The document summarizes trends in nutrition outcomes, determinants, and interventions in India between 2016 and 2021 based on data from the National Family Health Survey (NFHS)-4 (2015-16) and NFHS-5 (2019-21). Key findings include a reduction in undernutrition among children and women at the national level, though large variability remains across states. Stunting prevalence among children under 5 years declined in most states but remains a public health concern. The document also identifies districts with the highest prevalence of undernutrition and lowest coverage of interventions.

1. Trends in nutrition outcomes, determinants
and interventions between 2016 and 2021
Findings from NFHS-5 data
VERSION: December 29, 2021
This slide deck is an evolving work in progress, with updates being made frequently. If you want to use or cite this,
please email us at IFPRI-POSHAN@cgiar.org to receive the most updated version
Prepared by: Phuong H. Nguyen, Anjali Pant, Anita Christopher, Soyra Gune, Nishmeet Singh,
Sattvika Ashok, Soumyajit Ray, Rasmi Avula and Purnima Menon
International Food Policy Research Institute, New Delhi
Partners:
S.K. Singh, International Institute for Population Science (IIPS)
Rakesh Sarwal & Neena Bhatia, NITI Aayog

2. Table of content
2
1. Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2. Nutrition outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..7
2.1 Undernutrition outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.2 Overweight/obesity & non-communicable diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
3. Immediate determinants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
4. Underlying determinants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
5. Coverage of nutrition interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
6. Appendix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix

3. Overview
• Aims
• Conduct an initial analysis of multi-state and state-level trends in outcomes, determinants and
intervention coverage between 2016 and 2021
• Offer initial interpretations of trends at the multi-state level
• Intended audience
• Central and state government officials working in the sphere of maternal and child nutrition
• NGOs and other relevant organizations working on maternal and child nutrition
• Research institutes working on nutrition in Indian context
Note: NFHS-5 data source: Factsheets for 36 states/UTs
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
3

4. Data sources
• Data sources for trends analysis: National Family Health Survey (NFHS-4, 2015-16)
and (NFHS-5, 2019-21)
o NFHS-4 data were extracted from NFHS-5 (2019-21) national, state and district factsheets &
NFHS-4 (2015-16) national report
o NFHS-5 data were from NFHS-5 (2019-21) national, state and district factsheets
• Fieldwork for NFHS-4 was conducted between January 2015 and December 2016.
Fieldwork for NFHS-5 was conducted in two phases:
• 1) between June 2019 and January 2020 in 22 states
• 2) between January 2020 and April 2021 in 14 states
• 575 districts comparable across NFHS-4 and NFHS-5 included in the analyses
• Data sources for head count analysis:
o Census 2011 data to project state-level population of children under 5 year, women aged 15-
49, men aged 15-54 for the year 2019
o Number of pregnant and lactating women at state-level are computed using HMIS data for the
year 2019
o Prevalence from NFHS-5 factsheet
Note: NFHS-5 data source: Factsheets for 36 states/UTs
4
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix

5. Data analysis
• Trend analysis: To estimate change in the prevalence of key child and adult nutrition
outcomes, immediate determinants, and coverage of intervention between NFHS-4 and
NFHS-5
• National level trend using bar graphs
• National level variability by plotting the state level estimates (34 states comparable across NFHS-4
and 5) in a box-plot
• State level trend analysis using comet plots
• District level trend visualization using maps with prevalence cut-offs defined as per WHO
• Descriptive analysis: To identify top 20 districts with highest prevalence of child and adult
nutrition outcome and top 20 districts with lowest prevalence of determinants and
interventions
• State-level head count / burden analysis: State level headcount of nutrition outcomes,
determinants, and coverage of interventions was computed using the prevalence and
projected population data for 2019 / HMIS 2019 data.
Note: NFHS-5 data source: Factsheets for 36 states/UTs
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
5

6. Limitations
• Some indicators are unavailable in the NFHS-4 national report and NFHS-5 national, state and
district factsheet.
• Out of 707 districts for which NFHS-5 factsheet data is available, the analyses only focuses on
575 districts that are comparable between NFHS-4 and NFHS-5. Newly formed districts or old
districts (per Census 2011) from which new districts were carved out have been excluded from
the analyses.
• Ladakh, Dadra and Nagar Haveli and Daman and Diu were excluded from state-level trend
analysis (change between 2016-2021) as these are newly formed UTs. However, districts from
these two UTs were included in the district level analysis which compares NFHS 4 and 5.
• Due to unavailability of population level data, burden maps for few determinants indicators such
as teenage pregnancy, and households with improved source of drinking water, sanitation
facility, and electricity could not be created.
6
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Note: NFHS-5 data source: Factsheets for 36 states/UTs

7. Trends in undernutrition outcomes, 2016 & 2021
Source: NFHS-4 (2015-16) national report & NFHS-5 (2019-21) national factsheet
Undernutrition among children <5y Undernutrition among women (15-49y)
Note: Data on children < 5y who had low birth weight not available in NFHS-5 factsheets (2019-21).
Overview
Nutrition
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Immediate
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Underlying
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of
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Appendix
7
18.2
38.4
21.0
7.5
35.8
58.6
22.9
53.2
50.4
NA
35.5
19
7.7
32.1
67.1
18.7
57.2
52.2
0
20
40
60
80
100
Low birth weight Stunting Wasting Severe wasting Underweight
(children)
Anemia
(children)
Underweight
(women)
Anemia
(non-pregnant
women)
Anemia
(pregnant
women)
%
2016 2021

8. Variability in undernutrition outcomes, 2016 & 2021
(n= 34 states that are comparable over time)
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds. Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Median Bo
x
Whiske
r
Q3
Q1
Ma
x
Min
Overview
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Underlying
determinants
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of
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Appendix
8

9. Change in stunting prevalence among children
< 5 years by state, 2016 & 2021
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the undernutrition prevalence and
the total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5
state factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019
data.
Number of stunted children by state, 2021
9
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interventions
Appendix
Note: The units of the numbers in the graph above is thousands

10. Change in stunting prevalence among children < 5 years,
2016 & 2021
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<10 Low 0.0 0.0
10% to <20% Medium 4.6 5.3
20% to <30% High 26.5 34
30% to <40% Very high 30.2 37.2
≥40% Severe 38.8 23.5
2016 2021
20 districts with highest prevalence
District (State), 2021 %
Pashchimi Singhbhum ( JH ) 60.6
West Khasi Hills ( ML ) 59.0
Yadgir ( KA ) 57.6
Dohad ( GJ ) 55.3
Sitamarhi ( BR ) 54.2
Bijapur ( CG ) 53.8
Sheikhpura ( BR ) 53.6
Bahraich ( UP ) 52.1
Budaun ( UP ) 51.8
Sambhal ( UP ) 51.6
South West Khasi Hills ( ML ) 51.4
Pakur ( JH ) 51.3
Fatehpur ( UP ) 51.1
Banda ( UP ) 51.0
Shrawasti ( UP ) 50.9
Kurnool ( AP ) 50.5
Patan ( GJ ) 50.5
Araria ( BR ) 49.9
East Jantia Hills ( ML ) 49.8
Jogulamba Gadwal ( TG ) 49.7
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021 map
has used all available 707 districts.
Note: Stunting prevalence ≥20% is considered to be a public health
concern (Source: WHO(2011)).
10
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix

11. Change in wasting prevalence among
children < 5 years by state, 2016 & 2021
Number of wasted children by state, 2021
11
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) district factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis. Wasting
prevalence for Maharashtra and West Bengal are different across the two rounds but appear similar when rounded to one
decimal place.
Source: IFPRI estimates - The headcount was calculated as the product of the undernutrition prevalence and
the total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5
state factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019
data.
Note: The units of the numbers in the graph above is thousands

12. Change in wasting prevalence among children < 5 years,
2016 & 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021 map
has used all available 707 districts.
Note: Wasting prevalence ≥10% is considered to be a public health
concern. (Source: WHO (2011))
12 Districts: Rohtas ( BR ) and Jayashankar Bhupalapally ( TG )
12
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Nutrition
outcomes
Immediate
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Underlying
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Coverage
of
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Appendix
20 districts with highest prevalence
District (State), 2021 %
Karimganj ( AS ) 48.0
The Dangs ( GJ ) 40.9
Dhule ( MH ) 38.9
Chandrapur ( MH ) 38.5
Arwal ( BR ) 36.8
Tapi ( GJ ) 36.6
Jehanabad ( BR ) 36.6
Panch Mahals ( GJ ) 35.7
Komaram Bheem Asifabad (TG) 35.7
Sheohar ( BR ) 35.4
Kamareddy ( TG ) 34.5
Nagpur ( MH ) 34.0
Buxar ( BR ) 33.2
Sabar Kantha ( GJ ) 33.1
Saraikela-Kharsawan ( JH ) 32.9
Aurangabad ( BR ) 32.9
Shupiyan ( JK ) 32.8
Ranchi ( JH ) 32.7
Khunti ( JH ) 32.1
12 Districts 31.8
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 1.1 0.2
5% to <10% Medium 7 8.4
10% to <15% High 16.1 22.3
15% to <20% Very high 25.6 31.6
≥20% Severe 50.2 37.5
2016 2021

13. Change in severe wasting prevalence among
children < 5 years by state, 2016 & 2021
Number of severely wasted children by
state, 2021
13
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the undernutrition prevalence and the
total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

14. Change in severe wasting prevalence among children
<5 years, 2016 & 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021 map
has used all available 707 districts.
Note: Severe wasting prevalence ≥2% is considered a public health
concern (Source: WHO (2011))
14
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
20 districts with highest prevalence
District (State), 2021 %
Karimganj ( AS ) 30.5
Saraikela-Kharsawan ( JH ) 23.0
The Dangs ( GJ ) 22.2
Chandrapur ( MH ) 21.8
Sheohar ( BR ) 21.4
Nagpur ( MH ) 20.0
Panch Mahals ( GJ ) 19.7
Harda ( MP ) 18.8
Aurangabad ( BR ) 18.5
North Tripura ( TR ) 18.1
Dhule ( MH ) 18.1
Rohtas ( BR ) 18.0
Kamareddy ( TG ) 17.9
Shupiyan ( JK ) 17.4
Sonbhadra ( UP ) 17.4
Devbhumi Dwarka ( GJ ) 17.2
Tapi ( GJ ) 17.1
Kolkata ( WB ) 16.9
Khunti ( JH ) 16.8
Purbi Singhbhum ( JH ) 16.8
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 1% Low 1.1 0.4
1% to <2% Medium 2.5 2.1
2% to <5% High 25.1 26.3
5% to <10% Very high 47 48.1
≥10% Severe 24.4 23.2
2016 2021

