The document presents a nutrition profile for Pashchimi Singhbhum district in Jharkhand, highlighting the critical status of child undernutrition, with high rates of stunting (45.5%), underweight (46.4%), and anemia among children and women. It discusses immediate, underlying, and basic causes of undernutrition, including food insecurity and poor healthcare access, and emphasizes the need for equitable interventions. The report identifies challenges related to data availability and suggests areas for immediate action, particularly in sanitation, infant feeding practices, and health services access.

1. Jharkhand (2002 to 2005-06)*
(Children aged <5 years)
Pashchimi Singhbhum
(2002-2011)**
(Children aged <5years)
2002+ 2005-06+ 2002+ 2011+
Underweight 50.9% 60.2% 55.3% 46.4%
Stunting No data 51.1% No data 45.5%
Wasting No data 36.8% No data 26.9%
Pashchimi Singhbhum, Jharkhand
DISTRICT NUTRITION PROFILE
DISTRICT DEMOGRAPHIC PROFILE
Total Population 1,502,338
THE STATE OF NUTRITION IN PASHCHIMI SINGHBHUM
Page 1
96.9%
CHILDREN <6 YEARS
ARE ANEMIC2
CHILDREN <5 YEARS
ARE STUNTED1
CHILDREN <5 YEARS
ARE UNDERWEIGHT1
46.4%
45.5%
MALE FEMALE
URBAN RURAL
SC ST OTHER
CHANGES IN
NUTRITIONAL STATUS
OVER TIME 
*2002 (DLHS) to 2005-06 (NFHS-3) **2002 (DLHS) to 2011 HUNGaMA survey data
+Indicators are for rural population since the HUNGaMA survey data is based on rural population
49.9% 50.1%
14.5% 85.5%
3.8% 67.3% 28.9%
60.2
51.1
36.8
97.6
46.4 45.5
26.9
96.9
Children aged <5
years
underweight
(%)1,10
Children aged <5
years stunted
(%)1,10
Children aged <5
years wasted
(%)1,10
Children aged <6
years anemic
(%)2
Chronic energy
deficiency in
women (%)
Mothers with low
birthweight
children (%)
Adults who are
obese in the
district (%)
Jharkhand Pashchimi Singhbhum
NoData
NoData
NoData
NoData
NoData
NoData

2. 0
20
40
60
80
100
Percentageofchildstunting(%)
Age of child (in months)
Too late
Window of
opportunity
54.0%
63.7%
8.2%
21.4%
55.8%
97.8% 99.5%
60.8%
66.5%
6.5%
67.4%
100.0% 98.3%
Full immunization
coverage
Children (12-35mo)
who got vitamin A
supplementation
Acute diarrhoea in
children <2 years in
previous 2 weeks
Children <5 years
with diarrhoea
treated to ORS
Women aware of
danger signs of
pneumonia*
Women with access
to antenatal care
coverage
Anemia among
pregnant women
Anemia among
adolescent girls
10.2%
49.5%
72.5%
10.2%
Early initiation of
breastfeeding in
children*
Exclusive
breastfeeding of
children*
Children between 6-
8 mo who received
any solid/semi solid
food in the last 24
hours
Children who
achieve minimum
diet diversity
Jharkhand Pashchimi Singhbhum
Page 2
WHEN TO INTERVENE TO IMPROVE NUTRITION?
The most crucial period for child nutrition is
from pre-pregnancy to the second year of life2
HOW TO PREVENT UNDERNUTRITION?7
Optimum fetal and child nutrition and development
IMMEDIATE CAUSES
Breastfeeding, nutrient rich foods, and eating routine
Feeding and caregiving practices, parenting stimulation
Low burden of infectious diseases
UNDERLYING CAUSES
Food security: availability, economic access and use of food
Feeding and caregiving resources (maternal, household and
community level)
Access to and use of health services, a safe and hygienic environment
BASIC CAUSES
Knowledge and evidence
Politics and governance
Leadership, capacity and financial resources
Social, economic, political, and environmental context (national and
global)
Child undernutrition is caused by inadequacies in food, health and care for infants and young children, especially in
the first two years of life (immediate causes). Inadequate food, health and care arise from food insecurity, unsanitary
living conditions, low status of women, and poor health care (underlying causes). These are, in turn, caused by social
inequity, economic challenges, poor political will and leadership to address these causes (basic causes). Interventions
to address undernutrition must address these multiple causes of undernutrition and do so in an equitable manner.
IMMEDIATE CAUSES OF UNDERNUTRITION
Data challenges:
Areas for immediate action:
• No latest district-level data on infant and young child
feeding (IYCF) practices in Jharkhand.
• Immunisation requires further attention.
• Alarmingly high levels of anaemia among pregnant
women and adolescent girls.
• Outdated data; poor availability of district-level data on key immediate determinants of undernutrition.
• Where data are available, indicator definitions are non-standardized and often differ from World Health
Organization recommendations.
INFANT & YOUNG CHILD FEEDING10
IMMUNISATION & SUPPLEMENTATION4 DISEASE INCIDENCE4 ADOLESCENT & MATERNAL HEALTH2,4
NoData
NoData
NoData
NoData
NoData
NoData
NoData

