Malnutrition in India Essay

gate -Mal regi hands is fix to be a leading killer through surface the orbit, with at a lower place forage in the developing world the main nutrition hassle. The World Bank Estimate that India is ranked 2nd in the world of the bet of electric razorren scurvy from malnutrition after comeladesh (1998), w here 47% of the Children exhibit a sh atomic number 18 point of malnutrition. India is one of the fastest ripening region in marges of spate and economic growth rate , sitting at a nation of near ab go forth 1200 million (December 2010) and economy growing by 9% GDP growth rate from 2007-2008. Since independence Indian economy treated as low income state with majority of population at or to a lower place the p all overty line which is lead to paradoxs of malnutrition, hunger etc. the combination of people leaving in poverty and the repenny economic growth of India (as substantially as Maharashtra)has led to the co-emergence of both type of malnutrition1) Unde rnutrition2) Overnutrition.The case Family wellnessy pursue 2005-2006 shows that, while Maharashtra is one of the closely developed State among the country, It has in some(prenominal) case occupation of Malnutrition exists, merely nutrition feature in Maharashtra is slightly kick downstairs than the subject orbital cavity bonnie. subject field Nutrition Monitoring Bureau (NNMB) paper quoted that much than 40 lakh children were affected with variety 2 to 4 malnutrition in Maharashtra. This denominate the seriousness of the trouble of malnutrition.Definition of the Term MalnutritionMalnutrition carries different con nonations to different people. To some, malnutrition fashion undernourishment, while to others it means starvation. Some confuse malnutrition with hunger while others consider malnutrition as undernutrition. The writer would like to define the term malnutrition in the hobby pages and differentiate it from the other similar terms.MalnutritionThe word maln utrition might best be reserved to signalise the state of ill- wellness of a population or of some(prenominal) group of people in so far-off as that motive is consumed either by malnourishment or undernourishment. It is thus, to an extent, a medical term or a term for human bes health purposes. The students of public health be showing a tendency to use that term in much(prenominal) a sense to a greater extent(prenominal) consistently. The existence of malnutrition is revealed in miscellaneous morbid conditions and it is measurable in terms of indices which be medical, anthropological, or biostatistical (such as height, heaviness unit, and special diseases, etc. )Malnutrition is the condition that develops when the body does not get right hand amount of Vitamins, Minerals and other nutritions (Proteins) is needs to admits healthy tissues and harmonium function.Malnutrition occurs in people who argon either undernourished or over nourished. Undernutrition is a conse quence of consuming as well as few essential nutrients or excreting them more rapidly than they can be replaced. sisters, teenagers, young children, large(predicate) and breastfeeding women require additional nutrients. Overnutrition results from eating as well much eating too many another(prenominal) of the wrong things, not exercising enough or taking too many vitamins or other legislatetetic replacement malnourishmentRefers to an existent condition of diets in which not the quantity, but the quality of the feed stuff is to a fault involved. gibe to the present knowledge, a diet must(prenominal) supply some 30 or more nutrients in secernate to provide the proteins of high quality, as well as zipper pliable food. A population is give, even if it is able to use and is in the attire of using a quantity of energy yielding food stuffs, but if the people argon either unable or unaccustomed to maintain a fit diet including all the proper nutrient elements in correct pro portion, is still forgathering from malnourishmentUndernourishmentExpresses a dietary condition more often than not among the working people in which at that place is an actual insufficiency both in quantity and in quality of nutritive elements needed for health and well- creation.-Objectives of the studyWe nominate attempted to discuss the of import issue child malnutrition in Maharashtra State. Therefore we waitress at the pursuance objectives regarding malnutrition study in the state.1. To discuss the status of child malnutrition in the state.2. To recuperate out the major causes of malnutrition.3. To find out the effects / incidence of malnutrition line of work.4. To divvy up the way to eradicate the malnutrition tasks. MethodologyIn this research paper we generally used the secondary kind of data for analysis the issue. Researchers used large-analysis rule for analyze the malnutrition in the country as well as Maharashtra State.Types of Malnutritioneach form of ma lnutrition depends on what nutrients are missing in the diet, for how long and what age.A) Proteins cypher Malnutrition (PEM)This is the most basic kind of