As India observes National Nutrition Week, the latest government survey shows that child malnutrition remains widespread, even as some indicators have improved over the past five years.

The National Family Health Survey (NFHS-6), released this year and covering 2023-24, found that 29.3% of Indian children under five are stunted, or too short for their age. Another 19% are wasted, meaning they weigh too little for their height. Nearly a third, 31.8%, are underweight.

These numbers have come down from the previous round of the survey, NFHS-5 (2019-21), when stunting stood at 35.5% and underweight at 32.1%. The pace of improvement remains slow.

The share of children under six months who are exclusively breastfed fell from 63.7% in NFHS-5 to 55.8% in NFHS-6. Doctors consider exclusive breastfeeding in the first six months critical for a child’s immunity and growth.

The survey also found that only 15.3% of children aged 6 to 23 months receive what the government defines as an “adequate diet”, a diet with sufficient food groups and meal frequency. This is an improvement from 11% in NFHS-5, but it still means most young children in this age group are not being fed properly.

A study published in the journal Children in 2024, which analysed NFHS-5 data on more than 210,000 children, used a broader measure called the Composite Index of Anthropometric Failure. This index counted a child as malnourished if they showed signs of stunting, wasting or being underweight, either alone or in combination. By this measure, the study found that 52.59% of Indian children under five experienced some form of anthropometric failure.

The study, led by researchers at Georgia Southern University in the United States, found that girls had a slightly lower risk of malnutrition than boys after accounting for other factors. Children born average or large in size were less likely to be malnourished than those born small. However, children who were second, third, fourth, or later born faced a higher risk than firstborn children.

Maternal factors also played a role. Mothers aged 20 to 34 and those with secondary or higher education were less likely to have malnourished children, the study found. Severe anaemia in mothers was linked to a higher risk of malnutrition in their children.

Wealth mattered too. Children from middle-income and richer households, and those with access to a toilet at home, had a lower risk of malnutrition compared to poorer households and those without sanitation facilities.

The study concluded, “Child malnutrition remains a critical issue in India.”

At the same time, a separate 2025 study published in the journal Dialogues in Health pointed to a second, less discussed problem: rising obesity among Indian adults, even as child undernutrition persists.

The study, which tracked NFHS data from 2005-06 to 2019-21, found that the share of overweight or obese women rose from 12.6% to 24% over that period, while the figure for men rose from 9.3% to 22.9%. Meanwhile, underweight prevalence among adults nearly halved over the same years.

The researchers described this as a “malnutrition dichotomy”, where undernutrition in children coexists with rising overweight and obesity in adults, often within the same country and even the same households.

The study also found that only 11.3% of children aged 6 to 23 months across India were fed a minimum acceptable diet as measured in NFHS-5, leaving the rest at risk of missing key nutrients during a critical growth window.

India ranks 105th out of 127 countries in the 2024 Global Hunger Index, the Dialogues in Health study noted, citing global data on hunger and undernutrition.

Government policy has for years focused on interventions such as antenatal care, iron and folic acid supplementation for pregnant women, institutional delivery, early breastfeeding, timely complementary feeding, immunisation, and monitoring for severe and moderate acute malnutrition. Schemes such as the Integrated Child Development Scheme, Poshan Abhiyaan and Anaemia Mukt Bharat have been built around these interventions.

Writing in 2020, two public health officials associated with government think tank NITI Aayog, Dr Rakesh Sarwal and Dr Neena Bhatia, argued in a newspaper column that the success of nutrition programmes ultimately depends on mothers and families acting on the services made available to them.

They wrote, “Hence, efforts to reduce malnutrition must be accelerated.”

Researchers behind the more recent studies say that going forward, addressing malnutrition in India will require looking beyond just food availability, to include maternal health, sanitation access, household wealth, and dietary diversity among young children, alongside the emerging challenge of adult obesity.

To understand why these gaps persist, First Check spoke to Dr Aarthi Char, a resident doctor in community medicine, preventive and social medicine, at Sree Balaji Medical College and Hospital, Chennai, who works on nutrition and awareness camps at primary health centres.

Dr Char cited several government schemes for child nutrition, including Saksham Anganwadi, Poshan 2.0 and PM Poshan, formerly the midday meal programme, which follow fixed nutritional norms.

“In primary class, from standard one to five, almost 450 kilocalories will be given, 12 grams of protein will be given, and in that almost 100 grams should be grains, 20 grams should be pulses and 50 grams vegetables,” she said. 

“In upper primary, from sixth to eighth standard, we provide 700 kilocalories, because they are teenagers, and about 20 grams of protein,” she added. 

“We have schemes for that as well, like Anaemia Mukt Bharat, in which a specified dosage of iron supplements is given to children starting from infants to adolescents,” she said, also citing India’s iodised salt programme.

Asked why only 15.3% of children aged 6 to 23 months get an adequate diet as per NFHS-6 despite these schemes, Dr Char said the main barrier was awareness, not the absence of programmes. “The awareness among the poor people that these schemes are there to help them has not reached them, and that is the main problem,” she said.

She said families below the poverty line remain focused on daily survival, which shapes whether children are sent to school and, in turn, whether they receive school meals. “If you are constantly in survival mode, you do not think of anything futuristic,” she said. 

She added that girls are sometimes kept out of school, and some children are pushed into work instead. “If they are sending children, they would prefer them to do domestic chores, or they would want them to go and work in some labour work,” she mentioned, cutting them off from midday meal benefits.

Dr Char also flagged a gap between how schemes are designed and how they reach people. “We need to make sure that it reaches the children in the same manner when it comes to the state level or at a very basic level,” she noted.

She suggested taking nutrition services beyond schools, to panchayat offices or health centres, so families not sending children to school can still access food while being nudged toward enrolment. 

“Once the focus of the people gets out from the basic necessity of food, only then will they proceed towards progress,” she stated. “Seeking them out is our job, because a person who has not been educated will not know the importance of being educated,” she added.

National Nutrition Week is observed every year from September 1 to September 7 to raise awareness about the importance of nutrition for health and development.

Also read: Dual burden of malnutrition and obesity: India faces $440 billion economic threat by 2060