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46,1
25,5
44,0
67,8
33,5
18,6
3,9
38,2
18,3
34,4
70,8
30,3
18,9
2,6
Children	
  	
  stunted	
  
(%)1,2,^
Children	
  	
  wasted	
  
(%)1,2,^
Children	
  
underweight	
  
(%)1,2,^
Children	
  with	
  any	
  
anemia	
  (%)1,^^
Chronic	
  energy	
  
deficiency	
  in	
  
women	
  (%)1	
  
Children	
  with	
  
birthweight	
  
<2500gms	
  (%)2,3
Adults	
  who	
  are	
  
obese	
  in	
  the	
  
district	
  (%)1
Sambalpur Odisha
^Children	
  aged	
  <5years;	
  	
  ^^Children	
  aged	
  0-­‐59	
  months
Source:	
  Data	
   source	
  provided	
  on	
  Page	
  4
50,6% 49,4%
29,6% 70,4%
18,4% 34,1% 47,5%
Sambalpur,	
  Odisha
DISTRICT	
  NUTRITION	
  PROFILE
Page	
  1
THE	
  STATE	
  OF	
  NUTRITION	
  IN	
  SAMBALPUR
DISTRICT	
  DEMOGRAPHIC	
  PROFILE
Total	
  Population 10,41,099
MALE FEMALE
RURALURBAN
SC ST OTHERS
CHANGES	
  OVER	
  TIME
Odisha
(Children	
  aged	
  <5	
  years)
Sambalpur
(Children	
  aged	
  <	
  5	
  years)
2005-­‐06	
  
(NFHS-­‐3)
2013-­‐14	
  
(RSOC)
2002-­‐04	
  
(DLHS-­‐2)
2014
(CAB)
Stunting 42.4% 38.2% No	
  data	
   46.1%
Wasting 20.0% 18.3% No	
  data 25.5%
Underweight 39.5% 34.4% 52.2% 44.0%
CHILDREN	
  
STUNTED1
CHILDREN	
  
WASTED1
CHILDREN	
  
UNDERWEIGHT1
46.1%
25.5%
44.0%
THE	
  PREVALENCE	
  OF	
  
UNDERWEIGHT	
  HAS	
  
DECREASED	
  IN	
  THE	
  
DISTRICT	
  BETWEEN	
  
2002	
  AND	
  2014
Sambalpurranks	
  352th
amongst	
  599	
  districts	
  in	
  India
(District	
  Development	
  Index)13
Insert	
  map	
  here
76,8
28,0
78,5
65,4
20,1
85,0
28,3
78,7
30,7
55,5
25,8
68,8 68,6
14,0
87,2
58,3
Early	
  initiation	
  of	
  
breastfeeding	
  (%)
Exclusive	
  
breastfeeding	
  (%)
Children	
  (6-­‐8	
  mo)	
  
who	
  received	
  any	
  
solid/semi	
  solid	
  
food	
  in	
  the	
  last	
  24	
  
hours	
  (%)
Children	
  who	
  
achieve	
  minimum	
  
diet	
  diversity	
  (%)
Full	
  immunization	
  
coverage	
  (%)
Children	
  (6-­‐35mo)	
  
