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