National Family Health Survey-4 (2015-16) shows that there are 35.7% and 21% of the children under five years of age are underweight and wasted, respectively. The prevalence of malnutrition varies from state-to-state and within states of the country. With the launch of the national nutrition mission by the Indian government in 2017, focus to curb child malnutrition has shifted from state level to district level. However, the availability of regular, reliable and accurate data at the district level weakens this process despite various national surveys. 

In Chhattisgarh, however, the state government has launched the scheme “Vajan Tyohar” in 2016 to collect anthropometric data of all young children under the age of 6 years on an annual basis. In addition, it also provides geographical information of child at various hierarchal levels: district, sub-district, sector, village council (gram panchayat), village and Anganwadi centre. This information can help the government in building a real-time strategy and monitor the nutritional status of the children regularly at the district level. 

For this study, anthropometric assessment of 36944 children under the age of 3 years in Dhamtari district has been done at the gram panchayat level. Nutritional statuses of these children were classified as per WHO standards 2006. Out of these, only 31296 children with plausible anthropometric values were included in further analysis. Prevalence of child malnutrition calculated by aggregating data at the gram panchayat level, when projected onto the district map using QGIS software, showed clusters of gram panchayats with high and low burden of child malnutrition. 

From the pattern emerging from the analysis, two plausible recommendations are made. First, the individual child should be targeted in clusters with very small number of malnourished children. Second, clusters with a high burden of malnourished children in terms of absolute number as well as percentage should follow the community-based approach under programmatic actions for reducing child malnutrition. Gram panchayat with least burden in high burden cluster can be the source of positive deviance to understand plausible local solutions to curb child malnutrition. 

To conclude, data at the sub-unit level helps in designing programs that can solve issues at the local level through proper interventions. Further, mapping makes it easier to develop a context-specific nutrition action plan for optimized allocation of the resources to the children in need. A convergence of nutrition actions with other sectors e.g. sanitation, employment, immunization, etc. can be facilitated by overlaying different attributes.

P4-23-04 - Spatial analysis of the anthropometric data and customization of the district nutrition action plan: case study of Dhamtari district