who	
  got	
  vitamin	
  A	
  
supplementation	
  
(%)
Children	
  suffering	
  
from	
  diarrhoea	
  (%)
Children	
  <5	
  years	
  
with	
  diarrhoea	
  
treated	
  with	
  ORS	
  
(%)
Women	
  aware	
  of	
  
danger	
  signs	
  of	
  
pneumonia	
  (%)
Page	
  2	
  
Child undernutrition is caused by inadequacies in food, health and care for infants and young children, especially in
thefirst two years oflife (immediatecauses). Inadequate food, health and care arise from food insecurity, unsanitary
living conditions, low status ofwomen, and poor health care(underlying causes). These are, in turn, caused by social
inequity, economic challenges, poor political will and leadership to address these causes (basic causes). Interventions
to address undernutrition must address thesemultiplecauses ofundernutritionand do so in an equitablemanner.
IMMEDIATE	
  CAUSES	
  OF	
  UNDERNUTRITION
Areas	
  for	
  action:
Data	
  challenges:
IMMEDIATE	
   CAUSES
Breastfeeding,	
  nutrient	
  rich	
  foods,	
  and	
  eating	
  routine
Feeding	
  and	
  caregiving	
  practices,	
  parenting	
  stimulation
Low	
  burden	
  of	
  infectious	
  diseases
Optimum	
  fetal	
  and	
  child	
  nutrition	
  and	
  development
WHAT	
  FACTORS	
  CAUSE	
  UNDERNUTRITION? 4
UNDERLYING	
  CAUSES
Food	
  security:	
  availability,	
  economic	
  access	
  and	
  use	
  of	
  food
Feeding	
  and	
  caregiving	
  resources	
  (maternal,	
  household	
  and	
  
community	
  level)
Access	
  to	
  and	
  use	
  of	
  health	
  services,	
  a	
  safe	
  and	
  hygienic	
  environment
BASIC	
  CAUSES
Knowledge	
  and	
  evidence
Politics	
  and	
  governance
Leadership,	
  capacity	
  and	
  financial	
  resources
Social,	
  economic,	
  political,	
  and	
  environmental	
  context	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  
(national	
  and	
  global)
The	
  most	
  crucial	
  period	
  for	
  child	
  nutrition	
  is	
  	
  
from	
  pre-­‐pregnancy	
  to	
  the	
  second	
  year	
  of	
  life2
HOW	
  CAN	
  NUTRITION	
   IMPROVE?
ADOLESCENT	
   & MATERNAL	
  HEALTH1,3,5
DISEASE	
   BURDEN3IMMUNIZATION	
  &	
  
SUPPLEMENTATION3
INFANT	
  AND	
  YOUNG	
  
CHILD	
  FEEDING2,3
0
10
20
30
40
50
60
70
80
90
100
Age	
  of	
  child	
  (in	
  months)
Percentage	
  of	
  child	
  stunting	
  (%)
Window	
   of	
  
opportunity
Too	
  late
No	
  Data
No	
  Data
98,4 99,9
62,6
98,0 97,6
78,4
Women	
  with	
  access	
  to	
  
at	
  least	
  1	
  antenatal	
  
care	
  coverage	
  (%)
Any	
  anemia	
  among	
  
pregnant	
  women	
  (%)
Any	
  anemia	
  among	
  
adolescent	
  girls	
  (%)
Sambalpur Odisha
• Very	
  poor	
  rates	
  of	
  exclusive	
  breastfeeding,	
  which	
  need	
  
urgent	
  attention
• No	
  district	
  level	
  data	
  available	
  on	
  children’s	
  diets
• Alarming	
  levels	
  of	
  anaemia	
  among	
  pregnant	
  women	
  and	
  
adolescent	
  	
  girls
• Out-­‐dated	
  data;	
  poor	
  availability	
  of	
  data	
  on	
  key	
  immediate	
  
determinants	
  of	
  under	
  nutrition	
  from	
  national	
  surveys
• Where	
  data	
  are	
  available,	
  indicator	
  definitions	
  are	
  non-­‐
standardized	
  and	
  often	
  differ	
  from	
  World	
  Health	
  Organisation	
  
recommendations
2,2
75,5
21,0
77,1
4,4
12,1 11,9
73,6
18,3
76,6
7,5
Girls	
  	
  married	
  when	
  
<18years	
  old	
  (%)	
  
Ever	
  married	
  
women/mothers	
  
who	
  completed	
  
primary	
  school	
  (%)	
  
Women	
  who	
  
completed	
  
secondary	
  school	
  
(%)	
  
Women's	
  
ownership	
  of	
  land	
  
(%)	
  
Access	
  to	
  improved	
  
drinking	
  water	
  
sources	
  (%)	
  
Access	
  to	
  improved	
  
sanitation	
  facilities	
  
(%)	
  
Open	
  defecation	
  
(%)	
  
Child	
  stool	
  disposal	
  
in	
  a	
  sanitary	
  
manner	
  (%)	
  