malnutrition, results from a diet lacking in energy and Protein because of a deficit in all major macro nutrients such as carbohydrates, fats and Proteins.B) Micronutrients deficienciesMicronutrients deficiencies are also a widespread problem in India. More than 75% of pre check children suffer from iron inadequateness anaemia (IDA) and 57%preschool children shake subclinical vitamin A deficiency (VAD). Iodine deficiency is endemic in 85% districts (In India) mostly due to the lack of iodinated salt. The prevalence of deferent micro nutrients deficiency varies widely across states.Degrees of Malnutrition mixture of Protein Energy Malnutrition (PEM) is done by Gomez. Degree of PEM % of desired body weight for age and sex.1. Mild Malnutrition (Grade I )90% -100%2. Moderate Malnutrition (Grade II)75% 89%3. Severe Malnutrition (Grade III) 60%Status of Malnutrition in Maharashtra -As far as Maharashtra State is concern, deaths regarding to the malnutrition seems high in tribal dominated districts e.g. Gadchiroli, Amravati, Yewatmal, Chandrapur, Bhandara and Melghat etc. Dr. Abhay Bang committee (2004) account statemented that mingled with 1.20 lakh and 1.75 lakh children diet any(prenominal)(prenominal) social class in the state for medical reasons. The storey blamed an unreactive bureaucracy for the plight of nearly 8 lakh children whose lives were stakeed by category 3 or 4 malnutrition. gibe to the written report during 1988 to 2002 the perpennyage of affected by grade 3 or 4 malnutrition had travel by mere 0.6% solely which is found curt betterments.According to interior(a) Nutrition Monitoring Bureau (NNMB) study quoted that more than 40lakh children were affected with grade 2 to 4 malnutritionin Maharashtra. It estimated that 82000 children died both Year in country-bred areas of th e state 23, 500 in the tribal areas and 56000 in urban slums.According to the presidency statistics in the stallion Maharashtra state child death were estimated 45,000 (during July 2004 to June 2005) due to the malnutrition out of these 12,000 fall flow to severe malnutrition and the keep oning 33,000 children died due to the mild or moderate malnutrition. The malnutrition is also the underlying cause in approximately 480 of the 2850 maternal deaths each year in the state.Child Death And Action Group (CDSAG) study found that 10.4% child death are recorded on an account of malnutrition in the state. Tribal Dominated Districts of Amravati, Yewatmal, Gadchiroli, Chandrapur and Bhandara in Vidarbh region as well as Melghat in North Maharashtra region were affected worsely by malnutrition problem. most 38% of children under age trine are stunted (India 38.4%) Almost 40% are weedy (India 45.9%) There is a strong correlation amongst child malnutrition and the take of maternal instruction. There are significance battles mingled with country-bred and urban areas, where the farming(prenominal) areas world more affected by malnutrition. The prevalence of overweight and obesity in Maharashtra is higher than the subject average for both male and female.Causes of Malnutrition1. The economist Amartya Sen discover that poverty is major cause of malnutrition and famine has always a problem of poverty and unbalanced distribution of food.2. Hike in food prices or food inflation.3. Insufficient food production (availability)4. Changes in climate threaten the food security.5. People with drug or alcohol dependencies are also at increased risk of infection of malnutrition.Effect of MalnutritionMalnutrition including both protein energy malnutrition and micro nutrient deficiencies not only affect physical appearance and energy level, but also in a flash affects many aspects of the children mental functions, growth and evolution. According to the Jean Ziegler UN special report on the right to food (for 2000 to border 2008), death rate due to malnutrition accounted for 58% of the total mortality in 2006. adept in twelve people world wide is give. WHO, also indicate that malnutrition is the biggest contributor to child mortality. Malnourished children grow up with worse health and lower educational achievements. Their own children also tend to be smaller. Malnutrition increases the risk of infection and infectious disease. Malnutrition affects adversely physically as well as psychologically. Malnutrition in the form of ioden deficiency is most common preventable cause of mental impairment worldwide. Ioden deficiency specially in heavy(predicate) women and infants, move intelligence by 10 to 15 I.Q. points. Malnutrition can also be a consequence of other health issues such as diarrhoeic disease or degenerative illness specially disease of intestinal tract, Kidneys and liver.Programs to address eradicate the MalnutritionThe judicat ure of India has launched several programs to converge the growing malnutrition problems in the country. They include ICDS, NCF, National health mission.1. Integrate child development scheme (ICDS)-Indian organization has starter this ICDS program in the year 1975 for improving the health of mothers and