15. Change in underweight prevalence among
children by state, 2016 & 2021
Number of underweight children by state,
2021
15
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the undernutrition prevalence and the
total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

16. Change in underweight prevalence among children
< 5 years, 2016 & 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: Underweight prevalence ≥20% is considered to be a
public health concern (Source: WHO(2011))
16
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
2016 2021
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<10 Low 1.6 1.2
10% to <20% Medium 15.3 16.8
20% to <30% High 24.2 33.2
30% to <40% Very high 25.3 34.2
≥40% Severe 33.7 14.6
20 districts with highest prevalence
District (State), 2021 %
Pashchimi Singhbhum ( JH ) 62.4
Nandurbar ( MH ) 57.2
The Dangs ( GJ ) 53.1
Dohad ( GJ ) 53.0
Arwal ( BR ) 52.9
Karimganj ( AS ) 52.9
Narmada ( GJ ) 52.8
Adilabad ( TG ) 52.0
Panch Mahals ( GJ ) 51.9
Tapi ( GJ ) 51.8
Jehanabad ( BR ) 51.7
Pakur ( JH ) 51.4
Banda ( UP ) 49.8
Mahisagar ( GJ ) 49.0
Saraikela-Kharsawan ( JH ) 48.7
Aurangabad ( BR ) 48.7
Rohtas ( BR ) 48.2
Chhota Udaipur ( GJ ) 48.1
Katihar ( BR ) 48.1
Araria ( BR ) 47.8

17. Change in anemia prevalence among
children by state, 2016 & 2021
Number of anemic children by state, 2021
17
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the undernutrition prevalence and the
total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

18. Change in anemia prevalence among children < 5 years,
2016 & 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: Anemia prevalence ≥40% is considered to be a public
health concern (Source: WHO(2011))
18
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
2016 2021
20 districts with highest prevalence
District (State), 2021 %
Leh(Ladakh) ( LD ) 95.5
Narmada ( GJ ) 93.2
Sukma ( CG ) 91.4
Lahul & Spiti ( HP ) 91.0
Panch Mahals ( GJ ) 91.0
Dantewada ( CG ) 89.9
Ganderbal ( JK ) 89.8
Tawang ( AR ) 89.6
Aravali ( GJ ) 89.5
Dibang Valley ( AR ) 88.6
Kishtwar ( JK ) 88.5
Kargil ( LD ) 87.9
Chhota Udaipur ( GJ ) 87.7
Valsad ( GJ ) 87.6
Dohad ( GJ ) 87.2
Chhatarpur ( MP ) 87.2
Narayanpur ( CG ) 86.8
Khandwa (East Nimar) ( MP ) 86.8
Vadodara ( GJ ) 86.4
Mahesana ( GJ ) 86.0
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 0.0 0.0
5% to <20% Medium 2.3 0.0
20% to <40% High 12.5 5.1
40% to <60% Very high 39.3 23
≥60% Severe 46 71.9

19. Change in underweight prevalence
among women by state, 2016 & 2021
Number of underweight women by
state, 2021
19
Overview
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outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-4 (2015-16) & NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the undernutrition prevalence and the
total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet , 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

20. Change in underweight prevalence among women,
2016 & 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: Underweight prevalence ≥10% is considered to be a
public health concern. (Source: WHO(2011))
20
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
2016 2021
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 1.2 4.7
5% to <10% Medium 8.4 11.1
10% to <15% High 30.7 43.9
15% to <20% Very high 38.4 34.7
≥20% Severe 21.2 5.6
20 districts with highest prevalence
District (State), 2021 %
Bijapur ( CG ) 43.6
Dohad ( GJ ) 39.1
Malkangiri ( OR ) 38.6
Banas Kantha ( GJ ) 36.7
Nandurbar ( MH ) 36.1
Tapi ( GJ ) 35.4
Bastar ( CG ) 34.9
Sukma ( CG ) 34.5
Aravali ( GJ ) 34.4
Pakur ( JH ) 34.4
Puruliya ( WB ) 33.7
The Dangs ( GJ ) 33.7
Pashchimi Singhbhum ( JH ) 33.1
Panch Mahals ( GJ ) 33.1
Deoghar ( JH ) 32.5
Kheda ( GJ ) 32.2
Chatra ( JH ) 32.2
Anand ( GJ ) 32.0
Madhepura ( BR ) 32.0
Arwal ( BR ) 31.9

21. Change in anemia prevalence among non-
pregnant women by state, 2016 & 2021
Number of anemic non-pregnant women by
state, 2021
21
Overview
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determinants
Underlying
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Coverage
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interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the undernutrition prevalence and the
total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet , 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

22. Change in anemia prevalence among non-pregnant women,
2016 & 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: Anemia prevalence ≥40% is considered to be a public
health concern (Source: WHO (2011))
22
Overview
Nutrition
outcomes
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determinants
Underlying
determinants
Coverage
of
interventions
Appendix
2016 2021
20 districts with highest prevalence
District (State), 2021 %
Leh(Ladakh) ( LD ) 94.6
Kargil ( LD ) 92.8
Kishtwar ( JK ) 86.2
Dakshin Dinajpur ( WB ) 82.8
Lahul & Spiti ( HP ) 82.3
Udalguri ( AS ) 82.2
Paschim Medinipur ( WB ) 82.0
Pakur ( JH ) 80.4
Kodagaon ( CG ) 79.5
Chhota Udaipur ( GJ ) 79.1
Sukma ( CG ) 79.0
Purba Barddhaman ( WB ) 78.4
Jamtara ( JH ) 78.4
Birbhum ( WB ) 78.2
Murshidabad ( WB ) 78.0
Ganderbal ( JK ) 77.9
The Dangs ( GJ ) 77.6
Tapi ( GJ ) 77.6
Kulgam ( JK ) 77.5
Bankura ( WB ) 77.3
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 0.0 0.0
5% to <20% Medium 1.1 0.2
20% to <40% High 17.9 11.2
40% to <60% Very high 56 49.8
≥60% Severe 25.1 38.8

23. 23
Change in anemia prevalence among
pregnant women by state , 2016 & 2021
Number of anemic pregnant women by state,
2021
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis.
Chandigarh has been excluded from the above plot since data on anemia among pregnant women in unavailable in NFHS-5
state factsheet for Chandigarh
Source: IFPRI estimates - The headcount was calculated as the product of the undernutrition prevalence and the
total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

24. Change in anemia prevalence among pregnant women,
2016 & 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: Anemia prevalence ≥40% is considered to be a public
health concern (Source: WHO(2011))
24
Overview
Nutrition
outcomes
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determinants
Underlying
determinants
Coverage
of
interventions
Appendix
2016 2021
20 districts with highest prevalence
District (State), 2021 %
Kodagaon ( CG ) 87.6
Uttar Dinajpur ( WB ) 84.4
Aravali ( GJ ) 82.6
Bastar ( CG ) 79.0
Leh(Ladakh) ( LD ) 79.0
Gajapati ( OR ) 77.4
Rayagada ( OR ) 77.3
Bharuch ( GJ ) 77.2
Rohtak ( HR ) 77.1
Jogulamba Gadwal ( TG ) 76.9
Unakoti ( TR ) 76.7
Kargil ( LD ) 76.7
Golaghat ( AS ) 76.7
Anugul ( OR ) 75.7
Narmada ( GJ ) 75.6
Dhalai ( TR ) 75.4
Pashchimi Singhbhum ( JH ) 74.8
Kendujhar ( OR ) 74.7
Purnia ( BR ) 74.6
Nawada ( BR ) 74.3
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 0.2 0.2
5% to <20% Medium 1.9 2.6
20% to <40% High 21.2 16.7
40% to <60% Very high 45.1 38.1
≥60% Severe 31.6 42.5

25. National prevalence (%)
Worst
performing
states
Best
performing
states
Highest
burden states
(millions)
% of districts (575) with public
health concern1
Children
<5 years
2016 2021 2016-2021 2016-2021 2021 2016 2021
Stunting 38 35
TR(+8.0)
GA(+5.7)
RJ(-7.3)
SK(-7.2)
UP(10.2)
BR(6.3)
95.5 94.7
Wasting 21 19
NL(+7.9)
JK(+6.8)
PD(-11.2)
HR(-9.7)
UP(4.4)
BR(3.4)
91.9 91.4
Severe
Wasting
7 8
LA(+5.8)
JK(+4.1)
HR(-4.7)
UK(-4.3)
UP(1.9)
BR(1.3)
96.5 97.6
Underweight
(children)
36 32
NL(+10.1)
JK(+4.4)
MP(-9.8)
RJ(-9.1)
UP(8.2)
BR(6.0)
83.2 82.0
Anemia
(children)
59 67
AS(+32.7)
MZ(+27.1)
CH(-18.6)
LA(-10.6)
UP(15.3)
BR(9.2)
85.3 94.9
Non pregnant
women
(15-49 years)
Underweight
(women)
23 19
PN(+1.0)
KL(+0.4)
AS(-8.0)
RJ(-7.4)
UP(11.8)
BR(7.8)
90.3 84.2
Anemia
(non-pregnant
Women)
53 57
AS(+20.3)
JK(+18.2)
LA(-20.3)
CH(-15.8)
UP(31.4)
WB(20.3)
81.1 88.6
Pregnant
women
(15-49 years)
Anemia
(pregnant
women)
50 52
SK(+17.1)
PD(+16.5)
LA(-18.1)
NL(-10.5)
UP(3.1)
BR(2.2)
76.7 80.6
Summary of undernutrition outcomes in India, 2016-2021
1 Public health concern is defined as ≥20% for stunting, ≥10% for wasting, ≥2% for severe wasting, ≥20% for underweight (children), ≥40% for anemia (children), ≥10% for underweight (women),
≥40% for anemia among non-pregnant women and ≥40% for anemia among pregnant women. Source: WHO (2011)
pp - percentage points
25
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Data source: NFHS-4 and NFHS-5 state and district factsheets. Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
AN: Andaman & Nicobar Islands AP: Andhra Pradesh AR: Arunachal Pradesh AS: Assam BR: Bihar CH: Chandigarh CG: Chhattisgarh DL: Delhi GA: Goa GJ: Gujarat HR: Haryana HP: Himachal Pradesh JK: Jammu & Kashmir JH: Jharkhand KA:
Karnataka KL: Kerala LA: Lakshadweep MP: Madhya Pradesh MH: Maharashtra MN: Manipur ML: Meghalaya MZ: Mizoram NL: Nagaland OD: Odisha PD: Puducherry PN: Punjab RJ: Rajasthan SK: Sikkim TN: Tamil Nadu TG: Telangana TR:
Tripura UP: Uttar Pradesh UK: Uttarakhand WB: West Bengal