Households	
  who	
  
washed	
  hands	
  with	
  
soap	
  before	
  a	
  meal	
  
(%)^	
  
67,6 67,9
55,6
100,0 100,0
54,4 51,4
63,7
50,8
70,6
52,4
94,6
66,9
45,0
Adult	
  literacy	
  rate	
  (%)7 Births	
  attended	
  by	
  
skilled	
  health	
  personnel	
  
(%)6
Household	
  has	
  access	
  
to	
  Anganwadi	
  worker	
  
(%)6
Household	
  has	
  access	
  
to	
  a	
  Sub-­‐Health	
  Centre	
  
(%)6
Household	
  has	
  access	
  
to	
  primary/middle	
  
school	
  (%)6
Households	
  who	
  
demanded	
  and	
  received	
  
work	
  through	
  NREGA	
  
(%)10
Households	
  availing	
  
banking	
  services	
  (%)7
Sambalpur Odisha
46,8
40,4
34,4
39,3
49,0
44,8
50,848,5
37,8
45,8
32,6
50,5
42,4 43,0
Household	
  share	
  of	
  
expenditure	
  on	
  food	
  
(%)	
  
Household	
  share	
  of	
  
food	
  expenditure	
  on	
  
cereals	
  (%)	
  
Households	
  in	
  the	
  
district	
  involved	
  in	
  
agriculture	
  (%)	
  
Below	
  Poverty	
  Line	
  
households	
  (%)	
  
Households	
  ownership	
  
of	
  agricultural	
  land	
  (%)	
  
Households	
  living	
  in	
  a	
  
permanent	
  house	
  (%)	
  
Access	
  to	
  electricity	
  (%)	
  
Sambalpur Odisha
SOCIO	
  ECONOMIC	
  CONDITIONS7,10,11
Page	
  3
UNDERLYING	
  CAUSES	
  OF	
  UNDERNUTRITION
BASIC	
  CAUSES	
  OF	
  UNDERNUTRITION
No	
  Data
No	
  Data
No	
  Data
No	
  Data
No	
  Data
WOMEN’S	
  STATUS3,6 WATER,	
   SANITATION	
  AND	
  HYGIENE7,8,9
FOOD	
  SECURITY10
No	
  Data
^Data	
   based	
  on	
  rural	
  population	
  only
Areas	
  for	
  immediate	
  action:	
  
• Very	
  high	
  rates	
  of	
  open	
  defecation;	
  critical	
  need	
  to	
  increase	
  awareness	
  about	
  washing	
  hands	
  with	
  soap	
  and	
  
ensuring	
  access	
  to	
  using	
  improved	
  sanitation	
  facilities
• Food	
  insecurity,	
  especially	
  diet	
  quality,	
  is	
  a	
  challenge	
  that	
  can	
  holdback	
  improvements	
  in	
  nutrition
• Very	
  few	
  households	
  live	
  in	
  a	
  permanent	
  house	
  and	
  have	
  access	
  to	
  electricity
Data	
  challenges:
• Difficult	
  to	
  compare	
  indicators	
  of	
  water,	
  sanitation	
  and	
  hygiene	
  over	
  time	
  as	
  census	
  data	
  do	
  not	
  provide	
  data	
  
on	
  child	
  stool	
  disposal	
  or	
  on	
  hand	
  washing	
  
• Per	
  capita	
  gross	
  district	
  domestic	
  	
  product	
  of	
  Sambalpur ranked	
  5th	
  amongst	
  30	
  districts	
  of	
  Odisha	
  12
• Access	
  to	
  skilled	
  health	
  personnel	
  during	
  child	
  delivery	
  is	
  very	
  limited	
  and	
  few	
  households	
  avail	
  banking	
  services
• Action	
  needs	
  to	
  be	
  taken	
  to	
  improve	
  adult	
  literacy	
  which	
  is	
  low
• No	
  data	
  available	
  on	
  indicators	
  of	
  governance	
  and	
  political	
  will	
  to	
  address	
  nutrition
No	
  Data
Data	
   sources	
  