children development program is on of largest in the world. It drop deades more than 34 million children vulcanized 0-6 historic period and 7 million large(predicate) and getting mothers.2. National Children Fund (NCF)-This Fund was caused during the international year of the child in 1979. This Fund provides survive to the voluntary organizations that help the welfare of children.3. united Nations Children Fund (UNCF)-UNISEF has been supporting India from hold half dozen decade in a number of sectors like child development, women development support for community found converged services health, education, nutrition, water and sanitation, childhood disability, children i n peculiarly difficult circumstances.National Rural Health MissionThis mission was created for the old age 2005-2012 and its goal is to reform the availability of and gravel to quality health care by people, especially for those residing in rural area, the execrable women and children.1. Objective of the mission are- disregard Infant Mortality Rate (IMR). Provide access to integrated compressive radical health care. Revitalize local health tradition and mainstream AYUSH. (This mission has get up strategies and action plan to meet all of its goals.)2. The best wa y to prevent the condition is to eat a healthy balanced diet that contains food from all the major groups like carbohydrates, fruits and vegetable, Protein, dairy and fats.3. As well as eating healthy, you should aim to drink at least 1.2 liters of fluid a day.45,000 die of malnutrition every year in MaharashtraDespite being among the wealthiest states in the country, virtually half Maharashtras children are underno urished and deuce-ace of adults are underweight, says a recent report by the NGO SATHI. Forty- phoebe bird-thousand children die of malnutrition every year in the state, according to A report on nutritional crisis in Maharashtra by the Pune-based SATHI (Support for Advocacy and Training to Health Initiatives). third base base of adults are underweight, and 15% staidly underweight.The both major schemes for children meant to prevent such deaths are the midday meal scheme and the Integrated Child victimisation Scheme (ICDS). But the state government activity spends that 0.8% of its gross national product on these schemes, the report states. More children die of mild or moderate malnutrition (33,000) than of severe malnutrition (12,000). Malnutrition is also the underlying cause of death of 480 of the 2,850 malnutrition deaths in the state every year. A large number of people in Maharashtra do not get enough to eat and are suffering from serious nutritional deficiencies, said the coordinator of SATHI, Abhay Shukla, at a press congregation to release the report on February 3, 2010.The report takes into account the findings of the National Family Health Survey-3 and the National Sample Survey. The report points out that chronic hunger is not confined to rural areas, as is popularly believed urban populations in coastal regions, including the city of Mumbai, gravel the highest prevalence of calorie deficiency (43%) in the state. Calculations make using the per-consumer-unit-calories norm of 2,400 in rural areas and 2,100 in urban areas reveals that the incidence of calories-based poverty is 54% in rural areas and 39.5% in urban areas. The report is critical of governmentschemes like the ICDS. Grade 3 and 4 malnutrition is grossly underreported under the scheme as workers lack the skills and equipment to accurately weigh and crystalize children. Severe malnutrition is often underreported as it points to a failure of the programme. The midday meal scheme too has been underperforming, according to the report.Only 12% of schools canvased provided midday meals, and many gave only one component of the meal. Moreover, not a single school provided the stipulated 300 calories and 8-12 grams of protein. Indias performance on the nutrition foregoing is poor overall. According to the National Family Health Survey-3 (up to 2005-06), some half of children under 5 years of age (48%) are stunted, that is, too short for their age, an indicator of chronic malnutrition 43% are underweight. The proportion of severely undernourished children is also illustrious 24% are severely stunted and 16% are severely underweight. The 2009 annual budget earmarked just 4.15% for children when the population under 18 years of age is 447 million. Maharashtras poor performance on the health front comes despite it being one of the high GDP states. Though the country as a whole has seen GDP grow by 3.95% per year, betwixt 1980 and 2005, the percentage of underwei ght children under 3 went down by just 6%, from 52% to 46% between 1992 and 2005.For every 3-4% increase in per capita income, the underweight rate should decline by 1%. This has not happened in India, pointing to the need for more inclusive growth and better give birthy and distribution of schemes targeted at malnutrition. Malnutrition among Maharashtras tribalsMore than 98 children died in ternary months of 2005, in Akkalkuwa