Friday, November 14, 2025

Child Nutrition in Haryana at a Crossroads: Empirical Insights and Strategies for Accelerated Improvement

 

-Ramphal Kataria

Abstract

Haryana has adopted a multi-pronged strategy aligned with Poshan Abhiyaan to reduce undernutrition, especially among girl children. This paper uses NFHS-4 (2015–16) and  (2019–21) survey data, Agriculture Census evidence, and recent State Budget and programme information to:

1. describe the current nutritional situation in Haryana;

2. diagnose structural and behavioural causes (including declining livestock ownership, shrinking landholdings and dietary transition);

3. assess the capacity of the Women & Child Development (WCD) Department to respond through Anganwadi networks, supplementary nutrition and fortification; and

4. propose an integrated, budgeted, cross-departmental action plan with clear monitoring and evaluation metrics.

1. Introduction

Malnutrition in early childhood reduces human capital, impairs cognition, and increases morbidity and mortality. While Haryana has recorded measurable improvements between NFHS-4 and NFHS-5, pockets of vulnerability persist—particularly among Scheduled Castes, landless families, and economically weaker groups.

Despite Haryana’s agricultural wealth and historically milk-rich diets, structural changes in agriculture, livestock patterns, and market behaviour have reduced nutrient-dense food access among vulnerable households. This paper provides an evidence-based assessment and proposes a multidimensional strategy tailored to Haryana’s emerging needs.

2. Data Sources and Methods

2.1 Data Sources

NFHS-4 (2015–16) and NFHS-5 (2019–21) state fact sheets

Agriculture Census 2015–16 and state agricultural datasets

WCD Departmental Data related to SNP, AWC functioning, and Poshan Tracker

Haryana Budget (2024–25) — Demand for Grants of WCD Department

Relevant research literature on diet change, livestock economics and fodder availability

2.2 Methods

Descriptive trend analysis comparing NFHS-4 and NFHS-5

Causal inference based on literature and socioeconomic patterns

Gap analysis of programme design and resource allocation

Indicative cost modelling for supplementation and fortification interventions

3. Nutritional Status: Trends from NFHS-4 to NFHS-5

Below are core NFHS indicators inserted in table format.

Table 1: Prevalence of Underweight (0–5 years)

Indicator

NFHS-4 (2015–16)

NFHS-5 (2019–21)

Change

Underweight children

29.4%

21.5%

–7.9 percentage points

 

Table 2: Prevalence of Stunting (0–5 years)

Indicator

NFHS-4 (2015–16)

NFHS-5 (2019–21)

Change

Stunted children

34.0%

30.0%

–4.0 percentage points

 

Table 3: Prevalence of Wasting (0–5 years)

Indicator

NFHS-4 (2015–16)

NFHS-5 (2019–21)

Change

Wasted children

21.2%

17.3%

–3.9 percentage points

 

Table 4: Prevalence of Severe Wasting (0–5 years)

Indicator

NFHS-4 (2015–16)

NFHS-5 (2019–21)

Change

Severe wasting

7.0%

6.4%

–0.6 percentage point

 

Table 5: Anaemia Prevalence in Children (6–59 months)

Indicator

NFHS-4 (2015–16)

NFHS-5 (2019–21)

Change

Anaemia (6–59 months)

71.7%

73.2%

+1.5 percentage points

 

3.1 Key Observations

Haryana shows significant improvement in underweight, stunting, wasting and severe wasting.

Anaemia has worsened, indicating micronutrient deficiency remains unaddressed.

The improvement is uneven across districts, with SC, landless and low-income households showing higher vulnerability.

Poshan Tracker quarterly snapshots (2022–2025) show incremental improvement in growth monitoring quality and SNP coverage but highlight district-level data inconsistencies.

4. Structural Causes and Pathways

4.1 Dietary Transition & Declining Household Milk Availability

Traditionally, Haryana’s nutrition relied heavily on home-produced milk. However:

Shrinking landholdings

High fodder prices

Decline in common grazing lands

Reduced household livestock ownership

have collectively reduced daily milk availability among poorer households, especially girls.

4.2 Shrinking Operational Landholdings

Agriculture Census shows:

Average holding size has decreased, reducing crop residues and by-product fodder.

Marginal farmers face difficulty maintaining even 1–2 milch animals.

4.3 Market & Agronomic Transformation

Shift toward herbicide-driven, high-intensity cropping reduces fodder grasses.

Commercial crops (cotton, vegetables) produce less fodder than traditional cereals.

4.4 Poverty, Inequity & Social Norms

Lower-income households prioritise low-cost, filling foods over nutrient-dense ones.

Intra-household gender disparities negatively affect girl children’s diet.

