India’s more developed States, especially its southern States, have seen improvements in child nutrition over the last five years, but have a patchy record on immunisation, new official data shows.

The Ministry of Health and Family Welfare has begun releasing data for the fourth round of the District Level Health Survey, which covers all of the country, except the eight backward northern States known as the Empowered Action Group (EAG) states, and Assam. As of Friday, data for all the other major States, except Gujarat, was available. The new numbers deal with nutritional and health coverage for 2012-13 based on a large sample survey conducted by the Mumbai-based International Institute for Population Studies.

The DLHS data confirms the fall in child stunting previously reported by The Hindu from other sources. In all five southern States, child stunting has declined to between 20 and 30 percentage of all children. Maharashtra, Karnataka, Haryana and Punjab have seen the largest declines in child stunting.

India’s more developed States also show large increases in breastfeeding and in institutional deliveries. The mean age at marriage has risen to 20 in the southern States, and indices show that fertility will continue to fall in India; the proportion of women aged 20-25 with more than two children has declined, most sharply in Maharashtra and Karnataka.

However, on several other health indicators, the picture is more mixed. Female sterilisation remains by far the most common method of family planning, with over 95 per cent of all contraception in Tamil Nadu and Andhra Pradesh being female sterilisation. In several developed States – Tamil Nadu, Maharashtra, Haryana and Punjab – the proportion of children between one and two years of age who are fully immunised has actually fallen.

“Routine immunisation has suffered at the cost of aggressive pushing of the polio vaccine,” a senior health official said, asking not to be named. However in Tamil Nadu, for instance, immunisation against all diseases, including polio has declined, The Hindu found. “There is also not enough investment going into outreach workers,” the official added.

While stunting, recently identified by the World Bank as the key indicator of malnutrition, has declined, the proportion of children underweight and those with a below average weight for height has increased in some States including Tamil Nadu and Maharashtra. The situation in less developed States, moreover, remains unknown.

“The EAG States and Assam are being covered by the Annual Health Survey conducted by the Registrar General of India, and hence our mandate was not to cover those states,” IIPS director Dr. Faujdar Ram explained to The Hindu. The AHS, however, does not include malnutrition data for the EAG states.