Exhibiting the Changes in Nutritional Status of Children in India: An Empirical Insight from the Human Opportunity Index

Abstract

Enhancing the nutritional status is essential for fostering human resource development and attaining sustainable development. The objective of this study is to analyse the temporal change in the opportunity to access adequate nutritional outcomes (Normal height for age, Normal weight for age, and Normal weight for height) for children under the age of five in India. The analysis of the study is based on three sets (2005–06, 2015–16 and 2019–21) of National Family Health Survey (NFHS) data, at both the national and sub-national levels. It used the Human Opportunity Index (HOI), D-index, Shapley decomposition of D-index and time decomposition of HOI to examine temporal change in the opportunity to access adequate nutritional outcomes. At the national level, HOI increased in all three nutritional opportunities from 2005–06 to 2019–21, owing to the increase in coverage rate and decline in D-index. On the contrary, a sub-national analysis for the same period finds HOI to increase in all major states only in the case of Normal height for age and Normal weight for age. Whereas, states such as Punjab, West Bengal, Assam, Manipur, Mizoram, Nagaland, Sikkim, Andhra Pradesh, Karnataka, Uttar Pradesh, Goa, Maharashtra and Gujarat saw negative change in HOI for normal weight for height. Estimates from Shapley decomposition of D-index indicated that mother's education, wealth, social group, and access to toilet had major contribution to the unequal distribution of opportunities across all survey years. Further, the time decomposition of HOI revealed that the equalisation effect, which is the heart of the principle of equal opportunity, did not play a prominent role in expanding access to opportunities. Even a negative equalization effect is observed in Jammu & Kashmir, some states of the northeast, and even the rich states like Karnataka and Maharashtra. The study suggests a multi-pronged approach to address challenges, including increasing coverage and decreasing inequity in accessibility. Possible solutions include augmenting spending, minimizing leakages, and guaranteeing the delivery of services to the final recipients. A nuanced balance between "equality of outcomes" and "equality of opportunity" is needed.