With around 48 mil, India has largest number of stunted children, says report

New Delhi: Around 48 million children or two in every five children under the age of five years in India are stunted, making India home to largest number of stunted children in world in terms of volumes, a new report said on Tuesday.

"India, the world's second most populous nation and a country with a well-known sanitation crisis has been named as having the greatest number of children in the world who are stunted.

"The report reveals 48 million children in India, or two in every five under five, are suffering from stunted growth, which affects their physical development as well as cognitive and emotional development," the report 'Caught Short' - How a lack of toilets and clean water contributes to malnutrition' brought out by international development charity WaterAid said.

Noting that India has the highest concentration in the world of people practising open defecation, the report said that high rates of open defecation have a strong correlation with increased rates of stunting, as faeces in the environment contaminate hands and surroundings and spread disease and infection.

It said that Nigeria and Pakistan rank second and third with 10.3 and 9.8 million children stunted respectively.

The Southeast Asian nation of Timor-Leste tops the list of countries having the highest percentage of children who are stunted at 58 per cent.

"Currently, more than 650 million people in the world do not have access to clean water and more than 2.3 billion do not have access to an adequate toilet. Diarrhoeal diseases caused by dirty water and poor sanitation are the second biggest killer of children under five after pneumonia, taking 315,000 young lives every year. "Even those children who survive severe bouts of diarrhoea are at risk of having their lives, and life chances, forever changed," the report said. Globally 159 million children under the age of 5 are stunted - one in four children of this age, it said. Stunting is defined as children having low height for age and indicates that children have not developed as they should, physically or cognitively.

Stunting is a consequence of malnutrition in the first 1,000 days from conception until age two. It is largely irreversible after the age of two, making those first 1,000 days critical to a child’s development.

The report said that some 140,000 children under five in India die each year of diarrhoeal diseases related to the lack of these basic services. Around 50 per cent of malnutrition cases are linked to infections, including chronic diarrhoea, caused by lack of safe water, sanitation and hygiene (WASH) including handwashing with soap, the report said. It said that in the developing world, a lack of clean water, sanitation and hygiene (WASH) is a major contributor to malnutrition and one impact of this is stunting, where severe and prolonged under-nutrition makes children shorter than normal for their age and affects their emotional, social and cognitive development.

"India has made progress on reducing child stunting, from 48 per cent of all children in 2006 to 39 per cent in 2014. However, alongside the high numbers of people without access to adequate toilets, India also has the highest concentration in the world of people practising open defecation.

"Research shows that high rates of open defecation have a strong correlation with increased rates of stunting as faeces in the environment contaminate hands and surroundings, and spread disease and infection," the report said. WaterAid India's Policy Manager Arundati Muralidharan, said that water, sanitation and hygiene are important determinants of nutrition.

"With open defecation rampant in India, frequent diarrhoea hinders the ability of children to absorb nutrients. India has made significant efforts to improve the nutritional status of children and women, but the beneficial impact of these efforts are threatened by poor WASH. "For our children to be healthy and well-nourished, we need both nutrition specific interventions that get essential nutrients to children, as well as nutrition sensitive interventions on WASH," she said. Last September world leaders made commitments in the UN Global Goals to end hunger and malnutrition and to reach everyone everywhere with clean water and sanitation, all by 2030. WaterAid also urged governments to make ambitious investments in water, sanitation and hygiene for all.