1. Census	
  of	
  India.	
  2014.	
  Clinical,	
  Anthropometric	
  &	
  Bio-­‐chemical	
  (CAB)	
  survey.	
  http://www.censusindia.gov.in/2011census/hh-­‐series/HH-­‐
2/Odisha%20CAB%20Sample%20Characteristics%202014.pdf
2. UNICEF.	
  2013-­‐2014.	
  Rapid	
  Survey	
  on	
  Children	
  (RSoC).	
  http://wcd.nic.in/RSOC/21.RSOC_Odisha.pdf
3. Census	
  of	
  India.	
  2012-­‐2013.	
  Annual	
  Health	
  Survey.	
  http://www.censusindia.gov.in/vital_statistics/AHSBulletins/AHS_Bulletin_2012_13/Odisha/Odisha.pdf
4. Robert	
  E	
  Black,	
  Cesar	
  G	
  Victora,	
  Susan	
  P	
  Walker,	
  Zulfiqar	
  A	
  Bhutta,	
  Parul Christian,	
  Mercedes	
  de	
  Onis,	
  Majid	
  Ezzati,	
  Sally	
  Grantham-­‐McGregor,	
  Joanne	
  Katz,	
  Reynaldo	
  
Martorell,	
   Ricardo	
  Uauy,	
  and	
  the	
  Maternal	
  and	
  Child	
  Nutrition	
  Study	
  Group.	
  2013.	
  “Maternal	
  and	
  Child	
  Undernutrition	
  and	
  Overweight	
  in	
  Low-­‐Income	
  and	
  Middle-­‐
Income	
  Countries”. The	
  Lancet	
  382	
  (9890),	
  427-­‐451
5. District	
  Level	
  Household	
  Survey	
  on	
  Reproductive	
  and	
  Child	
  Health	
  (DLHS-­‐2),	
  2002-­‐04,	
  India.	
  International	
  Institute	
  for	
  Population	
  Studies.	
  (IIPS).	
  2006.	
  District	
  Level	
  
Household	
  Survey	
  on	
  Reproductive	
  and	
  Child	
  Health	
  (DLHS-­‐2),	
  2002-­‐04,	
  India:	
  Nutritional	
  Status	
  of	
  Children	
  and	
  Prevalence	
  of	
  Anemia	
  among	
  Children,	
  Adolescent	
  Girls	
  
and	
  Pregnant	
  Women.	
  Mumbai:	
  IIPS.	
  October	
  28,	
  2015,	
  www.rchiips.org/pdf/rch2/National_Nutrition_Report_RCH-­‐II.pdf
6. International	
  Institute	
  for	
  Population	
  Studies	
  (IIPS).	
  2010.	
  District	
  Level	
  Household	
  Survey	
  and	
  Facility	
  Survey	
  (DLHS-­‐3),	
  2007-­‐08,	
  India,	
  Odisha.	
  Mumbai:	
  IIPS.	
  Accessed	
  
October	
  28,	
  2015,	
  www.rchiips.org/pdf/rch3/report/UP.pdf
7. Census	
  of	
  India.	
  2011.	
  Houselisting and	
  Housing	
  Census	
  Data. Accessed	
  October	
  28,	
  2015,	
  www.censusindia.gov.in/2011census/hlo/HLO_Tables.html
8. National	
  Family	
  Health	
  Survey	
  (NFHS-­‐3),	
  2005-­‐06,	
  India.	
  Mumbai:	
  International	
  Institute	
  for	
  Population	
  Studies.	
  
9. HUNGaMA:	
  Fighting	
  Hunger	
  &	
  Malnutrition	
  :	
  the	
  HUNGaMA	
  Survey	
  Report.	
  2011.	
  Naandi Foundation.	
  
10. Author’s	
  estimates	
  based	
  on	
  Household	
  Consumption	
  Expenditure,	
  National	
  Sample	
  Survey	
  Office	
  (NSSO)	
  68th	
  Round,	
  2011-­‐12.	
  Ministry	
  of	
  Statistics	
  and	
  Program	
  
Implementation.	
  Government	
  of	
  India.
11. Planning	
  Commission.	
  2013.	
  Press	
  note	
  on	
  poverty	
  estimates,	
  2011-­‐12.	
  Government	
  of	
  India.	
  Accessed	
  October	
  28,	
  2015.	
  
http://planningcommission.nic.in/news/pre_pov2307.pdf
12. Government	
   of	
  Odisha.	
  Economic	
  Survey	
  (2014-­‐15).	
  Accessed	
  October	
  28,	
  2015,	
  http://www.odisha.gov.in/pc/Download/Economic_Survey_2014-­‐15.pdf
13. Us-­‐India	
  Policy	
  Institute.	
  2015.	
  District	
  Development	
  and	
  Diversity	
  Index.	
  Accessed	
  October	
  28,	
  2015, http://www.usindiapolicy.org/updates/general-­‐news/225-­‐district-­‐
development-­‐and-­‐diversity-­‐index-­‐report
This	
  District	
  Nutrition	
  Profile	
  was	
  developed	
  by	
  XXXXXX	
  for	
  POSHAN.	
  	