26. Trends in overweight/obesity & non-communicable diseases,
2016 & 2021
26
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-4 (2015-16) national report & NFHS-5 (2019-21) national factsheet
NA refers to unavailability of that indicator in the specified NFHS round in either NFHS-4 national report or NFHS-5 national factsheet
2.1
20.6 18.9
11.0
NA NA NA
3.4
24.0 23 21.3
24.0
13.5 15.6
0
20
40
60
80
100
Overweight/obesity
(children)
Overweight/obesity
(women)
Overweight/obesity
(men)
Hypertension
(women)
Hypertension
(men)
Diabetes
(women)
Diabetes
(men)
%
2016 2021

27. Variability in overweight/obesity & non-communicable
diseases , 2016 & 2021
(n= 34 states that are comparable over time)
Median Bo
x
Whiske
r
Q3
Q1
Ma
x
Min
27
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds. Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis

28. Change in overweight/obesity among
children by state, 2016 & 2021
Number of overweight/obese children by
state, 2021
28
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the overweight/obesity prevalence and
the total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5
state factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

29. Change in overweight/obesity prevalence among children,
2016 & 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: Overweight/obesity prevalence ≥15% is considered to
be a public health concern (Source: WHO(2011))
29
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
2016 2021
20 districts with highest prevalence
District (State), 2021 %
Tawang ( AR ) 21.1
Kishtwar ( JK ) 21.1
Kulgam ( JK ) 20.6
Kra Daadi ( AR ) 20.2
Kathua ( JK ) 18.6
South District ( SK ) 16.6
Reasi ( JK ) 16.3
West Kameng ( AR ) 15.5
Doda ( JK ) 15.1
West Siang ( AR ) 14.9
Lower Subansiri ( AR ) 14.4
North District ( SK ) 14.1
Kargil ( LD ) 14.0
Upper Siang ( AR ) 13.5
Gariyaband ( CG ) 13.5
Dhalai ( TR ) 13.1
Siang ( AR ) 13.0
Srinagar ( JK ) 12.7
Leh(Ladakh) ( LD ) 12.7
Dima Hasao ( AS ) 12.5
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 90.5 72.3
5% to <10% Medium 7.9 22.6
10% to <15% High 1.2 3.7
15% to <20% Very high 0.4 0.9
≥20% Severe 0.0 0.5

30. Change in overweight/obesity among
women by state, 2016 & 2021
Number of overweight/obese women by state,
2021
30
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis.
Overweight/obesity prevalence for Maharashtra is different across the two rounds but appears similar when rounded to one decimal
place.
Source: IFPRI estimates - The headcount was calculated as the product of the overweight/obesity prevalence and
the total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

31. Change in overweight/obesity prevalence among women,
2016 & 2021
2016 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: Overweight/obesity prevalence ≥20% is considered to
be a public health concern (Source: WHO(2011))
31
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 1.2 1.1
5% to <10% Medium 15.3 7.5
10% to <15% High 45.1 37.4
15% to <20% Very high 25.1 28.2
≥20% Severe 13.3 25.8
20 districts with highest prevalence
District (State), 2021 %
Kanniyakumari ( TN ) 53.0
Yanam ( PD ) 51.6
Hyderabad ( TG ) 51.0
Thiruvananthapuram ( KL ) 50.6
Coimbatore ( TN ) 50.0
Sahibzada Ajit Singh Nagar ( PN ) 48.9
Thiruvallur ( TN ) 48.6
Puducherry ( PD ) 48.5
Jalandhar ( PN ) 48.3
Fatehgarh Sahib ( PN ) 48.2
Kancheepuram ( TN ) 46.4
Guntur ( AP ) 46.4
Vellore ( TN ) 45.4
West Godavari ( AP ) 45.3
Rupnagar ( PN ) 45.3
Theni ( TN ) 45.2
Ludhiana ( PN ) 45.1
Tiruppur ( TN ) 45.0
Central ( DL ) 44.8
East Godavari ( AP ) 44.4

32. Change in overweight/obesity among men
by state, 2016 & 2021
Number of overweight/obese men by state,
2021
32
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) district & state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the overweight/obesity prevalence and
the total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

33. Change in overweight/obesity prevalence among men,
2016 & 2021
2016 2021
33
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low
5% to <10% Medium
10% to <15% High
15% to <20% Very high
≥20% Severe
Data for
overweight/obesity
prevalence among men
is not available at the
district level.

34. Change in prevalence of hypertension
among women by state, 2016 & 2021
Number of women with hypertension by
state, 2021
34
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Note: Data on indicator for NFHS-4 unavailable in NFHS-5 (2019-21) state factsheet.
Source: IFPRI estimates - The headcount was calculated as the product of the overweight/obesity prevalence and
the total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Data
Unavailable
Note: The units of the numbers in the graph above is thousands

35. Change in hypertension prevalence among women,
2016 & 2021
2016 2021
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: hypertension prevalence ≥20% is considered to be a
public health concern (Source: WHO(2011))
Data on indicator for NFHS-4 (2015-16) unavailable in NFHS-5
district factsheets
35
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 0.0
5% to <10% Medium 0.5
10% to <15% High 44.7
15% to <20% Very high 47.2
≥20% Severe 7.5
20 districts with highest prevalence
District (State), 2021 %
Pathanamthitta ( KL ) 42.1
South District ( SK ) 41.0
North District ( SK ) 39.0
Gurdaspur ( PN ) 36.8
Sindhudurg ( MH ) 36.6
Hoshiarpur ( PN ) 35.9
Amritsar ( PN ) 35.9
Nicobars ( AN ) 35.4
Idukki ( KL ) 34.8
The Nilgiris ( TN ) 34.2
Kottayam ( KL ) 34.2
Mahe ( PD ) 33.3
Zunheboto ( NL ) 33.2
Pathankot ( PN ) 33.0
Sangrur ( PN ) 32.9
Barnala ( PN ) 32.8
West Siang ( AR ) 32.7
Shahid Bhagat Singh Nagar ( PN ) 32.7
West District ( SK ) 32.7
Jalandhar ( PN ) 32.5

36. Change in prevalence of hypertension
among men by state, 2016 & 2021
36
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: IFPRI estimates - The headcount was calculated as the product of the overweight/obesity prevalence and
the total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: Data on indicator for NFHS-4 unavailable in NFHS-5 (2019-21) state factsheet.
Number of men with hypertension by state,
2021
Data
Unavailable
Note: The units of the numbers in the graph above is thousands

37. Change in hypertension prevalence among men, 2016 & 2021
2016 2021
37
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 0.0
5% to <10% Medium 0.0
10% to <15% High 27.4
15% to <20% Very high 52.8
≥20% Severe 19.8
20 districts with highest prevalence
District (State), 2021 %
South District ( SK ) 49.6
North District ( SK ) 47.7
Nicobars ( AN ) 47.0
Dibang Valley ( AR ) 45.4
Bathinda ( PN ) 45.1
West District ( SK ) 45.1
Amritsar ( PN ) 43.0
Hoshiarpur ( PN ) 43.0
Shahid Bhagat Singh Nagar ( PN ) 42.8
Anjaw ( AR ) 42.6
Mansa ( PN ) 42.2
Pathanamthitta ( KL ) 41.9
Sangrur ( PN ) 41.8
Hyderabad ( TG ) 41.7
Central ( DL ) 41.5
Zunheboto ( NL ) 41.2
West Siang ( AR ) 41.1
Barnala ( PN ) 40.0
Gurdaspur ( PN ) 39.2
Kottayam ( KL ) 38.8
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: hypertension prevalence ≥20% is considered to be a
public health concern (Source: WHO(2011))
Data on indicator for NFHS-4 (2015-16) unavailable in NFHS-5
district factsheets

38. Change in prevalence of diabetes
among women by state , 2016 & 2021
Number of women with diabetes by state, 2021
38
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: IFPRI estimates - The headcount was calculated as the product of the overweight/obesity prevalence and
the total eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019-21 was estimated using Census 2011 and HMIS 2019 data.
Note: Data on indicator for NFHS-4 unavailable in NFHS-5 (2019-21) state factsheet.
Data
Unavailable
Note: The units of the numbers in the graph above is thousands

39. Change in diabetes prevalence among women, 2016 & 2021
2016 2021
39
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 0.9
5% to <10% Medium 35.4
10% to <15% High 54.9
15% to <20% Very high 8.6
≥20% Severe 0.2
20 districts with highest prevalence
District (State), 2021 %
Pathanamthitta ( KL ) 32.1
Kanniyakumari ( TN ) 29.0
Kottayam ( KL ) 28.7
Thrissur ( KL ) 28.3
Chennai ( TN ) 27.2
Mahe ( PD ) 27.1
Thiruvarur ( TN ) 26.5
Kollam ( KL ) 26.2
Thiruvananthapuram ( KL ) 26.1
Ernakulam ( KL ) 25.8
Alappuzha ( KL ) 25.2
Palakkad ( KL ) 24.6
Kannur ( KL ) 23.8
West Godavari ( AP ) 23.8
Karur ( TN ) 23.4
Krishna ( AP ) 23.3
Thanjavur ( TN ) 23.3
Prakasam ( AP ) 23.2
Kancheepuram ( TN ) 22.9
Theni ( TN ) 22.9
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: High sugar prevalence ≥20% is considered to be a public
health concern (Source: WHO(2011))
Data on indicator for NFHS-4 (2015-16) unavailable in NFHS-5
district factsheets