3. 52.1%
33.5%
9.0% 6.6%
37.2%
73.9%
45.8%
55.6%50.9%
32.0%
6.3% 7.9%
61.0%
70.9%
40.7%
48.4%
Household share
of expenditure
on food (%)
Household share
of food
expenditure on
cereals (%)
Household share
of food
expenditure on
milk (%)
Household share
of food
expenditure on
eggs/fish/meat
(%)
Households in
the district
involved in
agriculture (%)
Percentage of
population who
are Below
Poverty Line in
the district
(Tendulkar
Method) (%)
Percentage of
households who
own their own
plot of
agricultural land
(%)
Household lives
in a permanent
house (%)
Household has
electricity (%)
Adult Literacy
Rate (%)
Jharkhand Pashchimi Singhbhum
35.9%
7.7% 9.8%
59.1%
20.5%
77.0%
13.1%
25.0%
69.2%
10.8%
87.2%
1.6%
Girls married
when <18years
old
Ever married
women/mothers
who completed
primary school
(0-5 years of
schooling)
Women who
completed
secondary school
(6-8 years of
schooling)
Women's
ownership of
land
Women's
ownership of
livestock
Population using
improved
drinking-water
sources (%)
Population using
improved
sanitation
facilities (%)
Open defecation
(%)
Child stool
disposal in a
sanitary manner
(%)
Households
washed hands
with soap before
eating
NoData
Page 3
BASIC CAUSES OF UNDERNUTRITION
Food Security6 Poverty5,12 Other Indicators5
UNDERLYING CAUSES OF UNDERNUTRITION
Areas for immediate action:
• Households have poor access to improved sanitation facilities leading to high rates of open defecation and
inability to wash hands with soap prior to meals; critical need to increase household sanitation facilities in the
district.
• Food insecurity, and diet quality, especially poor milk and protein intakes, may be holding back improvements in
nutrition.
Data challenges:
• Limited data available on women’s status and no data available on land ownership.
• Difficult to compare indicators of water, sanitation and hygiene over time as census data do not provide data on
hand washing.
• Although there is access to services,
access can be further improved,4,5 (see
figure on the right)
• No data on access to NREGA.
• District domestic product of Pashchimi
Singhbhum8:
207767.0 (in Rs. Lakh)
• State domestic product of Jharkhand:
4217009.0 (in Rs. Lakh)
• Governance and political will to address
nutrition. No data
available
WaSH1,5,10Women’s Status4
24.9%
94.2%
29.6%
89.1%
53.9%
30.5%
100.0%
35.7%
97.6%
40.2%
Births attended by skilled health personnel
Household has access to Anganwadi Worker
Household has access to a Sub Health Centre
Household has access to Primary/Middle School
Access to NREGA
Households availing Bank services
Pashchimi
Singhbhum
Jharkhand
NoData
NoData
NoData
NoData
NoData
NoData
NoData
NoData
NoData
NoData
NoData

4. WHAT WILL IT TAKE TO IMPROVE NUTRITION IN PASHCHIMI SINGHBHUM?
This District Nutrition Profile was developed by Abhilasha Vaid for POSHAN. This version, dated August
20, 2014 is a draft intended for use in a district-level workshop in Delhi, and will be revised following
workshop discussions.
Source:UNICEF/India/2010/GrahamCrouch
Data sources
1. HUNGaMA Survey Report 2011, accessed on August 16, 2014, http://www.hungamaforchange.org/HungamaBKDec11LR.pdf
2. District Level Health Survey-2 Nutrition Report (2002-04) Report, accessed on August 16, 2014,
http://www.rchiips.org/pdf/rch2/National_Nutrition_Report_RCH-II.pdf
3. Annual Health Survey (2012-13) Jharkhand Report, accessed on August 16, 2014, http://censusindia.gov.in/2011-
common/AHSurvey.html
4. District Level Health Survey-3 (2007-08), accessed on August 16, 2014, http://www.rchiips.org/pdf/rch3/report/JH.pdf
5. Census of India 2011, accessed on August 16, 2014, http://censusindia.gov.in/
6. National Sample Survey 68th Round
7. The politics of reducing malnutrition: building commitment and accelerating progress. S Gillespie, L Haddad, V Mannar, P
Menon, N Nisbett. Lancet 382 (9891), 552-569
8. Directorate of Economics & Statistics, accessed on August 20, 2014, http://desjharkhand.nic.in/stateincom.html
9. National Family Health Survey-3 (2005-06) Report, accessed on August 16, 2014, http://www.rchiips.org/nfhs/NFHS-
3%20Data/Orissa_state_report.pdf
10. National Family Health Survey 3 Dataset
11. National Family Health Survey 2 (1998-1999) Report accessed on August 16, 2014, http://www.rchiips.org/nfhs/jharkhan.shtml
12. Planning commission data, accessed on August 16, 2014, http://planningcommission.nic.in/news/pre_pov2307.pdf
*District Level Health Survey-2 Data was not accessible
Possible district-levels actions to support nutrition: