Decline of Child Stunting in India: State-Level Variations and Policy Implications from NFHS-6 (2023–24)

Abstract

Background: Despite significant policy investment under related programs, child stunting, defined as height-for-age below −2 standard deviations from the WHO reference median, remains a major public health concern in India. Objective: To analyse state-level trends in the prevalence of childhood stunting between NFHS-5 and NFHS-6, identify high-burden states where progress has stalled, and create evidence-based policy recommendations. Materials & Methods: The NFHS-6 fact sheet data from all 28 states and seven Union Territories except Manipur were subjected to a cross-sectional secondary analysis. The prevalence of stunting (height-for-age < −2 SD, WHO Child Growth Standards) and matching NFHS-5 values were tabulated. The absolute change in the prevalence of stunting was used to categorize states into four performance groups. Results: Over the course of almost four years, the national prevalence of stunting decreased by 6.2 percentage points (pp), from 35.5% (NFHS-5) to 29.3% (NFHS-6). Stunting varied from 16.6% (Puducherry) to 37.1% (Dadra & Nagar Haveli and Daman & Diu) in all 35 states and UTs (except Manipur). In comparison to NFHS-5, two UTs (Andaman & Nicobar Islands and Lakshadweep) reported worsening stunting. West Bengal (−11.4 pp), Tripura (−10.4 pp), and Himachal Pradesh (−10.2 pp) were Tier I strong performers (reduction ≥ 10 pp). In almost every state and UT, there is still a significant stunting disparity between urban and rural areas. Conclusion: Although the overall drop in stunting in India is positive, the persistence of high-burden regions necessitates targeted, area-specific programming. An essential baseline for SDG 2.2 monitoring is provided by NFHS-6.