India is the sixth largest and fastest growing economy in the world. While we have the world’s third highest number of billionaires, we are also home to an astounding 190 million undernourished people, the highest in the world, leading to a loss of nearly 4% of India’s GDP1. India is also home to 253 million adolescents, a majority of whom have low BMI and are anemic. According to national data 41.9% girls and 44.8% boys between 15-19 years are underweight (BMI <18.5) while 54% of girls and 29% of boys are anemic2.
In recent times, Govt. of India has taken progressive steps, such as the launch of a nation-wide Poshan Abhiyaan or National Nutrition Mission, focusing on improving convergence between relevant departments to address undernutrition and anemia3. To support the Govt. of India, JSI R&T India Foundation in partnership with NGO SHARP launched ‘Project ANSH’ in February 2018. ANSH is supported by GSK Consumer Health under their Corporate Social responsibility (CSR). The project is implemented in one district each of four northern and eastern states of India with poor nutrition indicators i.e. Uttar Pradesh, Bihar, Assam, and Madhya Pradesh. ANSH aims to reach 150,000 rural adolescents to improve their Body Mass Index (BMI) and reduce Anaemia. The strategy is multi-pronged, seeking to improve nutritional literacy & WASH practices, strengthening nutrition services and promoting consumption of fortified foods and weekly Iron Folic Acid (IFA) supplementation among adolescents. In two of the larger districts, Bahraich district of UP and Gaya district of Bihar, a core group of 2000 school-going and 400 non-school going adolescents is being more intensely counseled to adopt healthy nutrition practices using one-to-one and group counseling methodologies. They will be regularly followed-up to document the changes in their behavior and in their nutrition parameters with the larger objective to generate evidence and learnings for further scale-up.
A project baseline survey of the above-mentioned core group of adolescents (10-19 years) was done in Oct-Nov 2018, capturing their height and weight to calculate BMI (calculated as Weight/Height in meteres2). A BMI of 18.5-24.9 is considered normal while anything below and above is underweight or overweight respectively.
As seen in Figure 1, In Bahraich the survey yielded poorer status than UP averages (NFHS 3), with 89%
boys and 75% of girls underweight. The difference between the two genders was significant. A very small proportion of children were overweight.
With 51% boys and 48% girls underweight (figure 2), the situation among adolescents of Gaya district
was better than Bahraich but very similar to Bihar averages. A mere 2% of children were overweight.
Overall, the survey data presents a substantially poor nutritional situation of adolescents in Bahraich
than estimated through a national survey and worse for boys than girls. The sudden growth spurt
among boys may be the responsible factor. As the project progresses, we will document nutrition and
WASH practices of the adolescents of this region in an attempt to identify factors that may be
responsible for the current situation.
Currently, the project is in the process of connecting with those adolescents and their parents
identified with low BMI to enroll them in regular interpersonal and group counseling sessions on
nutrition and hygiene. In the near future, we will also document the Hemoglobin status of the core
group of children with the aim to initiate targeted interventions for those with anemia to raise their
Authors: Dr. Amrita Misra, Ashok Singh, Abhishek Anand, Ranajit Sengupta