40. Change in prevalence of diabetes
among men by state , 2016 & 2021
Number of men with diabetes by state, 2021
40
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: IFPRI estimates - The headcount was calculated as the product of the overweight/obesity prevalence
and the total eligible projected population for each state in 2019. Prevalence estimates were obtained from
NFHS 5 state factsheet, 2019-21 and projected population for 2019-21 was estimated using Census 2011 and
HMIS 2019 data.
Note: Data on indicator for NFHS-4 unavailable in NFHS-5 (2019-21) state factsheet.
Data
Unavailable
Note: The units of the numbers in the graph above is thousands

41. Change in diabetes prevalence among men, 2016 & 2021
2016 2021
41
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 0.2
5% to <10% Medium 18.4
10% to <15% High 65.4
15% to <20% Very high 15.1
≥20% Severe 0.9
20 districts with highest prevalence
District (State), 2021 %
Thiruvananthapuram ( KL ) 36.2
Pathanamthitta ( KL ) 34.7
Thrissur ( KL ) 31.7
Kollam ( KL ) 30.2
Prakasam ( AP ) 30.2
Kottayam ( KL ) 29.4
Thanjavur ( TN ) 29.0
Karur ( TN ) 28.9
Mahe ( PD ) 28.6
East Godavari ( AP ) 27.6
Hyderabad ( TG ) 26.8
Tiruchirappalli ( TN ) 26.5
Palakkad ( KL ) 26.3
Sivaganga ( TN ) 26.2
Thiruvarur ( TN ) 25.9
Guntur ( AP ) 25.9
Ernakulam ( KL ) 25.5
Alappuzha ( KL ) 25.4
Thoothukkudi ( TN ) 25.4
Kanniyakumari ( TN ) 25.2
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: High sugar prevalence ≥20% is considered to be a public
health concern (Source: WHO(2011))
Data on indicator for NFHS-4 (2015-16) unavailable in NFHS-5
district factsheets

42. National prevalence (%)
Worst
performing
states
Best
performing
states
Highest
burden
states
(millions)
% of districts (575) with
public health concern1
Children
<5 years
2016 2021 2016-2021 2016-2021 2021 2016 2021
Overweight/
obesity
(children)
2 3
LA(+8.8)
MZ(+5.9)
GA(-0.9)
TN(-0.7)
UP(0.8)
MH(0.4)
0.4 1.4
Women
(15-49 years)
Overweight
/obesity
(women)
21 24
HR(+12.1)
PD, TN,
PK(+9.5)
LA(-7.1)
NL(-1.7)
UP(13.2)
TN(8.6)
38.4 54.0
Hypertension3
(women)
11 21 NA NA
UP(11.4)
MH(8.2)
NA 54.7
Diabetes2
(women)
NA 14 NA NA
UP(6.2)
WB(4.9)
NA 8.8
Men
(15-54 years)
Overweight
/obesity
(men)
19 23
LA(+17.1)
DL(+13.4)
AP(-2.5)
UP(11.3)
MH(8.9)
NA NA
Hypertension2
(men)
NA 24 NA NA
UP(13.2)
MH(8.8)
NA 72.6
Diabetes2
(men)
NA 16 NA NA
UP(7.0)
WB(6.3)
NA 16.0
Summary of overweight/obesity and non-communicable
disease outcomes in India, 2016-2021
1 Public health concern is defined as prevalence ≥15% for overweight/obesity (children), ≥20% for overweight/obesity (women, men) , ≥ 20% hypertension(women and men) and ≥20% high sugar (women and men). Source: WHO (2011)
2NFHS-4 data not available for indicator in NFHS-5 (2019-21) national, state and district factsheets and NFHS-4 (2015-16) national report
3NFHS-4 data is not available for indicator in NFHS-5 (2019-21) national, state and district factsheets.
42
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
pp - percentage points. Data source: NFHS-4 (2015-16) national factsheet and report and state factsheets and NFHS-5 (2019-21) national and state factsheets Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been
excluded from the analysis
AN: Andaman & Nicobar Islands AP: Andhra Pradesh AR: Arunachal Pradesh AS: Assam BR: Bihar CH: Chandigarh CG: Chhattisgarh DL: Delhi GA: Goa GJ: Gujarat HR: Haryana HP: Himachal Pradesh JK: Jammu & Kashmir JH: Jharkhand KA:
Karnataka KL: Kerala LA: Lakshadweep MP: Madhya Pradesh MH: Maharashtra MN: Manipur ML: Meghalaya MZ: Mizoram NL: Nagaland OD: Odisha PD: Puducherry PN: Punjab RJ: Rajasthan SK: Sikkim TN: Tamil Nadu TG: Telangana TR: Tripura
UP: Uttar Pradesh UK: Uttarakhand WB: West Bengal

43. NUTRITION
DETERMINANTS

44. Changes in immediate determinants of child undernutrition,
2016 & 2021
Note 1: Timely introduction of CF - timely introduction of complementary feeding,
Note 2: Data on continued breastfeeding at 2 years for NFHS-4 & 5 unavailable in NFHS-4 national report and NFHS-5 national factsheet
44
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source:NFHS-4 (2015-16) national report & NFHS-5 (2019-21) national factsheet
22.9
30.3
41.6
54.9
42.7
9.6 9.2
2.7
18.7
44.1 41.8
63.7
45.9
11.3
7.3
2.8
Underweight
(women)
Consumed IFA
100+ days
Early initiation of
breastfeeding
Exclusive
breastfeeding
Timely introduction
of CF
Adequate diet Diarrohea in the
last two weeks
ARI in the last two
weeks
%
2016 2021

45. Variability in immediate determinants of child undernutrition,
2016 & 2021
(n= 34 states that are comparable over time)
Median Bo
x
Whiske
r
Q3
Q1
Ma
x
Min
45
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds. Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis

46. Change in prevalence of underweight
women by state, 2016 & 2021
Number of underweight women by state,
2021
46
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source :NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the immediate determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

47. Change in prevalence of underweight women, 2016 & 2021
2016 2021
47
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
< 5% Low 2.5 6.1
5% to <10% Medium 8.4 10
10% to <15% High 30.5 43.5
15% to <20% Very high 37.4 34.7
≥20% Highest 21.2 5.6
20 districts with highest prevalence
District (State), 2021 %
Bijapur ( CG ) 43.6
Dohad ( GJ ) 39.1
Malkangiri ( OR ) 38.6
Banas Kantha ( GJ ) 36.7
Nandurbar ( MH ) 36.1
Tapi ( GJ ) 35.4
Bastar ( CG ) 34.9
Sukma ( CG ) 34.5
Aravali ( GJ ) 34.4
Pakur ( JH ) 34.4
Puruliya ( WB ) 33.7
The Dangs ( GJ ) 33.7
Pashchimi Singhbhum ( JH ) 33.1
Panch Mahals ( GJ ) 33.1
Deoghar ( JH ) 32.5
Kheda ( GJ ) 32.2
Chatra ( JH ) 32.2
Anand ( GJ ) 32.0
Madhepura ( BR ) 32.0
Arwal ( BR ) 31.9
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

48. Change in prevalence of consumed IFA
100+ days by state, 2016 & 2021
Number of mothers who did not consume
100+ IFA during pregnancy by state, 2021
48
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the immediate determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

49. Change in prevalence of consumed IFA 100+ days,
2016 & 2021
2016 2021
49
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20 Low 37.2 14.9
20% to <40% Medium 30.9 25.8
40% to <60% High 23.2 30.4
60% to <80% Very high 8.1 22.1
≥80% Highest 0.7 6.8
20 districts with lowest prevalence
District (State), 2021 %
Kiphire ( NL ) 1.6
Longleng ( NL ) 2.6
Tuensang ( NL ) 3.3
Zunheboto ( NL ) 5.5
Peren ( NL ) 6.1
Leh(Ladakh) ( LD ) 9.5
Pashchim Champaran ( BR ) 9.9
West Siang ( AR ) 9.9
Ghazipur ( UP ) 10.6
Mon ( NL ) 10.6
East Kameng ( AR ) 11.2
Kaimur (Bhabua) ( BR ) 11.2
Sheohar ( BR ) 11.3
East Siang ( AR ) 11.4
Mirzapur ( UP ) 11.6
Kheri ( UP ) 12.0
Saharsa ( BR ) 12.1
Bara Banki ( UP ) 12.5
Mokokchung ( NL ) 12.5
Upper Siang ( AR ) 12.6
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

50. Change in prevalence of early initiation of
breastfeeding by state, 2016 & 2021
Number of children under 3 not breastfed
within an hour of birth by state, 2021
50
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source:NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the immediate determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

51. Change in prevalence of early initiation of breastfeeding,
2016 & 2021
2016 2021
51
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20 Low 4.6 8.1
20% to <40% Medium 37.9 30.4
40% to <60% High 35.8 40.5
60% to <80% Very high 19.8 20.2
≥80% Highest 1.9 0.9
20 districts with lowest prevalence
District (State), 2021 %
Sant Ravidas Nagar (Bhadohi)
( UP ) 7.8
Ballia ( UP ) 8.0
Mirzapur ( UP ) 8.7
Unnao ( UP ) 11.7
Basti ( UP ) 12.1
Ghazipur ( UP ) 12.4
Faizabad ( UP ) 12.5
Sant Kabir Nagar ( UP ) 12.5
Kannauj ( UP ) 12.6
Jhansi ( UP ) 12.7
Pratapgarh ( UP ) 13.2
Mahrajganj ( UP ) 13.4
Jamtara ( JH ) 13.8
Fatehpur ( UP ) 13.9
Shrawasti ( UP ) 14.1
Balrampur ( UP ) 14.1
Giridih ( JH ) 14.5
South Tripura ( TR ) 15.8
Dumka ( JH ) 16.1
Una ( HP ) 16.4
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