  This	
  version,	
  dated	
  XX-­‐XX-­‐XXXX	
  is	
  a	
  
draft	
  intended	
  for	
  use	
  in	
  a	
  district-­‐level	
  workshop	
  in	
  Sambalpur,	
  and	
  will	
  be	
  revised	
  following	
  workshop	
  
discussions.
WHAT	
  WILL	
  IT	
  TAKE	
  TO	
  IMPROVE	
  NUTRITION	
  IN	
  SAMBALPUR?
Possible	
  district-­‐level	
  actions	
  to	
  support	
  nutrition:
Source:	
  POSHAN/IFPRI-­‐NDO
e	
  

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POSHAN District Nutrition Profile_Sambalpur_Odisha

  • 1. 46,1 25,5 44,0 67,8 33,5 18,6 3,9 38,2 18,3 34,4 70,8 30,3 18,9 2,6 Children    stunted   (%)1,2,^ Children    wasted   (%)1,2,^ Children   underweight   (%)1,2,^ Children  with  any   anemia  (%)1,^^ Chronic  energy   deficiency  in   women  (%)1   Children  with   birthweight   <2500gms  (%)2,3 Adults  who  are   obese  in  the   district  (%)1 Sambalpur Odisha ^Children  aged  <5years;    ^^Children  aged  0-­‐59  months Source:  Data   source  provided  on  Page  4 50,6% 49,4% 29,6% 70,4% 18,4% 34,1% 47,5% Sambalpur,  Odisha DISTRICT  NUTRITION  PROFILE Page  1 THE  STATE  OF  NUTRITION  IN  SAMBALPUR DISTRICT  DEMOGRAPHIC  PROFILE Total  Population 10,41,099 MALE FEMALE RURALURBAN SC ST OTHERS CHANGES  OVER  TIME Odisha (Children  aged  <5  years) Sambalpur (Children  aged  <  5  years) 2005-­‐06   (NFHS-­‐3) 2013-­‐14   (RSOC) 2002-­‐04   (DLHS-­‐2) 2014 (CAB) Stunting 42.4% 38.2% No  data   46.1% Wasting 20.0% 18.3% No  data 25.5% Underweight 39.5% 34.4% 52.2% 44.0% CHILDREN   STUNTED1 CHILDREN   WASTED1 CHILDREN   UNDERWEIGHT1 46.1% 25.5% 44.0% THE  PREVALENCE  OF   UNDERWEIGHT  HAS   DECREASED  IN  THE   DISTRICT  BETWEEN   2002  AND  2014 Sambalpurranks  352th amongst  599  districts  in  India (District  Development  Index)13 Insert  map  here
  • 2. 76,8 28,0 78,5 65,4 20,1 85,0 28,3 78,7 30,7 55,5 25,8 68,8 68,6 14,0 87,2 58,3 Early  initiation  of   breastfeeding  (%) Exclusive   breastfeeding  (%) Children  (6-­‐8  mo)   who  received  any   solid/semi  solid   food  in  the  last  24   hours  (%) Children  who   achieve  minimum   diet  diversity  (%) Full  immunization   coverage  (%) Children  (6-­‐35mo)   who  got  vitamin  A   supplementation   (%) Children  suffering   from  diarrhoea  (%) Children  <5  years   with  diarrhoea   treated  with  ORS   (%) Women  aware  of   danger  signs  of   pneumonia  (%) Page  2   Child undernutrition is caused by inadequacies in food, health and care for infants and young children, especially in thefirst two years oflife (immediatecauses). Inadequate food, health and care arise from food insecurity, unsanitary living conditions, low status ofwomen, and poor health care(underlying causes). These are, in turn, caused by social inequity, economic challenges, poor political will and leadership to address these causes (basic causes). Interventions to address undernutrition must address thesemultiplecauses ofundernutritionand do so in an equitablemanner. IMMEDIATE  CAUSES  OF  UNDERNUTRITION Areas  for  action: Data  challenges: IMMEDIATE   CAUSES Breastfeeding,  nutrient  rich  foods,  and  eating  routine Feeding  and  caregiving  practices,  parenting  stimulation Low  burden  of  infectious  diseases Optimum  fetal  and  child  nutrition  and  development WHAT  FACTORS  CAUSE  UNDERNUTRITION? 