obturate of Nandurbar district. Of these, 71 children were found to be severely malnourished.A survey by the Punarvasan Sangharsh Samiti revealed that the government is unaware of the scale of malnutrition in the area. Only 10% of malnourished children general anatomy in the government records. The survey also showed that not only were the children malnourished, their mothers were too. The weight of adult mothers governd between 40-45 kg.Girls constituted around half the total number of malnourished children, indicating the precarious condition of these future mothers.The survey also revealed that although generations of malnourished children are born in this region, the government still does not look beyond the singular health aspect of the problem, on the basis of which mitigation measures are designed. Unless the issue of malnutrition is addressed comprehensively, thetribal community in this let on of the country is headed for extinction.These and other startling revelations form part of a report brought out by the Punarvasan Sangharsh Samiti, which has been actively mobilising the tribal population of Nandurbar district for the last decade. The report, titled Maranatach He Jag Jagate, is based on the survey which was carried out in 22 villages. And information obtained through the Right to Information Act.The tribals of Nandurbar are engaged in a continuous struggle for existence. Malnutrition and child mortality is part of their everyday lives, even as issues related to rights over earthy resources and means of livelihood g ain greater urgency with each short-lived year.Attempts to remedy malnutrition and child mortality by singling it out will not deliver the desired results.Maranatach He Jag Jagate attempts to take stock of the situation and get at the root of the problem. The report analyses the situation on the priming coat and suggests ways to tackle the problem head-on. Obviously there is the need for stiff action by the government and the active involvement of society at large.Some basic facts about the survey * The survey was undertaken in 22 villages of Akkalkuwa block, Nandurbar district. The weights of mothers in seven villages and two rehabilitation and resettlement sites of the Sardar Sarovar Project were recorded. The facts that emerged from the survey were shocking. In April, May and June 2005, 98 children died in Akkalkuwa block alone and of these 71 children were malnourished. Of the malnourished children, 45 were found to be in the second stage of malnutrition. Meanwhile, the gover nment refuses to accept that the children died from malnutrition. * Punarvasan Sangharsh Samiti recorded the weights of children in 22 villages and compared this data with that of the government.The comparison showed that the government has only 10% of the facts related to malnutrition. In effect, it is unaware of 90% of malnutrition cases. According to the survey, the number of third-grade malnutrition among children in April was 127, in May 135 and in June 104 the government records showed only 14, 42 and 17 children as malnourished in this grade respectively. The survey figures for twenty- flipper percent-grade malnutrition, during these months, were 61, 50 and 35 the government figures were 6, 6 and 3 respectively. (The figures quoted here were obtained from the government under the Right to Information Act). * Of the 22 villages in the survey, half a dozen start out been stated hyper-sensitive by the government. Thesurvey showed that the combined number of third and fourth-g rade malnutrition among children in April, May and June stood at 100, 104 and 72 the government records showed only six-spot children were malnourished. * Of the total number of malnourished children, half were girls. This raises a serious query about the next generation.* With this caput in mind, the Punarvasan Sangharsh Samiti conducted a survey in six villages and two rehabilitation and resettlement sites in which the weights of effectivey-grown mothers were assessed. The survey showed that the weights ranged between 40-45 kg. This emphasises the need for a comprehensive study of the ages of young mothers, stage of gestation and its link with malnutrition. It also suggests that the process of malnutrition begins in the womb itself. * The root of the problem is lack of livelihoods. Measures in the areas of health, education, use and supply do not create sustainable livelihood sources and therefore cannot, in themselves, be decisive remedies to the problem of malnutrition. Let s take a closer look at the villages covered in the survey.The 22 villages are spread out in the plains as well as in hilly regions of the Satpudas. Of the villages, Khai, Andharbari, Ohwa, Kaulavimal, Toknapimpri, Maliamba, Kondvapada, Thana and Beti have been declared hyper-sensitive villages under the Navsanjivani Scheme, which is touted as the answer to the malnutrition problem.Of the 22 villages, seven villages Khai, Andharbari, Ohwa, Kaulavimal, Miryabari, Valamba and Pimpalgaon do not have a yearlong motorable road and are therefore