52. Change in prevalence of exclusive
breastfeeding by state, 2016 & 2021
Number of children under 6 months not
exclusively breastfed by state, 2021
52
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis.
Chandigarh has been excluded from the above plot since data on exclusive breastfeeding is unavailable in NFHS-5 state
factsheet for Chandigarh
Source: IFPRI estimates - The headcount was calculated as the product of the immediate determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

53. Change in prevalence of exclusive breastfeeding ,
2016 & 2021
2016 2021
53
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20 Low 1.4 0.2
20% to <40% Medium 10.4 2.3
40% to <60% High 25.6 17.0
60% to <80% Very high 26.7 36.3
≥80% Highest 36.0 44.2
20 districts with lowest prevalence
District (State), 2021 %
Patna ( BR ) 22.3
East Khasi Hills ( ML ) 25.1
Tuensang ( NL ) 27.1
Jehanabad ( BR ) 32.8
Buxar ( BR ) 33.0
Bhojpur ( BR ) 33.8
Patan ( GJ ) 35.9
Katihar ( BR ) 36.1
Dindigul ( TN ) 36.4
Ribhoi ( ML ) 36.8
Peren ( NL ) 38.3
Murshidabad ( WB ) 39.0
Upper Subansiri ( AR ) 39.2
Nainital ( UK ) 41.2
West Khasi Hills ( ML ) 41.5
Darjiling ( WB ) 41.6
Chitrakoot ( UP ) 41.6
Rajouri ( JK ) 42.1
Hardwar ( UK ) 42.4
Agra ( UP ) 43.1
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

54. Change in prevalence of timely introduction
of complementary foods by state, 2016 &
2021
54
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis.
Andaman & Nicobar, Chandigarh, Goa and Lakshadweep have been excluded from the above graph since data for timely
introduction of complementary feeding is not available for these states in the NFHS-5 (2019-21) state factsheets.
Number of children 6-8 months not timely
introduced to complementary foods by
state, 2016 & 2019
Source: IFPRI estimates - The headcount was calculated as the product of the prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5
state factsheet, 2019 and projected population for 2019 was estimated using Census 2011.
Note: The units of the numbers in the graph above is thousands

55. Change in prevalence of timely introduction of
complementary foods, 2016 & 2021
2016 2021
55
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20 Low 3.2 0.9
20% to <40% Medium 14.4 4.0
40% to <60% High 8.2 3.5
60% to <80% Very high 4.2 1.2
≥80% Highest 70.0 90.4
20 districts with lowest prevalence
District (State), 2021 %
Auraiya ( UP ) 7.9
Mahoba ( UP ) 14.1
Siddharthnagar ( UP ) 15.1
Purnia ( BR ) 16.2
Gorakhpur ( UP ) 16.8
Simdega ( JH ) 20.6
Basti ( UP ) 20.9
Hardoi ( UP ) 20.9
Budaun ( UP ) 21.3
Sant Kabir Nagar ( UP ) 22.8
Sultanpur ( UP ) 25.4
Shrawasti ( UP ) 25.5
Sambhal ( UP ) 25.7
Hailakandi ( AS ) 25.8
Etah ( UP ) 26.1
Latehar ( JH ) 29.6
Mewat ( HR ) 29.7
Allahabad ( UP ) 29.9
Karauli ( RJ ) 30.6
Kishanganj ( BR ) 30.6
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

56. Change in prevalence of adequate diet by
state, 2016 & 2021
Number of children aged 6-23 months
without an adequate diet by state, 2021
56
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the immediate determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

57. Change in prevalence of adequate diet , 2016 & 2021
2016 2021
57
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20 Low 85.8 84.9
20% to <40% Medium 13.9 14.7
40% to <60% High 0.4 0.2
60% to <80% Very high 0.0 0.2
≥80% Highest 0.0 0.0
20 districts with lowest prevalence
District (State), 2021 %
Mahesana ( GJ ) 0.0
Navsari ( GJ ) 0.0
Allahabad ( UP ) 0.0
Azamgarh ( UP ) 0.0
Agar Malwa ( MP ) 0.0
Surendranagar ( GJ ) 0.9
Ballia ( UP ) 0.9
Kamrup Metropolitan ( AS ) 1.0
Mandsaur ( MP ) 1.2
Kheda ( GJ ) 1.2
Yanam ( PD ) 1.3
Tehri Garhwal ( UK ) 1.5
Hailakandi ( AS ) 1.6
Vizianagaram ( AP ) 1.8
Shamli ( UP ) 1.8
Parbhani ( MH ) 1.9
Kulgam ( JK ) 2.3
Gorakhpur ( UP ) 2.3
Lucknow ( UP ) 2.3
Chhota Udaipur ( GJ ) 2.4
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

58. Change in prevalence of diarrhea in the
last 2 weeks by state, 2016 & 2021
Number of children with diarrhea in the
last 2 weeks by state, 2021
58
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-4 (2015-16) & NFHS-5 (2019-21) district & state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the immediate determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

59. Change in prevalence of diarrhea in last 2 weeks,
2016 & 2021
2021
59
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20 Low 96.8 99.3
20% to <40% Medium 2.8 0.7
40% to <60% High 0.4 0.0
60% to <80% Very high 0.0 0.0
≥80% Highest 0.0 0.0
20 districts with highest prevalence
District (State), 2021 %
Supaul ( BR ) 39.3
Madhubani ( BR ) 30.2
Sitamarhi ( BR ) 26.6
Pashchim Champaran ( BR ) 22.1
Nashik ( MH ) 19.2
Washim ( MH ) 19.2
Jalna ( MH ) 19.0
Parbhani ( MH ) 18.6
Bastar ( CG ) 18.5
Baleshwar ( OR ) 18.3
Mayurbhanj ( OR ) 17.5
Aravali ( GJ ) 16.6
Araria ( BR ) 16.3
Nizamabad ( TG ) 16.2
Ahmadnagar ( MH ) 15.9
Saran ( BR ) 15.9
Siwan ( BR ) 15.8
Dhule ( MH ) 15.7
Bokaro ( JH ) 15.6
Gonda ( UP ) 15.4
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.
2016

60. Change in prevalence of ARI in the last 2
weeks by state, 2016 & 2021
Number of children with ARI in the last 2
weeks by state, 2021
60
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the immediate determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

61. Change in prevalence of ARI in last 2 weeks, 2016 & 2021
2016 2021
61
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20 Low 100.0 100.0
20% to <40% Medium 0.0 0.0
40% to <60% High 0.0 0.0
60% to <80% Very high 0.0 0.0
≥80% Highest 0.0 0.0
20 districts with highest prevalence
District (State), 2021 %
Gonda ( UP ) 11.2
Bundi ( RJ ) 9.5
Khammam ( TG ) 9.3
Khandwa (East Nimar) ( MP ) 9.3
South West ( DL ) 9.2
Harda ( MP ) 9.2
Jajapur ( OR ) 9.1
Etah ( UP ) 9.1
Bathinda ( PN ) 9.0
Kupwara ( JK ) 8.9
North West ( DL ) 8.8
Cuttack ( OR ) 8.4
Baran ( RJ ) 8.1
Bhadrak ( OR ) 7.9
Leh(Ladakh) ( LD ) 7.8
Anantnag ( JK ) 7.7
Kurukshetra ( HR ) 7.7
Ujjain ( MP ) 7.7
Basti ( UP ) 7.7
Mahamaya Nagar ( UP ) 7.6
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

62. National prevalence (%)
Worst
performing
states
Best
performing
states
Highest
burden states
(millions)
% of districts (575) with low
prevalence1
IYCF practices
2016 2021 2016-2021 2016-2021 2021 2016 2021
EIBF3 42 42
SK(-33.5)
AS(-15.3)
CH(+30.2)
DL(+23.2)
UP(11.7)
BR(6.1)
42.5 38.5
EBF4 55 64
SK(-26.4)
TR(-8.6)
PD(+19.4)
HR(+19.2)
UP(1.0)
BR(0.6)
11.8 2.5
Timely
introduction of
CF5
43 46
CG(-12.6)
MZ(-11.4)
TR(+39.4)
DL(+27.5)
UP(0.9)
BR(0.4)
17.6 4.9
Adequate diet 10 11
TN(-14.4)
JK(-9.9)
CH(+19.0)
OR(+11.9)
UP(8.0)
BR(4.4)
99.7 99.6
% of districts with high
prevalence 2
Maternal
determinants
Women with
BMI<18.5 kg/m2
23 19
PN(+1.0)
KL(+0.4)
AS(-8.0)
RJ(-7.4)
UP(11.8)
BR(7.8)
58.6 40.3
Consumed IFA
100+ days
30 44
LA(-1.6)
KA(-0.5)
WB(+34.4)
CH(+29.0)
UP(5.2)
BR(2.8)
68.1 40.7
Diseases
Diarrhea in the
last 2 weeks
9 7
SK(+3.7)
BR(+3.3)
UK(-12.6)
UP(-9.4)
BR(2.0)
UP(1.4)
3.2 0.7
ARI in the last 2
weeks
3 3
DL(+3.2)
PD,AP(+1.9)
CH(-2.5)
UK(-2.4)
UP(0.9)
BR(0.5)
0.0 0.0
Summary of immediate determinants of child undernutrition
in India, 2016-2021
pp - percentage points. Data source: NFHS-4 and NFHS-5 state and district factsheets Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
AN: Andaman & Nicobar Islands AP: Andhra Pradesh AR: Arunachal Pradesh AS: Assam BR: Bihar CH: Chandigarh CG: Chhattisgarh DL: Delhi GA: Goa GJ: Gujarat HR: Haryana HP: Himachal Pradesh JK: Jammu & Kashmir JH: Jharkhand KA:
Karnataka KL: Kerala LA: Lakshadweep MP: Madhya Pradesh MH: Maharashtra MN: Manipur ML: Meghalaya MZ: Mizoram NL: Nagaland OD: Odisha PD: Puducherry PN: Punjab RJ: Rajasthan SK: Sikkim TN: Tamil Nadu TG: Telangana TR:
Tripura UP: Uttar Pradesh UK: Uttarakhand WB: West Bengal. 1 Low prevalence is <40% prevalence for all indicators. 2 High prevalence is ≥20% for women with BMI<18.5 kg/m2 and ≥20% for diarrhea and ARI in the last 2 weeks. Source: WHO
(2011). 3Early initiation of breastfeeding; 4Exclusive breastfeeding ; 5Complementary foods;
Note: The high burden figure for all positive indicators is calculated by subtracting the burden for positive indicators from the total population concerned. The high burden figure for indicator EIBF, for example, refers to the states with the highest
number of women who did not practice early initiation of breastfeeding.
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix

