New Delhi: India’s prevalence of “zero-food” children – where they haven’t consumed anything at all in a 24-hour span – is comparable to the rates in the west African nations of Guinea, Benin, Liberia and Mali, the Telegraph reported, citing a study that used data from the Union health ministry’s National Family Health Survey for 2019-2021.The study estimated India’s prevalence of zero-food children at 19.3%, the third highest after Guinea’s 21.8% and Mali’s 20.5%.The figures are much lower in Bangladesh (5.6%), Pakistan (9.2%), DR Congo (7.4%), Nigeria (8.8%) and Ethiopia (14.8%).The study was conducted using health surveys across 92 low-income and middle-income countries at various times between 2010 and 2021. The research was conducted by population health researcher S.V. Subramanian from Harvard University and his colleagues, and was published in JAMA Network Open, a peer-reviewed journal.It revealed that South Asia has the highest prevalence of zero-food children, estimated at 8 million, with India alone accounting for over 6.7 million, as reported by the newspaper.Lack of feeding care to infantsHealth experts familiar with child nutrition issues in India told the Telegraph the deprivation of food leading to zero-food children is likely to reflect not a lack of access to food but the inability of many mothers to provide appropriate feeding care to their infants.Zero-food children are infants or toddlers aged between six months and 24 months who have not received any milk or solid or semisolid food over a 24-hour period.Across the 92 countries, over 99% of the zero-food children had been breastfed, indicating that almost all the children had received some calories even during the 24-hour period during which they had been deprived of food.But at six months, breastfeeding is no longer sufficient to provide children with the nutrition they require, said the report.Children then need adequate protein, energy, vitamins and minerals through additional food along with breastfeeding.“The numbers highlight… the urgent need for tailored interventions to address this issue,” said Subramanian and his colleagues said in their paper.They said that more research was needed to unravel “the underlying causes” of zero-food prevalence, the barriers to optimal adequate child-feeding practices, and the ways socioeconomic factors might influence child-feeding behaviour.Vandana Prasad, a paediatrician and public health specialist who was not associated with the study, told the daily that many infants and toddlers are deprived of complementary feeding because their mothers’ circumstances prevent them from providing the children with feeding care.“It is not easy to feed children who are six months old – it takes time and energy, and many of the women in households where zero-food children might have been found don’t have the support they require for adequate complementary feeding,” Prasad said.In economically disadvantaged households, whether in rural regions or urban slums, mothers often find themselves balancing responsibilities to earn wages and carry out household chores. This leaves them with insufficient time to dedicate to complementary feeding for their children.Maternity entitlements and childcare services could help address the issue but many women don’t have access to such services, said Prasad, who’s also a technical adviser to the Public Health Resource Network, a non-government agency that has shown through studies in Odisha how crèches can help reduce under-nutrition levels in children from vulnerable households.Cultural issues and the lack of information, too, may in some instances affect complementary feeding practices, she said.Findings from the previous studySubramanian and his colleagues had last year generated India’s first estimate of the prevalence of zero-food children, based on the 2019-2021 health survey data.The study revealed that nearly two among every 10 infants or toddlers in India face the risk of not receiving any food whatsoever for a full day, the Telegraph had reported. And this revealed virtually no change in this measure of food deprivation since 2016, it said.The percentage of “zero-food” children increased from 17.2% in 2016 to 17.8% in 2021.The sampled children were aged between six months and 23 months who hadn’t eaten any food with substantial calorific content for at least an entire day.“The data contained something unusual and unexpected — we don’t expect young children between six months and 23 months to go entirely unfed for a whole 24 hours,” Subramanian had told the daily.“We don’t know how long the deprivation lasted in each child sampled — that’s a limitation in the data. But we’d expect a child to receive at least some food over a whole day,” Subramanian said. “The absence signals severe food deprivation.”This study sampled over 600,000 households, and included questions that probed what food children aged six to 23 months had consumed over the previous 24 hours.Both the 2016 and 2021 surveys had multiple identical questions asking whether the child had consumed any of a variety of solid or liquid foods. An answer of “no” to all the food questions for a child meant the child received no food in the preceding 24 hours.According to the report, the analysis has yielded an estimated headcount of 5.9 million zero-food children in the six-23 months age group in India in 2021. Uttar Pradesh had the highest prevalence (27.4%) of zero-food children, followed by Chhattisgarh (24.6%), Jharkhand (21%), Rajasthan (19.8%), and Assam (19.4%).Bengal is one of around 20 states where the prevalence of zero-food children has decreased since 2016. In Bengal specifically, the proportion dropped from 12.1% in 2016 to 7.5% in 2021, the report said.Goa had the most substantial drop from 18.9% to 5.1%, it added.This study was published in eClinicalMedicine, a member of The Lancet family of journals.