4 UNDERLYING  CAUSES Food  security:  availability,  economic  access  and  use  of  food Feeding  and  caregiving  resources  (maternal,  household  and   community  level) Access  to  and  use  of  health  services,  a  safe  and  hygienic  environment BASIC  CAUSES Knowledge  and  evidence Politics  and  governance Leadership,  capacity  and  financial  resources Social,  economic,  political,  and  environmental  context                                 (national  and  global) The  most  crucial  period  for  child  nutrition  is     from  pre-­‐pregnancy  to  the  second  year  of  life2 HOW  CAN  NUTRITION   IMPROVE? ADOLESCENT   & MATERNAL  HEALTH1,3,5 DISEASE   BURDEN3IMMUNIZATION  &   SUPPLEMENTATION3 INFANT  AND  YOUNG   CHILD  FEEDING2,3 0 10 20 30 40 50 60 70 80 90 100 Age  of  child  (in  months) Percentage  of  child  stunting  (%) Window   of   opportunity Too  late No  Data No  Data 98,4 99,9 62,6 98,0 97,6 78,4 Women  with  access  to   at  least  1  antenatal   care  coverage  (%) Any  anemia  among   pregnant  women  (%) Any  anemia  among   adolescent  girls  (%) Sambalpur Odisha • Very  poor  rates  of  exclusive  breastfeeding,  which  need   urgent  attention • No  district  level  data  available  on  children’s  diets • Alarming  levels  of  anaemia  among  pregnant  women  and   adolescent    girls • Out-­‐dated  data;  poor  availability  of  data  on  key  immediate   determinants  of  under  nutrition  from  national  surveys • Where  data  are  available,  indicator  definitions  are  non-­‐ standardized  and  often  differ  from  World  Health  Organisation   recommendations
  • 3. 2,2 75,5 21,0 77,1 4,4 12,1 11,9 73,6 18,3 76,6 7,5 Girls    married  when   <18years  old  (%)   Ever  married   women/mothers   who  completed   primary  school  (%)   Women  who   completed   secondary  school   (%)   Women's   ownership  of  land   (%)   Access  to  improved   drinking  water   sources  (%)   Access  to  improved   sanitation  facilities   (%)   Open  defecation   (%)   Child  stool  disposal   in  a  sanitary   manner  (%)   Households  who   washed  hands  with   soap  before  a  meal   (%)^   67,6 67,9 55,6 100,0 100,0 54,4 51,4 63,7 50,8 70,6 52,4 94,6 66,9 45,0 Adult  literacy  rate  (%)7 Births  attended  by   skilled  health  personnel   (%)6 Household  has  access   to  Anganwadi  worker   (%)6 Household  has  access   to  a  Sub-­‐Health  Centre   (%)6 Household  has  access   to  primary/middle   school  (%)6 Households  who   demanded  and  received   work  through  NREGA   (%)10 Households  availing   banking  services  (%)7 Sambalpur Odisha 46,8 40,4 34,4 39,3 49,0 44,8 50,848,5 37,8 45,8 32,6 50,5 42,4 43,0 Household  share  of   expenditure  on  food   (%)   Household  share  of   food  expenditure  on   cereals  (%)   Households  in  the   district  involved  in   agriculture  (%)   Below  Poverty  Line   households  (%)   Households  ownership   of  agricultural  land  (%)   Households  living  in  a   permanent  house  (%)   Access  to  electricity  (%)   Sambalpur Odisha SOCIO  ECONOMIC  CONDITIONS7,10,11 Page  3 UNDERLYING  CAUSES  OF  UNDERNUTRITION BASIC  CAUSES  OF  UNDERNUTRITION No  Data No  Data No  Data No  Data No  Data WOMEN’S  STATUS3,6 WATER,   SANITATION  AND  