The National Nutrition Scene: an analysis of results of two national surveys.

Extrapolation of data from two national nutritional surveys in India--the National Family Health Survey (NFHS) and surveys conducted by the National Nutrition Monitoring Bureau (NNMB)--enabled the ranking of states on the basis of criteria such as nutritional status of children under 5 years of age. The most recent NNMB survey report (1988-90) indicates that between 42.5% (Kerala) and 69.5% (Orissa) of under-fives are undernourished (defined as 2 or more standard deviations below the median); 11.8% (Kerala) to 41.8% (Madhya Pradesh) were severely malnourished (3 or more standard deviations below the median). Surprising was the lack of association between average household calorie and protein consumption in the state and the prevalence of child undernutrition. The NHFS (1992-93) found lower rates of child undernutrition (28% in Mizoram and Kerala to 63% in Bihar) and severe malnutrition (6% in Kerala to 31% in Bihar); states with the lowest child mortality rates had the lowest prevalence of child malnutrition. The NFHS data were used to develop an Index of Nutrition and Social Development for each state based on life expectancy, median years of schooling, and nutritional status of children under 5 years of age. This value was lowest for Bihar and highest in Kerala. There were marked gender disparities in child mortality, even in states with high female literacy. The largest differential (43% higher for girls) was in the mortality rate for children 1-4 years old.