63. Changes in underlying determinants of child undernutrition,
2016 & 2021
NA refers to unavailability of that indicator in the specified NFHS round in either NFHS-4 national report or NFHS-5 national factsheet
Note 1: Data on age at first birth < 20 years, open defecation, safe disposal of feces, HHs with hand washing facility and HHs with BPL card not available in NFHS-5 (2019-21) factsheets
Note 2: Several of these determinants are applicable for maternal undernutrition as well
63
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-4 (2015-16) national report & NFHS-5 (2019-21) national factsheet
NA
35.7
26.8
7.9
94.4
48.5
96.8
38.9
36.1
38.6
88.0
71.5
41.0
23.3
6.8
95.9
70.2
NA NA NA NA
96.8
0
20
40
60
80
100
Women who
are literate
Women with
≥ 10 years
education
Girls 20-24
married
before
the age of 18
years
Women 15-
19
with child
or pregnant
HHs with
improved
drinking water
source
HHs with
improved
sanitation
facility
HHs with
hand washing
facility
Open
defecation
Safe disposal
of feces
HHs with BPL
card
HHs with
electricity
%
2016 2021

64. Variability in underlying determinants of child
undernutrition , 2016 & 2021
Median Bo
x
Whiske
r
Q3
Q1
Ma
x
Min
64
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds. Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis

65. Change in prevalence of women with ≥10
years education by state , 2016 & 2021
Number of women without ≥10 years of
education by state , 2021
65
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the underlying determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

66. Change in prevalence of women with ≥10 years of education ,
2016 & 2021
2016 2021
66
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 15.4 6.1
20% to <40% Medium 52.1 45.8
40% to <60% High 26.7 38.6
60% to <80% Very high 5.3 8.2
≥80% Highest 0.5 1.2
20 districts with lowest prevalence
District (State), 2021 %
Pakur ( JH ) 13.6
Dhalai ( TR ) 13.9
Mewat ( HR ) 13.9
Malkangiri ( OR ) 14.0
Bahraich ( UP ) 14.4
Kishanganj ( BR ) 15.0
Nabarangapur ( OR ) 15.5
Devbhumi Dwarka ( GJ ) 15.8
Sukma ( CG ) 15.9
Sheopur ( MP ) 15.9
Shrawasti ( UP ) 15.9
Jhabua ( MP ) 16.0
Supaul ( BR ) 16.2
West Khasi Hills ( ML ) 16.4
Araria ( BR ) 16.8
Balrampur ( UP ) 16.8
Siddharthnagar ( UP ) 17.0
Alirajpur ( MP ) 17.3
Ashoknagar ( MP ) 17.6
Koraput ( OR ) 17.6
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

67. Change in prevalence of women aged 20-
24 married before 18 years by state , 2016
& 2021
Number of women aged 20-24 married
before 18 years by state , 2021
67
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-4 (2015-16) & NFHS-5 (2019-21) district & state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis. Women
aged 20-24 years married before 18 years prevalence for Meghalaya and West Bengal are different across the two rounds but
appears similar when rounded to one decimal place.
Source: IFPRI estimates - The headcount was calculated as the product of the underlying determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

68. Change in prevalence of women aged 20-24 married before
18 years, 2016 & 2021
2016 2021
68
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 42.8 55.6
20 to <40% Medium 41.6 35.3
40% to <60% High 14.9 9.1
60% to <80% Very high 0.7 0.0
≥80% Highest 0.0 0.0
20 districts with highest prevalence
District (State), 2021 %
Purba Medinipur ( WB ) 57.6
Lakhisarai ( BR ) 56.1
Supaul ( BR ) 55.9
Paschim Medinipur ( WB ) 55.7
Murshidabad ( WB ) 55.4
Araria ( BR ) 52.0
Madhepura ( BR ) 52.0
Sepahijala ( TR ) 51.9
Shrawasti ( UP ) 51.9
Jamui ( BR ) 51.9
Purnia ( BR ) 51.2
Saharsa ( BR ) 51.0
Dhubri ( AS ) 50.8
Jamtara ( JH ) 50.5
Purba Barddhaman ( WB ) 50.4
Birbhum ( WB ) 49.9
Samastipur ( BR ) 49.8
Begusarai ( BR ) 49.5
Banka ( BR ) 49.4
Katihar ( BR ) 49.4
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

69. Change in prevalence of women aged
15-19 who have a child or are pregnant
by state , 2016 & 2021
69
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Number of women aged 15-19 who have a
child or are pregnant by state. 2021
Data
Unavailable
Note: Data on projected number of households for 2019 is unavailable and therefore burden cannot be
calculated.

70. Change in prevalence of women aged 15-19 who have a
child or are pregnant, 2016 & 2021
2016 2021
70
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 97.4 98.1
20% to <40% Medium 2.6 1.9
40% to <60% High 0.0 0.0
60% to <80% Very high 0.0 0.0
≥80% Highest 0.0 0.0
20 districts with highest prevalence
District (State), 2021 %
Koch Bihar ( WB ) 27.3
Dhalai ( TR ) 26.9
Sepahijala ( TR ) 26.6
Paschim Medinipur ( WB ) 25.0
Birbhum ( WB ) 25.0
Gomati ( TR ) 24.4
Khowai ( TR ) 24.3
Saharsa ( BR ) 23.5
South Tripura ( TR ) 23.1
Dhubri ( AS ) 22.4
Purba Medinipur ( WB ) 22.0
South Salmara Mancachar ( AS ) 22.0
Purba Barddhaman ( WB ) 21.9
Purnia ( BR ) 21.4
Unakoti ( TR ) 21.2
Madhepura ( BR ) 20.8
Guntur ( AP ) 20.7
Murshidabad ( WB ) 20.6
Deoghar ( JH ) 20.2
West Tripura ( TR ) 20.2
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

71. Change in prevalence of HHs with
improved drinking water source by state ,
2016 & 2021
71
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-4 (2015-16) & NFHS-5 (2019-21) district & state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Note: Data on projected number of households for 2019 is unavailable and therefore burden cannot be
calculated.
Number of HHs without improved drinking
water source by state, 2021
Data
Unavailable

72. Change in prevalence of HHs with improved drinking water source,
2016 & 2021
2016 2021
72
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 0.4 0.2
20% to <40% Medium 0.2 0
40% to <60% High 2.5 0.9
60% to <80% Very high 10.9 6.3
≥80% Highest 86.1 92.6
20 districts with lowest prevalence
District (State), 2021 %
Hailakandi ( AS ) 41.2
Cachar ( AS ) 43.8
West Karbi Anglong ( AS ) 44.7
Dima Hasao ( AS ) 50.2
Ukhrul ( MN ) 50.9
North Garo Hills ( ML ) 51.5
Tamenglong ( MN ) 51.6
South West Garo Hills ( ML ) 58.6
South Garo Hills ( ML ) 60.4
Karimganj ( AS ) 62.3
Longding ( AR ) 62.5
Churachandpur ( MN ) 62.5
Dhenkanal ( OR ) 63.4
Kandhamal ( OR ) 64.4
Senapati ( MN ) 64.4
Dindori ( MP ) 66.1
Simdega ( JH ) 66.7
East Garo Hills ( ML ) 67.0
Khunti ( JH ) 68.6
Chandel ( MN ) 68.6
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

73. Change in prevalence of HHs using improved
sanitation facility by state, 2016 & 2021
73
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Number of HHs not using improved
sanitation facility by state, 2021
Note: Data on projected number of households for 2019 is unavailable and therefore burden cannot be
calculated.
Data
Unavailable

74. Change in prevalence of HHs using improved sanitation
facility, 2016 & 2021
2016 2021
74
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 11.4 0
20% to <40% Medium 31.4 2.6
40% to <60% High 24.4 20.7
60% to <80% Very high 20.4 44.2
≥80% Highest 12.5 32.5
20 districts with lowest prevalence
District (State), 2021 %
Puruliya ( WB ) 29.2
Bijapur ( CG ) 30.6
Araria ( BR ) 32.2
Madhepura ( BR ) 34.6
Sukma ( CG ) 35.5
Purnia ( BR ) 35.6
Dohad ( GJ ) 35.9
Gulbarga ( KA ) 36.5
Saran ( BR ) 37.2
Yadgir ( KA ) 37.4
Jamui ( BR ) 37.6
Pashchimi Singhbhum ( JH ) 37.7
Banka ( BR ) 38.2
Madhubani ( BR ) 38.2
Pakur ( JH ) 38.3
Koraput ( OR ) 39.4
Saharsa ( BR ) 40.5
Damoh ( MP ) 40.6
Banswara ( RJ ) 40.8
Malkangiri ( OR ) 41.4
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

75. Change in prevalence of HHs with
electricity by state , 2016 & 2021
75
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis. HHs
with electricity prevalence for Himachal Pradesh is different across the two rounds but appear similar when rounded to one
decimal place.
Number of HHs without electricity by
state, 2021
Note: Data on projected number of households for 2019 is unavailable and therefore burden cannot be
calculated.
Data
Unavailable

