POSHAN District Nutrition Profiles (DNPs) draw on diverse sources of data to compile a set of indicators on the state of nutrition and its cross-sectoral determinants. The profiles are intended to be conversation-starters at the district level and to enable discussions about why undernutrition levels are high, and which factors, at multiple levels, might need to be addressed to improve nutrition. PLEASE NOTE that POSHAN is regularly tracking data sources as they are released and updating the profiles accordingly.

1. 47.3
67.0
7.9
91.7
44.7
54.0
18.9
96.2
0
10
20
30
40
50
60
70
80
90
100
Children aged
<5 years
underweight
Children aged
<5 years stunted
Children aged
<5 years wasted
Children aged
<6 years anemic
Chronic energy
deficiency in
women
Mothers with low
birthweight
children
Adults who are
obese in the
districtShravasti Uttar Pradesh
Shravasti, Uttar Pradesh
DISTRICT NUTRITION PROFILE 014
Page 1
THE STATE OF NUTRITION IN SHRAVASTI
DISTRICT DEMOGRAPHIC PROFILE
Total Population 1117361
MALE FEMALE
RURALURBAN
SC ST OTHERS
3.5% 96.5%
CHANGES OVER TIME
Sources: *DLHS-2 (2002-04) and NFHS-3 (2005-06);
** DLHS-2 (2002-04) and author’s estimates based on HUNGaMA survey data(2011)
Uttar Pradesh (2002 to 2005-06)*
(Children aged <5 years)
Shravasti (2002-2011)**
(Children aged <5years)
2002+ 2005-06+ 2002+ 2011+
Underweight 53.05% 44.66% 45.91% 47.29%
Stunting No data 53.96% No data 67.02%
Wasting No data 18.86% No data 7.94%
CHILDREN
STUNTED1
CHILDREN
WASTED1
NO DATA ON
WOMEN’S
NUTRITIONAL
STATUS
CHILDREN
UNDERWEIGHT1
47.3%
67.0%
7.9%
+Indicators reported are specific to rural areas as HUNGaMA survey data is based on rural population
NODATA
THE PREVALENCE OF
UNDERWEIGHT HAS
INCREASED IN THE
DISTRICT BETWEEN
2002 AND 2011+
NODATA
NODATA
NODATA
NODATA
NODATA
!
PERCENTAGE(%)

2. 2.8
37.3
14.9
19
25.5
76.7
7.1
46.9
56.2
11.2
30.3 32.3
16.2 17.4
58.1
0
10
20
30
40
50
60
70
80
90
100
Early initiation of
breastfeeding
Exclusive
breastfeeding
Children
between 6-8 mo
who received any
solid/semi solid
food in the last
24 hours
Children who
achieve
minimum diet
diversity
Full
immunization
coverage
Children (12-
35mo) who got
vitamin A
supplementation
Acute diarrhea in
children <2 years
in previous 2
weeks
Children <5 years
with diarrhea
treated to ORS
Women aware of
danger signs of
pneumonia
59.1
86.8
93.7
64.4
95.8 97.8
0
10
20
30
40
50
60
70
80
90
100
Women with
access to antenatal
care coverage
Anemia among
pregnant women
Anemia among
adolescent girls
Shravasti Uttar Pradesh
Page 2
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
Areas for immediate action:
Data challenges:
• Outdated data; poor availability of data on key immediate
determinants of undernutrition.
• Where data are available, indicator definitions are non-standardized
and often differ from World Health Organization recommendations.
• Poor state of infant and young child feeding (IYCF): low
rates of timely initiation breastfeeding and exclusive
breastfeeding.
• Low immunization rates, which need urgent attention.
• Alarming levels of anemia among pregnant women and
adolescent girls.
IMMEDIATE CAUSES
Breastfeeding, nutrient rich foods, and eating routine
Feeding and caregiving practices, parenting stimulation
Low burden of infectious diseases
Optimum fetal and child nutrition and development
WHAT FACTORS CAUSE UNDERNUTRITION? 7
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)
The most crucial period for child nutrition is
from pre-pregnancy to the second year of life2
WHEN TO INTERVENE TO IMPROVE NUTRITION?
ADOLESCENT & MATERNAL HEALTH3,5
NODATA
DISEASE INCIDENCE4,5IMMUNIZATION & SUPPLEMENTATION5
NODATA
NODATA
INFANT AND YOUNG CHILD FEEDING2,4
PERCENTAGE(%)
PERCENTAGE(%)
0
10
20
30
40
50
60
70
80
90
100
Age of child (in months)
Percentageofchildstunting(%)
Window of
opportunity
Too late

