DISTRICT NUTRITION PROFILE JANGOAN | TELANGANA SEPTEMBER 2022 About District Nutrition Profiles: District Nutrition Profiles (DNPs) are available for 707 districts in India. They present trends for key nutrition and health outcomes and their cross-sectoral determinants in a district. The DNPs are based on data from the National Family Health Survey NFHS-4 (2015-2016) and NFHS-5 (2019-2021). They are aimed primarily at district administrators, state functionaries, local leaders, and development actors working at the district-level. Figure 1: Map highlights district Jangoan in the state/UT of Telangana Source: Adapted from Black et al. (2008) What factors lead to child undernutrition? Given the focus of India’s national nutrition mission on child undernutrition, the DNPs focus on the determinants of child undernutrition (Figure on the left). Multiple determinants of suboptimal child nutrition and development contribute to the outcomes seen at the district-level. Different types of interventions can influence these determinants. Immediate determinants include inadequacies in food, health, and care for infants and young children, especially in the first two years of life. Nutrition-specific interventions such as health service delivery at the right time during pregnancy and early childhood can affect immediate determinants. Underlying and basic determinants include women’s status, household food security, hygiene, and socio-economic conditions. Nutrition-sensitive interventions such as social safety nets, sanitation programs, women’s empowerment, and agriculture programs can affect underlying and basic determinants. District demographic profile, 2019 Jangoan 1,066/1,000 Sex ratio (females per 1,000 males) of the total population NA Number of women of reproductive age (15–49 yrs) 7,564 Total number of pregnant women registered for ANC 7,641 Number of live births 7,633 Number of institutional births NA Total number of children under 5 yrs Source: IFPRI estimates - Headcount = Prevalence x Eligible projected population for each district in 2019. Prevalence estimates: NFHS-4 (2015-16) & NFHS-5 (2019-21) state/district factsheets, national/state reports and IFPRI estimates using unit-level data. Projected population for 2019 (children <5 yrs and women 15-49 yrs) was estimated using Census 2011 Data on number of pregnant women, live births, and institutional deliveries are from HMIS. NA: unavailable/implausible data Citation: Singh. N., P.H. Nguyen, A. Pant, A. Christopher, M. Jangid, S.K. Singh, R. Sarwal, N. Bhatia, R. Johnston, W. Joe, and P. Menon. 2022. District Nutrition Profile: Jang- oan, Telangana. New Delhi, India: International Food Policy Research Institute. Acknowledgement: Financial support was provided by the Bill & Melinda Gates Foundation through POSHAN, led by the International Food Policy Research Institute. We thank Amit Jena (Independent Researcher) for design and programming support and IFPRI research analysts for cross checks. The state of nutrition outcomes among children (<5 years) Jangoan Telangana 2020 Burden of nutrition outcomes (2020) Indicators No. of children (<5 yrs) Low-birth weight NA Stunted NA Wasted NA Severely wasted NA Underweight NA Overweight/obesity NA Anemia NA Total children NA 0% 20% 40% 60% 80% 100% Low-birth weight Stunted Wasted Severely wasted Underweight Overweight/obesity Anemia 11% 33% 23% 10% 31% 6% 69% Note: NA refers to data unavailable for a given round of NFHS/Census. Points of discussion: • What are the trends in undernutrition among children under five years of age (stunting, wasting, underweight, and anemia)? • What are the trends in overweight/obesity among children under five years of age in the district? The state of nutrition outcomes among women (15-49 years) Jangoan Telangana 2020 Burden of nutrition outcomes (2020) Indicators No. of women (15-49 yrs) Underweight NA Overweight/obesity NA Hypertension NA Diabetes NA Anemia (non-preg) NA Anemia (preg) NA Total women (preg) 7,564 Total women NA 0% 20% 40% 60% 80% 100% Underweight (BMI <18.5 kg/m²) Overweight/obesity Hypertension Diabetes Anemia (non-pregnant) Anemia (pregnant) 18% 24% 26% 14% 57% NA Note: NA refers to data unavailable for a given round of NFHS/Census. Points of discussion: • What are the trends in underweight and anemia among women (15-49 yrs) in the district? • What are the trends in overweight/obesity and other nutrition-related non-communicable diseases in the district? 2 Immediate determinants Jangoan Telangana 2020 0% 20% 40% 60% 80% 100% Consumed IFA 100+ days (pregnant women) Consumed IFA 180+ days (pregnant women) Early initiation of breastfeeding (0-23 m) Exclusive breastfeeding (0-6 m) Continued breastfeeding (12-23 m) Timely introduction of complementary foods Adequate diet (0-23 m) Dietary diversity (0-23 m) Minimum meal frequency (0-23 m) Eggs and/or flesh foods consumption (6-23 m) Sweet beverage consumption (6-23 m) Bottle feeding of infants (0-23 m) 59% 35% 48% 79% 97% NA 11% 27% 23% 39% 11% 11% Note: NA refers to data unavailable for a given round of NFHS/Census. Points of discussion: • What are the trends in infant and young child feeding (early initiation of breastfeeding, exclusive breastfeeding, timely initiation of complementary feeding, and adequate diet)? What can be done to improve infant and young child feeding? • What are the trends in IFA consumption among pregnant women in the district? How can the consumption be improved? • What additional data are needed to understand diets and/or other determinants? Underlying determinants Jangoan Telangana 2020 0% 20% 40% 60% 80% 100% Women with ≥10 years of education Women 20-24 years married before the age of 18 Women 15-19 years with child or pregnant HHs using improved sanitation facility HHs with improved drinking water source Safe disposal of feces HHs with below poverty line (BPL) card HHs with health insurance 44% 20% 7% 84% 99% 17% 93% 72% Note: NA refers to data unavailable for a given round of NFHS/Census. Points of discussion: • How can the district increase women’s literacy, and reduce early marriage, if needed? • How does the district perform on providing drinking water and sanitation to its residents? Since sanitation and hygiene play an important role in improving nutrition outcomes, how can all aspects of sanitation be improved? • How can programs that address underlying and basic determinants (education, poverty, gender) be strengthened? • What additional data are needed on food systems, poverty or other underlying determinants? 3 Trends in coverage of interventions across the first 1,000 days Jangoan 2020 0% 20% 40% 60% 80% 100% 0% 20% 40% 60% 80% 100% Demand for FP satisfied Iodized salt Pregnancy registered (MCP card) ANC first trimester ≥ 4 ANC visits Weighing Birth preparedness counselling Breastfeeding counselling Tetanus injection Received IFA tab/syrup Deworming Food supplementation Institutional birth Financial assistance (JSY) Skilled birth attendant Postnatal care for mothers Postnatal care for babies Food supplementation Health & nutrition education Health checkup (ICDS) Full immunization Vitamin A Pediatric IFA Deworming Food supplementation (6-35 m) Weighing Counselling on child growth ORS during diarrhea Zinc during diarrhea Careseeking for ARI Preschool at AWC Health checkup from AWC 93% 97% 99% 90% 65% 99% 1% 97% 86% 94% 22% 91% 100% 5% 90% 86% 97% 88% 87% 81% 84% 81% 22% 23% 95% 80% 79% NA NA 81% 60% 74% Note: NA refers to data unavailable for a given round of NFHS/Census. Points of discussion: • How does the district perform on health and nutrition interventions along the continuum of care? Does it adequately provide both prenatal and postnatal services to women of reproductive age, pregnant women, new mothers and newborns? • How has access to health and ICDS services changed over time (food supplementation, health and nutrition education and health checkups)? 4