76. Change in prevalence of HHs with electricity ,
2016 & 2021
2016 2021
76
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 0.0 0.0
20% to <40% Medium 0.9 0.0
40% to <60% High 6.5 0.0
60% to <80% Very high 14.4 1.9
≥80% Highest 78.2 98.1
20 districts with lowest prevalence
District (State), 2021 %
Sitapur ( UP ) 68.4
Hardoi ( UP ) 71.0
Shrawasti ( UP ) 73.7
Bara Banki ( UP ) 74.8
Unnao ( UP ) 75.4
West Jaintia Hills ( ML ) 75.4
Fatehpur ( UP ) 76.8
Bahraich ( UP ) 77.8
Balrampur ( UP ) 78.4
Kaushambi ( UP ) 78.7
Dibang Valley ( AR ) 79.2
South Salmara Mancachar ( AS ) 79.5
Kanpur Dehat ( UP ) 79.8
Budaun ( UP ) 80.7
Cachar ( AS ) 81.7
Sonbhadra ( UP ) 82.9
Pashchimi Singhbhum ( JH ) 83.3
Shahjahanpur ( UP ) 84.1
Simdega ( JH ) 84.1
Kheri ( UP ) 84.2
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

77. Summary of underlying determinants of child undernutrition,
2016-2021
National prevalence (%)
Worst
performing
states
Best
performing
states
Highest
burden states
(millions)
% of districts (575) with low
prevalence1
Maternal
determinants
2016 2021 2016-2021 2016-2021 2021 2016 2021
Women who are
literate3 NA 72 NA NA NA NA NA
Women with ≥10
years education
36 41 TR(-0.1)
JK(+14.1)
GA(+13.3)
UP(37.7)
BR(21.8)
67.5 51.9
% of districts (575) with high
prevalence2
Women married
before age of 18
years
27 23
TR(+7.0)
MN(+2.6)
RJ(-10.)
MP,CG(-9.3)
BR(1.8)
WB(1.7)
15.6 9.1
Women aged 15-19
who have a child or
are pregnant
8 7
TR(+3.1)
TN(+1.3)
TG(-4.8)
AR(-4.5)
NA 0.0 0.0
% of districts (575) with low
prevalence1
Household
determinants
HHs with improved
drinking water source
94 96
SK(-5.0)
CH(-0.9)
MN(+13.1)
ML(+8.9)
NA 0.6 0.2
HHs using improved
sanitation facility
48 70 SK(-2.4)
CG(+42.0)
UP(+32.4)
NA 42.8 2.6
HHs with electricity 88 97
LA(-0.2)
SK(-0.1)
BR(+36.3)
UP(+18.5)
NA 0.9 0.0
pp - percentage points. Data source: NFHS-4 and NFHS-5 state and district factsheets Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
AN: Andaman & Nicobar Islands AP: Andhra Pradesh AR: Arunachal Pradesh AS: Assam BR: Bihar CH: Chandigarh CG: Chhattisgarh DL: Delhi GA: Goa GJ: Gujarat HR: Haryana HP: Himachal Pradesh JK: Jammu & Kashmir JH: Jharkhand KA:
Karnataka KL: Kerala LA: Lakshadweep MP: Madhya Pradesh MH: Maharashtra MN: Manipur ML: Meghalaya MZ: Mizoram NL: Nagaland OD: Odisha PD: Puducherry PN: Punjab RJ: Rajasthan SK: Sikkim TN: Tamil Nadu TG: Telangana TR: Tripura
UP: Uttar Pradesh UK: Uttarakhand WB: West Bengal. 1Low prevalence is <40% prevalence for all indicators. 2 High prevalence is >40% prevalence for all indicators 3 NFHS-4 data not available for indicator in NFHS-5 (2019-21) national, state and
district factsheets and NFHS-4 (2015-16) national report. Note: The high burden figure for all positive indicators is calculated by subtracting the burden for positive indicators from the total population concerned. The high burden figure for indicator HHs
with electricity, for example, refers to the states with the highest number of HHs that do not have electricity.
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
77

78. COVERAGE OF
NUTRITION
INTERVENTIONS

79. Interventions across the first 1000 days , 2016 & 2021
PREGNANCY DELIVERY & POSTNATAL EARLY CHILDHOOD
Source: : NFHS-4 (2015-16) national report & NFHS-5 (2019-21) national factsheet
Note 1 : Information on received IFA tab/syrup, deworming-pregnancy, weighing-pregnancy, breastfeeding counselling, counselling on keeping baby warm, cord care counselling, food supplementation-pregnancy,
health and nutrition education-pregnancy, food supplementation-breastfeeding, health and nutrition education-breastfeeding, pediatric IFA, deworming during early childhood, weighing- early childhood and counselling
on child growth is not available in NFHS-5 national factsheet for 2019-21.
Note 2: Information on received IFA tab/syrup, deworming-pregnancy, weighing-pregnancy, breastfeeding counselling, counselling on keeping baby warm, cord care counselling, food supplementation-pregnancy,
health and nutrition education-pregnancy, food supplementation- breastfeeding, health and nutrition education- breastfeeding, pediatric IFA, deworming-early childhood, weighing-early childhood and counselling on
child growth for 2015-16 was taken from NFHS-4 national report. Data for remaining indicators for 2015-16 was taken from NFHS-5 national factsheet.
Note 3: Counselling on child growth during early childhood is conducted after taking weight measurement
79
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
PRE -
PREGNANCY
0
20
40
60
80
100
Iodized
salt
ANC
first
trimester
≥
4ANC
Received
MCP
card
Received
IFA
tab/syrup
Tetanus
injection
Deworming
-
pregnancy
Weighing
-
pregnancy
Breastfeeding
counselling
Counselling
on
keeping
baby
warm
Cord
care
counselling
Food
supplementation
-
pregnancy
Health
&
nutrition
education
-
pregnancy
Institutional
birth
Skilled
birth
attendant
Postnatal
care
for
mothers
Postnatal
care
for
babies
Food
supplementation
-
breastfeeding
Health
&
nutrition
education
-
breastfeeding
Full
immunization
Vitamin
A
Pediatric
IFA
Deworming
Care
seeking
for
ARI
ORS
during
diarrhea
Zinc
during
diarrhea
Weighing
-
early
childhood
Counselling
on
child
growth
(%)
2019 2016

80. Variability in interventions , 2016 & 2021
Median Bo
x
Whiske
r
Q3
Q1
Ma
x
Min
PREGNANCY DELIVERY & POSTNATAL EARLY CHILDHOOD
80
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
PRE -
PREGNANCY
Source: NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds. Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis

81. Change in iodized salt coverage by state ,
2016 & 2021
Number of households not using iodized
salt, 2021
81
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source: NFHS-5 (2019-21) district & state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the underlying determinant
prevalence and the total eligible projected population for each state in 2019. Prevalence estimates were
obtained from NFHS 5 state factsheet, 2019-21 and projected population for 2019 was estimated using
Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

82. Change in coverage of iodized salt , 2016 & 2021
2016 2021
82
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 0.0 0.0
20% to <40% Medium 0.0 0.0
40% to <60% High 0.2 0.2
60% to <80% Very high 6.3 2.8
≥80% Highest 93.5 97
20 districts with lowest prevalence
District (State), 2021 %
Koppal ( KA ) 47.9
Unnao ( UP ) 68.7
East Garo Hills ( ML ) 69.0
Kurnool ( AP ) 70.4
Raichur ( KA ) 73.3
South West Garo Hills ( ML ) 74.5
Etah ( UP ) 74.8
Mainpuri ( UP ) 74.9
Chitrakoot ( UP ) 75.8
Fatehpur ( UP ) 76.2
Yadgir ( KA ) 76.3
Srikakulam ( AP ) 76.5
Theni ( TN ) 76.8
Gadag ( KA ) 77.1
Etawah ( UP ) 77.2
Farrukhabad ( UP ) 77.5
Dhaulpur ( RJ ) 78.0
Bara Banki ( UP ) 78.2
Rae Bareli ( UP ) 79.5
Shahjahanpur ( UP ) 79.8
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

83. Change in ANC first trimester coverage by
state , 2016 & 2021
Number of mothers who did not have at least
one ANC visit during first trimester, 2021
83
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

84. Change in coverage of ANC first trimester , 2016 & 2021
2016 2021
84
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 1.9 0.0
20% to <40% Medium 13.5 1.2
40% to <60% High 32.1 18.6
60% to <80% Very high 39.6 50
≥80% Highest 12.8 30.2
20 districts with lowest prevalence
District (State), 2021 %
Purnia ( BR ) 26.3
Tuensang ( NL ) 27.1
Kiphire ( NL ) 27.2
Upper Subansiri ( AR ) 34.6
Saharsa ( BR ) 34.8
Kishanganj ( BR ) 37.6
Papum Pare ( AR ) 38.4
East Siang ( AR ) 39.9
Bahraich ( UP ) 40.2
North Garo Hills ( ML ) 40.3
Katihar ( BR ) 40.9
Unakoti ( TR ) 41.0
Biswanath ( AS ) 41.2
Araria ( BR ) 41.6
East Kameng ( AR ) 41.7
Shrawasti ( UP ) 42.2
Longleng ( NL ) 42.3
Hoshangabad ( MP ) 42.4
Bhojpur ( BR ) 42.7
Bara Banki ( UP ) 43.3
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

85. Change in 4+ ANC visits coverage by state,
2016 & 2021
Number of mothers who did not have at least
4+ ANC visits, 2021
85
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-4 (2015-16) & NFHS-5 (2019-21) district & state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

86. Change in coverage of 4+ ANC visits , 2016 & 2021
2016 2021
86
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 15.6 2.8
20% to <40% Medium 23.5 17.7
40% to <60% High 18.6 28.4
60% to <80% Very high 26.1 30.7
≥80% Highest 16.1 20.4
20 districts with lowest prevalence
District (State), 2021 %
Tuensang ( NL ) 4.4
Kiphire ( NL ) 5.8
Phek ( NL ) 9.5
Mon ( NL ) 9.7
Purnia ( BR ) 11.1
Zunheboto ( NL ) 11.2
Saharsa ( BR ) 11.7
Peren ( NL ) 14.5
Katihar ( BR ) 15.3
Longleng ( NL ) 15.4
Kishanganj ( BR ) 17.1
Khagaria ( BR ) 17.4
Jehanabad ( BR ) 17.4
Patna ( BR ) 17.9
Mokokchung ( NL ) 18.2
Kra Daadi ( AR ) 18.3
Unnao ( UP ) 19.8
Sitamarhi ( BR ) 20.3
Madhepura ( BR ) 20.9
Begusarai ( BR ) 21.6
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

87. Change in coverage of MCP cards received
by state, 2016 & 2021
Number of mothers who did not receive
MCP cards, 2021
87
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