3. 14.2
87.8
32.7
91.8
72.2
30
91.5
31.1
92.4
72
0
10
20
30
40
50
60
70
80
90
100
Births attended
by skilled
health
personnel
Household has
access to
Anganwadi
worker
Household has
access to a sub-
centre
Household has
access to
primary/middle
school
Access to
NREGA
Households
availing
banking
services
ACCESS TO SERVICES5,7
Shravasti Uttar Pradesh
73.9
9.0
86.9
37.0
88.6
31.4
63.0
23.0
Access to
improved
drinking-water
sources
Access to
improved
sanitation
facilities
Open
defecation
Child stool
disposal in a
sanitary
manner
Households
who washed
hands with
soap before a
meal
WATER, SANITATION AND HYGIENE (WASH)1,2,7
55.1
11.0
37.9
29.4
64.9
36.8
57.3
Below
Poverty Line
households
Households
ownership of
agricultural
land
Households
in a
permanent
house
Access to
electricity
Adult
Literacy Rate
(%)
SOCIO ECONOMIC INDICATORS7,9
49.9
26.2
18.9
2.1
36.2
49.1
23.8
19.5
3.7
29
0
10
20
30
40
50
60
70
80
90
100
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
FOOD SECURITY8
82.5
32.9
8.6
11.3
0
10
20
30
40
50
60
70
80
90
100
Girls married
when <18years
old
Ever married
women/mothers
who completed
primary school
Women who
completed
secondary school
Women's
ownership of
land
Women's
ownership of
livestock
WOMEN'S STATUS5
Page 3
UNDERLYING CAUSES OF UNDERNUTRITION
BASIC CAUSES OF UNDERNUTRITION
• Per capita district domestic product of
Shravasti in 2010-11 is Rs. 12357.787,10
• Access to services can be improved
but data on access are also poor and
outdated.
No data available on indicators of
governance and political will to address
nutrition.
[Per capita district domestic product of Lucknow is
Rs. 38967.58
Per capita state domestic product of Uttar Pradesh is
Rs. 21182.95].
NoData
NoData
NoData
NoData
NoData
NoData
NoData
Areas for immediate action:
• Very high rates of open defecation; critical need to increase the number of households using improved
sanitation facilities in the district.
• Early marriage of girls less than 18 years is highly prevalent in Shravasti; early marriage is related to poor
health and nutrition outcomes for mothers and babies.
• Food insecurity, especially diet quality, is a challenge that can hold back improvements in nutrition.
Data challenges:
• No district level data available on land ownership, poverty levels.
• Difficult to compare indicators of water, sanitation and hygiene over time as census data do not provide data
on child stool disposal or on hand washing.
NoData
NoData
NoData
NoData
PERCENTAGE(%)PERCENTAGE(%)
PERCENTAGE(%)
NoData
NoData
!

4. This District Nutrition Profile was developed by Shruthi Cyriac for POSHAN. This version, dated
September 11, 2014 is a draft intended for use in a district-level workshop in Shravasti, Uttar Pradesh,
and will be revised following workshop discussions.
WHAT WILL IT TAKE TO IMPROVE NUTRITION IN SHRAVASTI?
Source:UNICEFIndia/2010/GrahamCrouch
Possible district-level actions to support nutrition:
Data sources
1. Author’s estimates based on HUNGaMA: Fighting Hunger & Malnutrition : the HUNGaMA Survey Report. 2011. Naandi Foundation.
2. Author’s estimates based on National Family Health Survey (NFHS-3), 2005-06, India. Mumbai: International Institute for Population Studies.
3. Author’s estimates based on District Level Household Survey on Reproductive and Child Health (DLHS-2), 2002-04, India. International Institute for Population Studies.
(IIPS). 2006. District Level Household Survey on Reproductive and Child Health (DLHS-2), 2002-04, India: Nutritional Status of Children and Prevalence of Anemia among
Children, Adolescent Girls and Pregnant Women. Mumbai: IIPS. September 11, 2014, www.rchiips.org/pdf/rch2/National_Nutrition_Report_RCH-II.pdf
4. International Institute for Population Studies(IIPS). n.d. District Level Household Survey on Reproductive and Child Health (DLHS-2), 2002-04, India, Uttar Pradesh.
Mumbai: IIPS. Accessed September 11, 2014, www.rchiips.org/pdf/state/UttarPradesh.pdf
5. International Institute for Population Studies (IIPS). 2010. District Level Household Survey and Facility Survey (DLHS-3), 2007-08, India, Uttar Pradesh. Mumbai: IIPS.
Accessed September 11, 2014, www.rchiips.org/pdf/rch3/report/UP.pdf
6. Robert E Black, Cesar G Victora, Susan P Walker, Zulfiqar A Bhutta, Parul Christian, Mercedes de Onis, Majid Ezzati, Sally Grantham-McGregor, Joanne Katz, Reynaldo
Martorell, Ricardo Uauy, and the Maternal and Child Nutrition Study Group. 2013. “Maternal and Child Undernutrition and Overweight in Low-Income and Middle-
Income Countries”. The Lancet 382 (9890), 427-451
7. Census of India. 2011. Houselisting and Housing Census Data. Accessed June 20, 2014, www.censusindia.gov.in/2011census/hlo/HLO_Tables.html
8. Author’s estimates based on Household Consumption Expenditure, National Sample Survey Office (NSSO) 68th Round, 2011-12. Ministry of Statistics and Program
Implementation. Government of India.
9. Planning Commission. 2013. Press note on poverty estimates, 2011-12. Government of India. Accessed September 11, 2014.
http://planningcommission.nic.in/news/pre_pov2307.pdf
10. Directorate of Economic and Statistics, Government of Uttar Pradesh. Gross District Domestic Product at Constant Prices (2011-12). Accessed September 11, 2014,
http://updes.up.nic.in/STATE%20ACC%20STATISTICS/NDDP%20&%20GDDP/statedomestic(b).htm