Maharashtra’s Child Stunting Declines: What is Driving Them? Findings of a Multidisciplinary Analysis

Abstract

Between 2006 and 2012, Maharashtra’s stunting rate among children under two years of age was
\nreported to decline by 15 percentage points – one of the fastest declines in stunting seen anywhere
\nat any time. This was seemingly more remarkable because it occurred within a context where Indian
\nstunting levels nationally are regularly characterised as stuck or static. Maharashtra, the second
\nlargest state in India with a population of over 100 million people, appears to represent a major
\ndeparture from the norm. This report aims to understand the driving factors behind this rapid decline.
\n
\nThe report draws on three source papers written by the authors, which are summarised in this
\noverview paper: one drawing on secondary data (section 2 – Haddad 2014), one drawing on
\nprimary survey data (section 3 – Haddad and Valli 2014) and one drawing on primary qualitative
\ndata (section 4 – Barnett and Nisbett 2014).1 As will become clear, the three papers, using different
\nmethods and written by different combinations of the three principal authors, arrive at very similar
\nconclusions, giving us greater confidence in their validity.
\n
\nThis overview first surveys the literature to describe the broad economic, political and social
\nchanges occurring within the state in the 2000–2012 period. In what kind of environment did these
\ndeclines in stunting occur? Second, the paper analyses two child-level surveys undertaken in
\n2006 and 2012 to describe the distribution of stunting declines, identify factors correlated with the
\nhigher stunting (and wasting) rates in both years and to assess whether the relationship between
\nstunting, wasting and its correlates has profoundly changed. Third, we conducted interviews and
\nfocus group discussions with key stakeholders in academia, civil society, government, international
\npartner organisations, media and the private sector to identify the perceived critical factors for the
\ndecline in stunting. The final section of the paper concludes with a series of messages that we
\nbelieve are important for nutrition policymaking in India and globally.