4.5 Programme Gaps

Inconsistent SNP quality across AWCs

Occasional stock-outs and storage issues

Limited micronutrient testing (Vitamin D, Hb)

Incomplete supervision at circle/block level

5. Role of WCD & Anganwadi Network — Opportunities and Limits

Strengths

26,000+ Anganwadi Centres providing universal access

Existing SNP structure (hot-cooked meals + THR)

Poshan Tracker for near-real-time monitoring

Established platform for growth monitoring, BCC and maternal counselling

Limitations

Variability in capacity of Anganwadi Workers

Budget constraints for protein-rich supplementation

Limited infrastructure for cold storage

Inconsistent quality assurance mechanisms for fortified ingredients

6. Budget and Resource Assessment

The Haryana WCD Department's 2024–25 allocation broadly covers:

Supplementary nutrition

AWCs

Crèche support

Maternity and girl-child schemes

Capacity building

6.1 Preliminary Gap Assessment

Intervention

Cost Implication

Feasibility

Hb Test Kits (monthly screening)

Moderate recurring

High feasibility

Protein Milk Bars / 200 ml Milk

High recurring

Feasible in pilot districts

Fortified Flour Procurement

Low incremental

Statewide scalable

Fodder Banks

Capital-heavy

Convergence model needed

AWW Incentive System

Moderate recurring

Highly impactful

Existing budgets may support pilot interventions, but statewide scale-up requires convergence with Health, Agriculture, Rural Development and Finance Departments.

7. Cross-Departmental Cooperation Needed

Department

Key Roles

Health

Micronutrient testing, SAM/MAM management, deworming, facility referrals

Agriculture & Animal Husbandry

Fodder banks, dairy cooperatives, forage seed distribution

Education

PM Poshan coordination for continuity

Rural Development / PRIs

Land for community nutrition gardens, SHG mobilisation

Finance

Budget restructuring, outcome-based budgeting

 

8. Programmatic Recommendations (Operational + M&E)

1. Universal micronutrient screening (Hb + Vitamin D) for children and women.

2. SNP recipe optimisation:

Weekly millet menu

Twice-weekly protein milk bars / 200 ml milk

3. Mandatory fortification of flour supplied to AWCs; district testing labs.

4. Dairy revival pilot in high-burden blocks:

Fodder banks

Women’s dairy SHGs

5. District Convergence Cells for monthly joint review using Poshan Tracker dashboards.

6. Capacity building for AWWs, including performance-linked incentives.

7. Strong Monitoring & Evaluation with:

Stepped-wedge trials for protein supplementation

Independent evaluations

Monthly public dashboards

9. Indicative Budgeting

Example: Per Child Costing

Item

Unit Cost

Monthly Cost per Child

Hb Test Strip

₹12

₹12

Protein Milk Bar (2/week)

₹8 x 8

₹64

Fortified Flour Increment

₹0.5/kg

₹8

AWW performance incentive

₹20

Staged Rollout Model

Pilot phase: 3 high-burden districts, 6 months

Evaluation: Effect on wasting, anaemia

Scale-up: Statewide in 2–3 phases based on evidence and budget

10. Conclusion

Haryana has achieved measurable gains in child nutrition, but these remain fragile. A multidimensional strategy — combining short-term supplementation (protein bars, fortified ingredients, micronutrient screening) with medium-term structural changes (fodder support, dairy cooperatives, kitchen gardens, agrarian convergence) — is essential.

A phased, evidence-driven rollout with rigorous M&E and convergence between WCD, Health, Agriculture and Finance Departments will yield the highest return on investment in child and maternal nutrition.

References

1. Government of India. (2017). National Family Health Survey (NFHS-4), 2015–16: Haryana Fact Sheet.

2. Government of India. (2021). National Family Health Survey (NFHS-5), 2019–21: Haryana Fact Sheet.

3. Government of India. (2019). Agriculture Census 2015–16: Operational Holdings Report.

4. Government of Haryana. (2024). Demand for Grants 2024–25: Women & Child Development Department.

5. Ministry of Women & Child Development. (2022). Poshan Abhiyaan Guidelines.

6. International Institute for Population Sciences. (2022). NFHS-5 National Report.

7. Deolalikar, A. (2005). Poverty and child malnutrition in India. Asian Development Review.

8. Gulati, A., et al. (2024). Revitalising India’s Dairy Sector. ICRIER.

9. Kumar, P., & Singh, R. (2018). Fodder scarcity and livestock productivity. Indian Journal of Agricultural Economics.

10. UNICEF India. (2023). Improving Child Nutrition through Community-Based Approaches.

 

 

 

Annex 1: Detailed NFHS-4 & NFHS-5 Comparative Tables

A. Anthropometric Indicators (0–5 years)

Indicator

NFHS-4

NFHS-5

Change

Stunted

34.0%

30.0%

–4.0%

Severely Stunted

14.1%

11.2%

–2.9%

Wasted

21.2%

17.3%

–3.9%

Severely Wasted

7.0%

6.4%

–0.6%

Underweight

29.4%

21.5%

–7.9%

B. Anaemia (6–59 months)

Indicator

NFHS-4

NFHS-5

Change

Anaemic children

71.7%

73.2%

+1.5%

 

Annex 2: Indicative Budget Template

Budget Head

Unit Cost

Total Estimated Cost (Pilot 3 Districts)

Hb Testing

₹12/test

₹1.5 crore

Protein Milk Bars

₹64/child/month

₹8 crore

Fortified Flour

Minimal

₹0.5 crore

Training & Incentives

₹1 crore

M&E

₹0.8 crore

 

Annex 3: Monitoring Indicators

% children screened for Hb

% AWCs providing fortified flour

% children receiving protein supplementation

% AWCs achieving >90% growth monitoring quality

Reduction in wasting and anaemia in pilot districts

 


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