THE LANDSCAPE

In Chhattisgarh, just over three-quarters (77%) of the households are in rural areas. On average, households are comprised of 4.4 members. Sixteen percent of households are headed by women, with 13 percent of the population living in female-headed households. Over one-quarter (26%) of Chhattisgarh’s population is under age 15; only six percent is age 65 and over. The overall sex ratio of the population is 1,015 females per 1,000 males, and the sex ratio of the population under 7 years of age is lower at 947 females per 1,000 males.

Children’s nutritional status in Chhattisgarh has hardly changed since NFHS-4 by all measures. The percentage of children who are stunted decreased marginally from 38 percent to 35 percent in the 4 years between NFHS-4 and NFHS-5. The percentage of children who are underweight (31%) or wasted (19%) has decreased since NFHS-4. However, the continuing high levels of under nutrition are still a major problem in Chhattisgarh.

The infant mortality rate in Chhattisgarh in NFHS-5 is estimated at 44 deaths before the age of one year per 1,000 live births, down from the NFHS-4 estimate of 54, the NFHS-3 estimate of 71, and the NFHS-2 estimate of 81. The under-five mortality rate (U5MR) is estimated to be 50 deaths before five years of age per 1,000 live births, declined since NFHS-4 (64 per 1,000).

Among mothers who gave birth in the five years preceding the survey, 85 percent received antenatal care for their last birth from a health professional (41% from a doctor and 45% from an auxiliary nurse midwife (ANM), lady health visitor (LHV), nurse, or midwife). Five percent did not receive any antenatal care (ANC). The percentage of births in a health facility increased in the 4 years from 70 percent (NFHS-4) to 86 percent (NFHS-5).

Eighty percent of children under 6 years received services of some kind from an anganwadi centre in the 12 months preceding the survey. The most common services that age-eligible children receive are growth monitoring (79%), supplementary food (78%), health check-ups (74%), and immunizations (67%). The service that is least likely to be accessed is early childhood care or preschool (65%).

Although breastfeeding is nearly universal in Chhattisgarh, only 80 percent of children under 6 months are exclusively breastfed, as the World Health Organization (WHO) recommends. Ninety-two percent are put to the breast within the first day of life, but only 32 percent started breastfeeding in the first hour of life (as recommended). While exclusive breastfeeding indicators show an improvement since NFHS-4, many infants are still deprived of the highly nutritious first milk (colostrum) and the antibodies it contains.

More than one-third (37%) of women and 32 percent of men are either too thin or overweight or obese. Among women age 15-49, the proportion overweight or obese is 14 percent, which is slightly lower in NFHS-4 (12%). More men are thin (17%) than overweight or obese (15%). Twenty-three percent of women in Chhattisgarh are too thin. Over three-fifths of women (63%) 23 and 68 percent of men are at a healthy weight for their height. Under nutrition is particularly common in the younger age groups (especially age 15-19), in rural areas for women, and among scheduled tribes.

Fifty-five percent of women and 44 percent of men have a waist-to-hip ratio (WHR) that puts them at a substantially increased risk of metabolic complications.

Anaemia is a major health problem in Chhattisgarh, especially among women and children. More than two-thirds (67%) of children age 6-59 months are anaemic. This includes 29 percent who are mildly anaemic, 37 percent who are moderately anaemic, and 2 percent who have severe anaemia. The overall prevalence of anaemia in children increased from 42 percent in NFHS-4 to 67 percent in NFHS-5. There is a little difference in the prevalence of anaemia among girls and boys. Children of mothers who have anaemia are much more likely to be anaemic. Although anaemia levels vary somewhat according to background characteristics, anaemia among children is widespread in every group.

Sixty-one percent of women in Chhattisgarh have anaemia, including 27 percent with mild anaemia, 31 percent with moderate anaemia, and 3 percent with severe anaemia. Anaemia is particularly high among rural women, and scheduled tribe women, but anaemia exceeds 51 percent for every group of women. Anaemia among women has increased by 14 percentage points since NFHS-4. Over one-quarter (27%) of men in Chhattisgarh are anaemic.

Based on the findings from the evidence, technical and research studies, the CFNS and the potential partners will jointly work to take the Coalition agenda forward. In order to expand and catalyse the actions, the multi-stakeholder platforms at state and district level will work on revitalizing coordination and convergence mechanisms at sector, village and local governance level for a better impact delivery of nutritious foods.