated to ORS

Women aware ofdanger signs of

pneumonia

84.7%

96.7% 96.2%

64.4%

95.8% 97.8%

Women with accessto antenatal care

coverage

Anemia amongpregnant women

Anemia amongadolescent girls

Lucknow Uttarpradesh

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

Areas for immediate action:

Data challenges:• Outdated data; poor availability of data on key immediate

determinants of undernutrition• Where data are available, indicator definitions are non-

standardized and often differ from World Health Organization recommendations

• Poor state of infant and young child feeding (IYCF): low rates of exclusive breastfeeding and timely initiation of breastfeeding

• Need to improve immunisation rates to cover complete target population

• Alarming levels of anaemia among pregnant women and adolescent girls

IMMEDIATE CAUSESBreastfeeding, nutrient rich foods, and eating routine

Feeding and caregiving practices, parenting stimulationLow burden of infectious diseases

Optimum fetal and chid nutrition and development

WHAT FACTORS CAUSE UNDERNUTRITION? 7

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 life

WHEN TO INTERVENE TO IMPROVE NUTRITION?

NO

DA

TA

ADOLESCENT & MATERNAL HEALTH3,6

DISEASE INCIDENCE5,6IMMUNISATION & SUPPLEMENTATION6INFANT & YOUNG CHILD FEEDING2,5

0

20

40

60

80

100

Per

cen

tage

of

child

stu

nti

ng

(%)

Age of child (in months)

Too lateWindow of opportunity

NO

DA

TA

NO

DA

TA

45.5%

22.8%15.2%

3.1%11.2%

49.1%

23.8%19.5%

3.7%

29%

Householdshare of

expenditure onfood

Householdshare of food

expenditure oncereals

Householdshare of food

expenditure onmilk

Householdshare of food

expenditure oneggs/fish/meat

Households inthe districtinvolved inagriculture

Food Security8

Page 3

UNDERLYING CAUSES OF UNDERNUTRITION

BASIC CAUSES OF UNDERNUTRITION

Areas for immediate action: • Very poor availability of data on indicators of women’s status; low standard of living for women is related

to poor health and nutrition outcomes of babies• Food insecurity, especially diet quality, is a challenge that can hold back improvements in nutrition

Data challenges:• No district level data available on mothers’ schooling, land ownership or hygiene indicators. • Difficult to compare indicators of water, sanitation and hygiene over time as census data do not provide data

on child stool disposal or on hand washing

• District domestic product of Lucknow:10

17885.5 (in Rs. Crores)

• Access to services can be improved

but data on access are also poor1,6

(see figure on right)

• Governance and political will to address nutrition

No Data

State domestic product of Uttar Pradesh :423261.46 (in Rs. Crores)

30.0%

91.5%

31.1%

92.4%

72.0%

50.8%

83.3%

44.4%

100.0%

74.7%

Births attended by skilled health personnel

Household has access to Anganwadi Worker

Household has access to a Sub Health Centre

Household has access to Primary/Middle School

Access to NREGA

Households availing Bank services

Lucknow Uttar Pradesh

No data available

No

Dat

a

18.2%

32.9%

8.6% 11.3%

Girls marriedwhen <18years

old

Ever marriedwomen/motherswho completedprimary school

Women whocompleted

secondary school

Women'sownership of

land

Women'sownership of

livestock

Women's Status6

No

Dat

a

No

Dat

a

94.0%

62.8%

32.2%

88.6%

31.4%

63.0%

22.97%

Access toimproved

drinking-watersources

Access toimprovedsanitationfacilities

Opendefecation

Child stooldisposal in a

sanitary manner

Householdswho washed

hands with soapbefore a meal

Water Sanitation & Hygiene (WaSH)1,2

78.7%70.8%

29.4%

64.9%

36.8%

Below PovertyLine households

Householdsownership of

agricultural land

Households in apermanent house

Access toelectricity

Poverty1,9

68.1%

57.3%

Adult Literacy Rate(%)

OtherIndicators1

No

Dat

a

No

Dat

a

No

Dat

a

No

Dat

a

No

Dat

a

No

Dat

a

No

Dat

a

No

Dat

a

No

Dat

a

This District Nutrition Profile was developed by Shruthi Cyriac for POSHAN. This version, dated July 25, 2014 is a draft intended for use in a district-level workshop in Lucknow, Uttar Pradesh, and will be revised following workshop discussions.

WHAT WILL IT TAKE TO IMPROVE NUTRITION IN LUCKNOW?

Sou

rce:

UN

ICEF

Ind

ia/2

01

0/

Gra

ham

Cro

uch

Possible district-levels actions to support nutrition:

Data sources 1. Census of India 2011, accessed on June 20, 2014, http://censusindia.gov.in/2. National Family Health Survey-3 dataset3. District Level Health Survey-2 (2002-04) Nutrition Report, accessed on August 1, 2014, http://www.rchiips.org/PRCH-

2.html4. District Level Health Survey-2 dataset5. District Level Health Survey-2 (2002-04) State Report, accessed on August 1, 2014, http://www.rchiips.org/PRCH-2.html6. District Level Health Survey-3 (2007-08), accessed on August 1, 2014, http://www.rchiips.org/PRCH-3.html7. The politics of reducing malnutrition: building commitment and accelerating progress. S Gillespie, L Haddad, V Mannar,

P Menon, N Nisbett. Lancet 382 (9891), 552-5698. National Sample Survey 68th Round9. Planning commission data, accessed on June 15, 2014, http://planningcommission.nic.in/news/pre_pov2307.pdf10. Uttar Pradesh Directorate of Economic and Statistics, accessed on June 1, 2014,

http://updes.up.nic.in/STATE%20ACC%20STATISTICS/NDDP%20&%20GDDP/statedomestic(b).htm11. Annual Health Survey- 2012-13, accessed on May 22, 2014,

http://www.censusindia.gov.in/Vital_Statistics/AHSBulletins/AHS_Bulletin_2012-13_Presentation.pdf