Child Stunting in Bihar
For many of us child stunting will be a new concept but many children in the backward areas of the country are suffering from it. If talked globally there are around 209 million stunted children all around the world which is a huge number. Childhood stunting is reduction of growth rate in human development and can also be referred as primary manifestation of malnutrition in early childhood or before birth.
Causes and effects of Stunting
The main conditions leading to stunting of growth of children in India are poor feeding practices, poor maternal nutrition as well as poor sanitation. With increase in poverty in India, the children have suffered the most. There has been lack of adequate feeding of children as well as food which are deficient in vital nutrients are also given to them which is one reason for the stunted growth. Not only the child’s health but the deterioration of maternal health is equally responsible for stunting. Ill health of the mother during pregnancy and breastfeeding leads to stunted growth of children mothers who are anaemic during pregnancy are more likely to transmit intergenerational stunting. All these reasons of stunting are loosely connected to another reason i.e. poor sanitation. Household sanitation practices have great influence on the health of the whole family especially the younger ones. Children are more likely to ingest fecal bacteria by touching household items as well as putting dirty fingers in their mouth which leads to intestinal infections. This further leads to loss of nutrients from the body of children, reduction of absorption of nutrients as well as diminishing of hunger.
All these reasons lead to a great danger to public health. The obvious short stature of the human due to stunting poses great risk to health and even cause premature death. This not only hinders physical development but also hampers mental development of the child and reduces his/her cognitive capacity. The problem of stunting is transmittable through generation for instance woman of a short height due to stunting is more likely to transmit the problem to her offspring and hence, this danger passes through generations and poses a risk to future of the country.
Childhood stunting in Bihar
The state with third largest population in the country is Bihar having around a million of people out which around 13 million are under the age of five. Also, Bihar tops the list of the poorest states of India especially rural areas having approx 30 % of the population below poverty line. As discusses above, one of the fundamental reasons of stunted growth is poverty because the poor does not even get two time food let alone basic nutrients in their food as well as proper medical care which leads the younger population malnourished with short stature. In Bihar the maternal health is a serious concern as 60% of the pregnant women in the state are anaemic. Also, child marriage is one of the leading factors causing stunting as the female after marriage is not ready to bear a child in her womb and hence, give birth to premature babies or babies with abnormal growth. Even during pregnancy, lack of health care facilities in the state is responsible for the stunted growth of the baby. Minimum seven antenatal checkups are required for the mother but only 14% of the pregnant population reaches for four antenatal checkups. Basic childcare in the state is very rare as out of 38 districts only 19 have access to ORS (prescribed by WHO). In gender context, Bihar is the worst affected because of its sex ratio as well as low literacy levels.
During pregnancy, risk of a poor pregnancy outcome increases if the mother does not have access to essential healthcare facilities. Timely care as well as early inclusion of nutrients in the diet of the mother is optimal for the development of foetus. Despite improvement of the country due to declination of stunting but Bihar still is lagging behind in this race. For states like Bihar with a multi-million birth cohort, these are troubling numbers.
Conclusion
As compared to 10 years ago data, lesser of India’s children may now be stunted but the numbers are still very dismal. The irreversible damage done by the stunted growth includes delayed physical and mental development especially impaired cognitive function that leads to poor performance at study which in turn is increasing illiteracy in Bihar. At the same time, continued progress is needed to scale up all essential interventions. Collecting real-time data at the district level on all the indicators is critical for the preparation of district action plans to reduce child stunting.
In Bihar improvement in surveillance of nutrition to identify trends of stunting and other forms of malnutrition within the state is a necessary condition to address the problem effectively. The same should be done for risk factors such as anaemia, maternal under-nutrition, food insecurity, low birth-weight, breastfeeding practices etc. Political will to develop and implement national targets and strategies in line with evidence-based international guidelines as well as contextual factors. Hence, there is a lot more to do in Bihar to save the country’s future from deteriorating health conditions.