88. Change in coverage of MCP cards received , 2016 & 2021
2016 2021
88
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 0.0 0.0
20% to <40% Medium 1.4 0.0
40% to <60% High 0.5 0.4
60% to <80% Very high 11.9 1.2
≥80% Highest 86.1 98.4
20 districts with lowest prevalence
District (State), 2021 %
Imphal West ( MN ) 50.0
Imphal East ( MN ) 53.8
Senapati ( MN ) 77.1
Lakshadweep ( LA ) 77.8
Churachandpur ( MN ) 78.1
Ukhrul ( MN ) 78.3
Tamenglong ( MN ) 78.3
Thiruvananthapuram ( KL ) 79.1
Chandel ( MN ) 79.9
Dimapur ( NL ) 82.3
Siwan ( BR ) 82.9
Deoghar ( JH ) 83.1
Purba Champaran ( BR ) 83.5
Pashchim Champaran ( BR ) 83.9
Banka ( BR ) 84.0
Muzaffarpur ( BR ) 84.1
South Tripura ( TR ) 84.6
Kishanganj ( BR ) 84.7
Dhar ( MP ) 84.9
Bhagalpur ( BR ) 85.4
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

89. Change in protection against neonatal
tetanus coverage by state , 2016 & 2021
Number of women not protected against
neonatal tetanus, 2021
89
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

90. Change in coverage of protection against neonatal
tetanus, 2016 & 2021
2016 2021
90
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 0.0 0.0
20% to <40% Medium 0.5 0.0
40% to <60% High 2.3 0
60% to <80% Very high 11.4 5.4
≥80% Highest 85.8 94.6
20 districts with lowest prevalence
District (State), 2021 %
Kra Daadi ( AR ) 55.1
North Garo Hills ( ML ) 55.5
Kiphire ( NL ) 63.0
West Kameng ( AR ) 64.4
Tuensang ( NL ) 69.0
West Siang ( AR ) 72.0
Lawngtlai ( MZ ) 72.3
Saiha ( MZ ) 72.6
Patan ( GJ ) 72.9
East Kameng ( AR ) 73.1
Upper Siang ( AR ) 73.5
Mahesana ( GJ ) 73.8
Tirap ( AR ) 73.9
Papum Pare ( AR ) 74.0
Banas Kantha ( GJ ) 74.5
East Garo Hills ( ML ) 74.5
Lohit ( AR ) 74.6
East Siang ( AR ) 75.2
Longleng ( NL ) 75.5
Sivaganga ( TN ) 76.1
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

91. Change in institutional birth coverage by
state, 2016 & 2021
Number of live births not in an institutional
facility, 2021
91
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

92. Change in coverage of institutional birth, 2016 & 2021
2016 2021
92
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 0.5 0.0
20% to <40% Medium 2.6 1.1
40% to <60% High 11.8 1.8
60% to <80% Very high 28.2 14.7
≥80% Highest 56.8 82.5
20 districts with lowest prevalence
District (State), 2021 %
Mon ( NL ) 21.4
Phek ( NL ) 32.2
Kiphire ( NL ) 34.8
Tuensang ( NL ) 34.8
Zunheboto ( NL ) 35.0
Longleng ( NL ) 38.7
South West Khasi Hills ( ML ) 41.7
West Khasi Hills ( ML ) 41.7
West Jaintia Hills ( ML ) 42.2
Peren ( NL ) 43.5
Wokha ( NL ) 43.6
Ukhrul ( MN ) 44.6
Senapati ( MN ) 45.8
East Jantia Hills ( ML ) 48.4
Mokokchung ( NL ) 51.5
Lawngtlai ( MZ ) 53.7
Kishanganj ( BR ) 54.6
Chandel ( MN ) 55.5
Ribhoi ( ML ) 56.9
Tamenglong ( MN ) 57.7
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

93. Change in skilled birth attendant coverage
by state, 2016 & 2021
Number of births not attended by skilled
health personnel, 2021
93
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

94. Change in coverage of skilled birth attendant, 2016 & 2021
2016 2021
94
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 0.4 0.0
20% to <40% Medium 1.2 0.4
40% to <60% High 7.5 1.2
60% to <80% Very high 31.1 11.9
≥80% Highest 59.8 86.5
20 districts with lowest prevalence
District (State), 2021 %
Mon ( NL ) 30.9
Tuensang ( NL ) 39.2
Zunheboto ( NL ) 40.5
Longleng ( NL ) 44.6
Kiphire ( NL ) 46.7
West Khasi Hills ( ML ) 49.3
South West Khasi Hills ( ML ) 49.3
Phek ( NL ) 50.7
West Jaintia Hills ( ML ) 50.7
Peren ( NL ) 52.5
Ukhrul ( MN ) 54.5
East Jantia Hills ( ML ) 55.7
Lawngtlai ( MZ ) 59.9
Mokokchung ( NL ) 61.7
North Garo Hills ( ML ) 63.2
Wokha ( NL ) 63.5
Kishanganj ( BR ) 64.9
Longding ( AR ) 65.0
Senapati ( MN ) 65.0
Ribhoi ( ML ) 65.8
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

95. Change in postnatal care coverage for
mothers by state , 2016 & 2021
Number of mothers who did not receive
postnatal care, 2021
95
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

96. Change in coverage of postnatal care for mothers,
2016 & 2021
2016 2021
96
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 2.1 0.0
20% to <40% Medium 11.1 1.9
40% to <60% High 29.5 9.6
60% to <80% Very high 39.3 31.8
≥80% Highest 18.1 56.7
20 districts with lowest prevalence
District (State), 2021 %
Zunheboto ( NL ) 24.9
Mon ( NL ) 25.6
Longleng ( NL ) 28.5
West Jaintia Hills ( ML ) 28.6
Tuensang ( NL ) 29.5
Kiphire ( NL ) 31.9
East Khasi Hills ( ML ) 33.6
Kra Daadi ( AR ) 34.9
Senapati ( MN ) 37.0
Saharsa ( BR ) 38.5
West Kameng ( AR ) 38.9
Ribhoi ( ML ) 39.5
Phek ( NL ) 39.6
North Garo Hills ( ML ) 40.5
Kishanganj ( BR ) 40.7
Purnia ( BR ) 41.0
Bara Banki ( UP ) 41.5
Katihar ( BR ) 41.7
West Khasi Hills ( ML ) 42.0
South West Khasi Hills ( ML ) 42.9
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.

97. Change in coverage of postnatal care for
babies by state, 2016 & 2021
Number of babies who did not receive
postnatal care, 2021
97
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Note: Data on postnatal care for mothers is not available for NFHS-4 in NFHS-5 state factsheets.
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Data
Unavailable
Note: The units of the numbers in the graph above is thousands

98. Change in coverage of postnatal care for babies,
2016 & 2021
2016 2021
98
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 0.0
20% to <40% Medium 2.3
40% to <60% High 8.8
60% to <80% Very high 31.8
≥80% Highest 57.2
20 districts with lowest prevalence
District (State), 2021 %
Mon ( NL ) 22.4
Saiha ( MZ ) 22.8
Zunheboto ( NL ) 24.7
Lawngtlai ( MZ ) 28.4
Longleng ( NL ) 28.5
Tuensang ( NL ) 30.2
West Jaintia Hills ( ML ) 30.8
Aizawl ( MZ ) 33.2
Kiphire ( NL ) 33.5
West Kameng ( AR ) 33.8
Phek ( NL ) 34.9
Senapati ( MN ) 36.0
Kra Daadi ( AR ) 37.3
South West Khasi Hills ( ML ) 38.7
Ribhoi ( ML ) 39.3
Lunglei ( MZ ) 39.4
Saharsa ( BR ) 40.8
West Khasi Hills ( ML ) 41.4
Purnia ( BR ) 41.5
East Khasi Hills ( ML ) 41.6
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.
Data is not available for postnatal care for babies for NFHS-4
in NFHS-5 district factsheets.

99. Change in full immunization coverage by
state, 2016 & 2021
Number of children aged 12-23 months not
fully vaccinated, 2021
99
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Source NFHS-5 (2019-21) state factsheets, for 34 states across both survey rounds.
Note: Newly formed UTs : Ladakh, Dadra and Nagar Haveli and Daman and Diu have been excluded from the analysis
Source: IFPRI estimates - The headcount was calculated as the product of the coverage prevalence and the total
eligible projected population for each state in 2019. Prevalence estimates were obtained from NFHS 5 state
factsheet, 2019-21 and projected population for 2019 was estimated using Census 2011 and HMIS 2019 data.
Note: The units of the numbers in the graph above is thousands

100. Change in coverage of full immunization , 2016 & 2021
2016 2021
100
Overview
Nutrition
outcomes
Immediate
determinants
Underlying
determinants
Coverage
of
interventions
Appendix
Severity distribution of 575 comparable districts over time
Cut-offs Label 2016 2021
<20% Low 1.2 0.0
20% to <40% Medium 7.4 0.5
40% to <60% High 34.2 7.0
60% to <80% Very high 40.0 43.5
≥80% Highest 17.2 48.9
20 districts with lowest prevalence
District (State), 2021 %
Udalguri ( AS ) 38.3
Ukhrul ( MN ) 39.4
Tuensang ( NL ) 39.9
Wokha ( NL ) 42.8
Kiphire ( NL ) 42.8
Banas Kantha ( GJ ) 43.5
Jhansi ( UP ) 44.5
North Garo Hills ( ML ) 47.5
West Karbi Anglong ( AS ) 47.9
South Tripura ( TR ) 48.5
East Siang ( AR ) 48.8
East Khasi Hills ( ML ) 49.1
Kokrajhar ( AS ) 51.1
Bahraich ( UP ) 51.8
Palakkad ( KL ) 51.8
Prakasam ( AP ) 51.9
Parbhani ( MH ) 52.0
Bilaspur ( CG ) 52.5
Longding ( AR ) 52.7
Longleng ( NL ) 53.0
Source: NFHS-5 (2019-21) district factsheets.
Note: 2016 map has used 575 comparable districts and 2021
map has used all available 707 districts.
Note: WHO standard for prevalence not available.