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Projecting stunting and wasting under alternative scenarios in Odisha, India, 2015–2030: a Lives Saved Tool (LiST)-based approach
Authors: Nihar Ranjan Mishra, Sanjay K Mohanty, Devjit Mittra, Mansi Shah, and Wahengbam Bigyananda Meitei
Source: BMJ Open, 9: e028681; DOI: 10.1136/bmjopen-2018-028681
Topic(s): Child health
Country: Asia
Published: MAY 2019
Abstract: Objective Although nutrition-specific interventions are designed based on maternal, household and community-level correlates, no attempt has been made to project stunting and wasting and identify intervention priorities in India. The objective of this paper is to model the stunting and wasting in the state of Odisha, India by scaling up maternal and child health interventions under alternative scenarios. Design This study primarily used data from National Family Health Survey 4, 2015–2016. Measures The LiST (Lives Saved Tool) software is used to model the nutritional outcomes and prioritise interventions. The projections were carried out under four alternative scenarios: scenario 1—if the coverage indicators continued based on past trends; scenario 2—scaled up to the level of the richest quintile; scenario 3—scaled up to that of Tamil Nadu; and scenario 4—scaled up to an aspirational coverage level. Results In 2015, out of 3.52?million under-5 children in Odisha, around 1.20?million were stunted. By 2030, the numbers of stunted children will be 1.11?million under scenario 1, 1.07?million under scenario 2, 1.09?million under scenario 3 and 0.89?million under scenario 4. The projected stunting level will be 25% under scenario 4 and around 31% under all other scenarios. By 2030, the level of wasting will remain unchanged at 20% under the first three scenarios and 4.3% under scenario 4. Appropriate complementary feeding would avert about half of the total stunting cases under all four scenarios, followed by zinc supplementation. Water connection at home, washing hands with soap and improved sanitation are other effective interventions. Conclusion Sustaining the maternal and child health interventions, promoting evidence-based stunting and wasting reduction interventions, and a multisectoral approach can achieve the World Health Assembly targets and Sustainable Development Goals of undernutrition in Odisha.