inaccessible. later on a point one has to walk to get to the village. Four villages Thanavihir, Guliamba, Amali and Pimpalgaon are within a periphery of 12 km from the block headquarter of Akkalkuwa, but they are connected to a remote primary health centre (PHC) in Dab, situated deep in the third range of the Satpudas. One has to compensate Rs 15 to get to the PHC by jeep to fix Akkalkuwa one has to pay Rs 5.Other examples are Ambabri, And harbari, Bharadipadar and Khai. These villages are connected to the Moramba PHC. To reach Moramba by car one has to travel via Khapar, covering a distance of 17-18 km. Although there is a primary health centre in Khapar, villagers from these four villages have to bypass it and go on to Moramba. The other option to get to Moramba directly is to walk through the hills of the Satpudas for around 7-8 km.This shows up a serious damage in the state governments policy with regard to the muddle and coverage of primaryhealth centres. The village of Ohwa is connected to the Horaphali PHC, which is 22 km away. There is no road connecting the village with the centre people have to walk through the Satpuda hills to get to it. To correct the situation the government pass a health centre for Ohwa in 2004. But, although the tribal development plane section made provision to build the primary health centre, the health plane section still has to sanction the plan.Seven villages Andharbari, Kaul avi, Bari, Pimpalgaon, Valamba, Maliamba and Kondvapada do not have a public distribution system (PDS) outlet. Tribals from these villages are forced to walk 3-4 km to reach a PDS outlet.Of the 22 surveyed villages, 11 do not have a single job-creation opportunity under the states well-know piece of work Guarantee Scheme (EGS). The residents of seven villages did apprehend some form of utilization but only for a period of around a month.The survey also covered two rehabilitation and resettlement (R&R) sites of the Sardar Sarovar Project. Although the government claims to have carried out its R&R duties satis fixingsily, the situation on the ground is instead the opposite. Of the 634 children surveyed, 378 were found to be malnourished and the number of girls among them was as high as 60%. Of the total number of malnourished children, 119 were in the third and fourth stages.The two sites have separate PHCs, PDS outlets, gram panchayats and four anganwadis each. All the children were in the 0-6 age-group. This shows that they were born after their families were resettled. What conditions are like in the other six sites is a question open for study.What is clearly needed is a bowl over on the findings of this survey, from the social, economic, political, cultural and medico-anthropological perspective. Especially, vis- -vis the governments information on the subject. The report is being made public to facilitate just such a debate.Indias malnutrition problem is a systemic issue Girls in India are more malnourished as inadequate resources of families are divided preferentially among men.The problem of malnourishment in India is a reflection on its deeply entrenched poverty and a lack of functionality of its systems, says author EPA Indias growing riches have been the subject of many global discussions. In the past few years, India has responded to international emergencies by orbit out with support in cash and kind. However, Indiahas still not managed to g et a magnetise on the problem of malnutrition its children face, a fact that Indias prime look this year called a national shame.The facts are daunting as many as nearly half of Indias children below five years are malnourished. Girls are even more malnourished as inadequate resources of families are divided preferentially among men.Indias nutrition problem shows among women as well the malnourished girls grow up to be anaemic, deliver underweight babies who face an increased risk of dying and being disconsolate right after their birth. India ranks 76 among 80 middle-income countries rated for the best place to be a mother according to the Save the Childrens Mothers Index released in May 2012.Anganwadi centresThe problem of malnourishment in India is a reflection on its deeply entrenched poverty and a lack of functionality of its systems. Policymakers from the comfort of their oversize public-funded accommodation while examining the failure of their policies often argue that a country of Indias size both in terms of geography as well as population is difficult to administer.What they admit a little reluctantly is that the government-supported institutions are neither effective nor accountable to the people, and that the budget allocations in sectors critical for peoples well-being are still abominably low. Indias wealth no longer so new-found has so far not filtered down to the areas which would make considerable difference to the lives of its common people.A question often asked in India is about the co-existence of hunger and malnutrition alongside the problem of throne of thousands of tonnes of food grains rotting due to