Some of India's major cities have worse rates of child malnutrition than rural India, an analysis of data from the National Family Health Survey shows.
The data shows that over a quarter of children under the age of five are stunted (low height for age) in all of India's major state capitals, except in Kochi and Hyderabad. Bhopal has higher rates of child stunting than the rural Indian average, and Patna, Jaipur and Bhopal have worse levels of child stunting than Nigeria; in fact Delhi and Nigeria have nearly the same level of child stunting. Stunting is a key indicator of child malnutrition, and indicates that the child's height for her age is more than two standard deviations lower than expected.
According to the data, over a quarter are classified as wasted (low weight for height) in Mumbai, Bengaluru, Lucknow and Ahmedabad. While 7.4 per cent of rural children are severely wasted, this proportion is far higher in several big cities including Bengaluru, Chennai, Ahmedabad and Lucknow.
Over 20 per cent of children under the age of five are underweight in all megacities except Kochi and Hyderabad. Bhopal and Patna have a higher proportion of children underweight than Sudan.
Mumbai and Ahmedabad have particularly low levels of child immunisation, with just half of all children aged 12-23 months having received BCG, measles and three doses each of polio and DPT vaccines. A senior health official in Mumbai who asked not to be named blamed Mumbai's low immunisation coverage on constantly shifting migrant populations.
"Cities are home to immense inequality, even more so than in rural areas. So these malnutrition averages for big cities could be hiding the extremes. Particularly those who live in slums and in resettlement colonies could be very vulnerable to high rates of stunting," says Purnima Menon, nutrition expert, and Senior Research Fellow at the International Food Policy Research Institute's Poverty, Health and Nutrition Division. "The causes to some extent are the same as the causes more generally of malnutrition - lack of proper sanitation, lack of access to proper nutrition. In addition, social safety nets particularly for new migrants could be particularly weak, and these are almost entirely market dependent groups," Menon says.
Cities are home to immense inequality, even more so than in rural areas. So these malnutrition averages for big cities could be hiding the extremes.
The fourth round of the NFHS data was released in March this year after a gap of ten years and includes crucial data on child malnutrition. The NFHS is an internationally recognised, representative household-level large sample survey. Data for cities was derived from district level factsheets, and only the urban portion of the district was considered for this analysis.