The Complex Web Behind Indian Persistent Stunting Crisis

The Complex Web Behind Indian Persistent Stunting Crisis

Why in News

India continues to face a persistent stunting crisis among children, despite major national nutrition initiatives like POSHAN Abhiyaan, which was launched in 2018 with the aim of reducing stunting rates by 25% by 2022. According to the POSHAN Tracker (June 2025), stunting levels among children under five remain alarmingly high, standing at 37%, only a marginal reduction from 38.4% recorded in NFHS-4 (2015-16).

Experts attribute this slow progress to a host of interlinked issues, including teenage pregnancies, poor maternal and child nutrition, inadequate dietary diversity, low access to sanitation, and limited awareness about early childhood care. This has raised urgent concerns about India’s ability to meet its long-term Sustainable Development Goals (SDGs) on health and nutrition.

Introduction

Stunting is defined as a child being too short for his or her age due to chronic or recurrent undernutrition. It is not merely a measure of physical growth but a deeper reflection of cumulative deprivation—poor maternal health, inadequate child nutrition, early marriages, low access to healthcare, and poor sanitation.

In India, stunting affects over one-third of children below five years of age, making it one of the most critical public health and developmental challenges. Stunting has life-long consequences: reduced learning abilities, higher susceptibility to diseases, lower productivity, and a greater risk of poverty in adulthood.

Despite significant policy efforts, India’s progress in combating stunting has been sluggish. The ambitious target set by POSHAN Abhiyaan—to reduce stunting from 38.4% in 2016 to 25% by 2022—remains unmet, with current figures only showing marginal decline. This stagnation points to the multi-dimensional and complex nature of malnutrition, which cannot be solved by food supplementation alone.

Key Issues and Background

1. Teenage Pregnancies and Early Motherhood

• Nearly 6.8% of women aged 15–19 had begun childbearing as of NFHS-5 (2019–21).

• Early pregnancies mean the mother’s body is not biologically prepared to bear children, leading to low birth weight and greater risk of stunting.

• Young mothers are also less likely to provide adequate nutrition and care to their newborns.

2. Poor Maternal Nutrition

• Anaemia among mothers is widespread—affecting nearly 57% of women aged 15–49.

• Malnourished mothers give birth to malnourished babies, perpetuating the cycle of undernutrition.

3. Inadequate Infant and Young Child Feeding

• Only 11% of Indian children under two years meet the standard for a minimum acceptable diet.

• Exclusive breastfeeding for the first six months is followed by inadequate complementary feeding.

• Out of 23 months, only a small proportion of children receive both adequate dietary diversity and meal frequency.

4. Lack of Dietary Diversity

• Indian diets remain heavily carbohydrate-heavy (rice, wheat) with little protein or micronutrient intake.

• Most poor households rely on rice-based meals, lacking vegetables, eggs, and pulses.

5. Sanitation and Hygiene Deficit

• Around 19% of households in India still lack access to toilets, leading to high exposure to infections.

• Open defecation and poor sanitation contribute to enteric infections, which prevent nutrient absorption even when food intake is sufficient.

6. Education and Awareness Gaps

• Parents, especially mothers, often lack awareness about balanced diets, importance of exclusive breastfeeding, and antenatal care.

• Adolescent girls in particular miss out on interventions that can improve nutrition before motherhood.

7. Policy-Implementation Gap

• Although POSHAN Abhiyaan has brought nutrition into the spotlight, implementation remains fragmented and uneven across states.

• Food supplementation under Anganwadi centres often lacks dietary diversity, with many children receiving only rice-based meals.

Specific Impacts or Effects

1. Health Impacts

   • Stunted children are more vulnerable to diseases like diarrhoea, pneumonia, and anaemia.

   • Poor cognitive development leads to lower IQ levels.

2. Educational Outcomes

   • Stunted children perform worse in school, leading to higher dropout rates and poor educational achievements.

3. Economic Impacts

   • Stunting reduces future workforce productivity, leading to a cycle of poverty and low economic growth.

   • According to global studies, malnutrition can reduce a nation’s GDP by 2-3% annually.

4. Intergenerational Cycle

   • Malnourished mothers give birth to underweight babies, who grow up stunted and become malnourished mothers themselves.

5. State-wise Disparities

   • Uttar Pradesh, Jharkhand, and Bihar continue to have some of the highest stunting rates (above 40%).

   • Kerala, Punjab, and Tamil Nadu fare better but still have worrying numbers.

Challenges and the Way Forward

1. Tackling Teenage Pregnancies

• Strengthen enforcement of the Prohibition of Child Marriage Act.

• Provide comprehensive sex education and expand adolescent health programs.

2. Improving Maternal Nutrition

• Universal screening and treatment of anaemia among women of reproductive age.

• Strengthen maternal health schemes like Janani Suraksha Yojana with nutrition-focused interventions.

3. Enhancing Child Nutrition

• Improve complementary feeding practices through community outreach.

• Ensure dietary diversity in Anganwadi meals—include eggs, pulses, and vegetables instead of only rice/wheat.

4. Strengthening Sanitation

• Achieve universal toilet access under Swachh Bharat Mission 2.0.

• Link sanitation with nutrition outcomes in rural and urban areas.

5. Education and Awareness

• Launch mass awareness campaigns on early childhood nutrition.

• Train Anganwadi workers to spread awareness among mothers.

6. Integrated Policy Approach

• Nutrition cannot be addressed by food schemes alone. A holistic approach involving healthcare, sanitation, education, and women’s empowerment is needed.

7. Monitoring and Accountability

• Strengthen real-time monitoring under the POSHAN Tracker.

• Ensure state accountability for nutrition targets through regular audits.

Conclusion

India’s stunting crisis is not just a health issue—it is a national development challenge. Despite decades of policies, the problem persists because of interlinked social, economic, and cultural factors. Teenage pregnancies, maternal malnutrition, poor dietary diversity, and lack of sanitation together create a web of deprivation that traps millions of children in a cycle of poor growth and lost opportunities.

If India is to achieve its SDGs and ensure a healthier, more productive future generation, it must adopt a multi-sectoral, holistic approach. The fight against stunting requires not only nutritional supplementation but also empowerment of women, improved sanitation, better education, and stronger policy implementation. Breaking the cycle today will determine the health, productivity, and prosperity of tomorrow’s India.

5 Questions and Answers

Q1. What is stunting and why is it a major concern in India?
A1. Stunting is when a child is too short for his or her age due to chronic undernutrition. It is concerning because it affects physical growth, brain development, learning abilities, and future productivity, creating long-term national consequences.

Q2. What are the key factors behind India’s high stunting rates?
A2. The major factors include teenage pregnancies, poor maternal nutrition, lack of dietary diversity, inadequate breastfeeding and complementary feeding, poor sanitation, and lack of awareness among parents.

Q3. Why has POSHAN Abhiyaan failed to meet its stunting reduction targets?
A3. While POSHAN Abhiyaan created awareness, it suffered from implementation gaps, lack of dietary diversity in government food schemes, weak monitoring, and inadequate integration of sanitation and health services with nutrition efforts.

Q4. How does stunting impact India’s economic growth?
A4. Stunting reduces workforce productivity, lowers educational outcomes, and perpetuates poverty. It can cost India 2–3% of its GDP annually, making it not just a health but also an economic challenge.

Q5. What steps can India take to reduce stunting effectively?
A5. India must adopt a multi-sectoral approach—improving maternal nutrition, delaying early pregnancies, ensuring dietary diversity in child feeding, strengthening sanitation programs, raising awareness, and holding states accountable for nutrition outcomes.