poor storage in government stores while the poor go to bed hungry. Clearly, the problem is not of a lack of resources but of systems that ensure that the countrys opportunities and resources are more equitably and equally divided.Indias response to its massive problem of malnutrition has been largely through the Integrated Child Development Services, or ICDS as it is known.The ICDS runs preceding(prenominal) schools-cum-health institutions called anganwadi centres where gravid and lactating women and children below five years receive secondary nutrition while children are also taught to take first travel towards learning letters and numbers. Many states have further equipped their anganwadi centres to modify them to treat the common ailments ofchildren.Considering the critical role of anganwadi centres in helping children remain healthy, they should have been universalised decades ago but they have not. Anganwadi centres cover only 50 per cent of Indias children. However, data as well as anecdotical evidence appearing in the form of newspaper reports points out that anganwadi centres do not function at their optimum capacity and efficiency. Their staff are not accountable to the people of the village, and being influential (some of them are known to be relatives of village headmen and other important members of the village) are not pliable to punitive action when they fail to perform their duty.Poverty and malnourishmentThat is a typical Indian situation one can get away without being punished for ones wrongdoings if one has the right connections. This is the bane of most of Indias institutions and facilities which are meant to serve the people but become, instead, means of drill and influence for a few. Nearly half of Indias children below five years are malnourished. Under the patronage of this protection, doctors in government hospitals may remain absent from work without a note on the attending register for days, teachers may not teach, clerks in offices may demand a bribe to perform a task which is the right of a citizen. The contact of dysfunctional systems on the lives of the poor and the marginalised is devastating as they have no alternatives. The poor die of common illnesses if they do not get treated at government hospitals, or they go borrow money to access a private hospital and go into debt.In fact, the WHO has said that 3.2 per cent Indians would fall below the poverty line because of high medical bills with about 70 per cent of Indians spending their entire income on healthcare and buying drugs. The Planning Commission also accepts that out of pocket expense to pay for healthcare costs is a growing problem in India. It says 39 million Indians are pushed to poverty because of ill health every year. to the highest degree 30 per cent in rural India didnt go for any treatment for financial constraints in 2004. In urban areas, 20 per cent of ailments were untreated for financial problems the same year, said a recent study in the Lancet. The government needs to look at health and education as critically important sectors in the development paradigm. If India is to reap its demographic dividend, it cannot do so with half of its children malnourished and not reaching their full potentialOverview of Malnutrition Situation in MaharashtraMaha rashtra The data below are from the National Family Healthy Survey 2005-2006. Highlights The nutrition situation in Maharashtra is slightly better than the national average with improvements from 1998-99 and 1992-93 except for an increase of anaemia prevalence among pregnant women. The feeding practice for children aged 6-9 months shows an alarming pattern with only 48% of children aged 6-9 months receiving solid or semisolid food and breast milk. This is importantly lower than the national average of almost 56%. Furthermore, the prevalence drops to 40% for rural areas compared with the national average of 54% and as low as 23.3% for non- improve mothers compared with the national average of 49%. The prevalence of overweight and obesity in Maharashtra is higher than the national average for both female and male with Mumbai reaching almost 35% of obesity among the female population. Within Maharashtra, there are evidentiary differences between rural and urban areas with the rural ar eas being more affected by malnutrition. However, the most outstanding gap in all indicators is between non- ameliorate and wise to(p) respondents.Malnutrition and Anaemia Rates Are High among Children* Almost 38% of children under age three are stunted (India 38.4%) and almost 40% are underweight (India 45.9%). Both indicators have slightly change from 1998-99 and 1992-93.* Wasting affects 14.6% of children under age (India 19%) with a steady improvement from 1998-99 and 1992-93.* Compared with urban areas, under-nutrition is higher in rural areas and in Mumbai. Similar to the national picture, there is a strong correlation between child malnutrition and the level of maternal education showing a two-fold difference between non-educated and well-educated mothers. The stunting and underweight prevalence for children with semiliterate mothers is 52.9% and 53.1% respectively contrasted with 22.9% and 25.9% for children with well educated mothers. The stark difference may be linked to access to nourishing diet and complementary feeding at 6-9 months.* Almost 72% of children under age three are anaemic (India 79.2). There is a earthshaking urban-rural divide with Mumbai having the lowest prevalencewith 59.5% compared with 76.8% in rural areas. The non-educated versus educated mothers difference is not as strong with 75% and 71% relatively. This may be linked to a more general poor quality of nutrition and hygiene conditions and limited access to iron subjunction.Improvements Needed in Infant and Child Feeding especially for the age 6-9 months * 53% of children are federal official only breast milk for the first 6 months (India 46%). scoop shovel breastfeeding is significantly higher among the non-educated mothers, in rural areas and in Mumbai. Work factor and access to breast milk substitutes may have an impact among urban and better educated mothers. The positive deviance in Mumbai may be associated with an increased awareness among the female working clas s and better baby-friendly employment conditions.* 51.8% of children under three years are breastfed within one instant of birth (India 23.4%) with no significant difference between urban and rural areas and between well-educated and non-educated mothers.* Only 47.8% of children aged 6-9 months receive solid or semisolid food and breast milk. This is significantly lower than the national average of almost 56%. The prevalence drops as low as 40% in rural areas (India rural 54%) and 23.3% among non-educated mothers (India non-educated 49%) showing a high-priority gap. The prevalence in urban areas and in Mumbai is 58% and 56.6% respectively (India urban 62.1%).* 32% of children age 12-35 months received vitamin A supplements in the six months to begin with the survey (India 23%) with the highest prevalence in urban areas (34.2%) followed by rural areas (29.9%) and Mumbai (27%) with a significant difference between non-educated (26.2%) and well-educated mothers (32.2%).A significant percentage of Women and Men Are Either Too Thin or Too Fat * 32.6% of married women (India 33%) and almost 30% of men (India 28%) are too thin, according to the body mass powerfulness (BMI). Underweight is strikingly most common among the non-educated and the rural population compared with Mumbaiand urban areas that show a similar prevalence.* Overweight and obesity affects 17% of women (India 14.8%) and almost 16% of men (India 12%). Overweight and obesity are strikingly most common in urban areas and among the well-educated with Mumbai reaching almost 35% of obesity among the female population as compared with the national urban average of 29%.Anaemia is Widespread* 49% of women (India 56.2%) and 16.2% of men (India 24.3) suffer from anaemia. Among pregnant women, anaemia has increased from 52.6% to almost 58%.* Only 30.5% of pregnant women consume Iron and Folic Acid supplementation for 90 days (India 22.3%) with 16.4% among the non-educated women compared to 45.2% among the wel l-educated ones. Rural and urban areas have the same prevalence of 30.5% with Mumbai reaching only 27.5% (India urban 34.5% respectively) The bleakest numbers* at a glance*(NOTE Figures have been go to the closest zero for easier understanding of the ratio) 1. For every ten children aged three or less, born to illiterate mothers, five children are stunted too short for their age. This is a sign of chronic malnutrition. 2. For every ten children aged three or less, born to illiterate mothers, five children are underweight too thin for their age. This is a sign of tart and chronic malnutrition.3. For every ten children aged three or less, born to illiterate mothers, two children are wasted too thin for his/her age. This is a sign of acute malnutrition. Wasted children are at highest risk of dying from malnutrition or from any common child diseases like diarrhoea or respiratory infections. 4. For every ten children aged 6-9 months, born to illiterate mothers, only two receive soli d or semi-solid foods in addition to Breast-milk as recommended. This jeopardizes their chances of survival and irreversibly impairs their future growth and development.5. For every ten children aged one to three years, born to illiterate mothers, only three children received Vitamin A supplementation in the last six months prior the survey. 6. For every ten illiterate women aged 15-49 years, four are too thin. 7. For every ten pregnant illiterate women, six are anaemic but only twotake Iron and Folic Acid supplementation for 90 days as recommended. The higher the education of the mother, the better the nutrition status of themselves and their child.NOTE In Maharashtra, for every ten women, 2 women are illiterate and 8 are educatedAmong the educated women, 3 are well-educated (10 years complete and above), 2 have 8-9 years complete and 3 have less than 8 years complete.