HYGIENE7,8,9 FOOD  SECURITY10 No  Data ^Data   based  on  rural  population  only Areas  for  immediate  action:   • Very  high  rates  of  open  defecation;  critical  need  to  increase  awareness  about  washing  hands  with  soap  and   ensuring  access  to  using  improved  sanitation  facilities • Food  insecurity,  especially  diet  quality,  is  a  challenge  that  can  holdback  improvements  in  nutrition • Very  few  households  live  in  a  permanent  house  and  have  access  to  electricity Data  challenges: • Difficult  to  compare  indicators  of  water,  sanitation  and  hygiene  over  time  as  census  data  do  not  provide  data   on  child  stool  disposal  or  on  hand  washing   • Per  capita  gross  district  domestic    product  of  Sambalpur ranked  5th  amongst  30  districts  of  Odisha  12 • Access  to  skilled  health  personnel  during  child  delivery  is  very  limited  and  few  households  avail  banking  services • Action  needs  to  be  taken  to  improve  adult  literacy  which  is  low • No  data  available  on  indicators  of  governance  and  political  will  to  address  nutrition No  Data
  • 4. Data   sources   1. Census  of  India.  2014.  Clinical,  Anthropometric  &  Bio-­‐chemical  (CAB)  survey.  http://www.censusindia.gov.in/2011census/hh-­‐series/HH-­‐ 2/Odisha%20CAB%20Sample%20Characteristics%202014.pdf 2. UNICEF.  2013-­‐2014.  Rapid  Survey  on  Children  (RSoC).  http://wcd.nic.in/RSOC/21.RSOC_Odisha.pdf 3. Census  of  India.  2012-­‐2013.  Annual  Health  Survey.  http://www.censusindia.gov.in/vital_statistics/AHSBulletins/AHS_Bulletin_2012_13/Odisha/Odisha.pdf 4. Robert  E  Black,  Cesar  G  Victora,  Susan  P  Walker,  Zulfiqar  A  Bhutta,  Parul Christian,  Mercedes  de  Onis,  Majid  Ezzati,  Sally  Grantham-­‐McGregor,  Joanne  Katz,  Reynaldo   Martorell,   Ricardo  Uauy,  and  the  Maternal  and  Child  Nutrition  Study  Group.  2013.  “Maternal  and  Child  Undernutrition  and  Overweight  in  Low-­‐Income  and  Middle-­‐ Income  Countries”. The  Lancet  382  (9890),  427-­‐451 5. District  Level  Household  Survey  on  Reproductive  and  Child  Health  (DLHS-­‐2),  2002-­‐04,  India.  International  Institute  for  Population  Studies.  (IIPS).  2006.  District  Level   Household  Survey  on  Reproductive  and  Child  Health  (DLHS-­‐2),  2002-­‐04,  India:  Nutritional  Status  of  Children  and  Prevalence  of  Anemia  among  Children,  Adolescent  Girls   and  Pregnant  Women.  Mumbai:  IIPS.  October  28,  2015,  www.rchiips.org/pdf/rch2/National_Nutrition_Report_RCH-­‐II.pdf 6. International  Institute  for  Population  Studies  (IIPS).  2010.  District  Level  Household  Survey  and  Facility  Survey  (DLHS-­‐3),  2007-­‐08,  India,  Odisha.  Mumbai:  IIPS.  Accessed   October  28,  2015,  www.rchiips.org/pdf/rch3/report/UP.pdf 7. Census  of  India.  2011.  Houselisting and  Housing  Census  Data. Accessed  October  28,  2015,  www.censusindia.gov.in/2011census/hlo/HLO_Tables.html 8. National  Family  Health  Survey  (NFHS-­‐3),  2005-­‐06,  India.  Mumbai:  International  Institute  for  Population  Studies.   9. HUNGaMA:  Fighting  Hunger  &  Malnutrition  :  the  HUNGaMA  Survey  Report.  2011.  Naandi Foundation.   10. Author’s  estimates  based  on  Household  Consumption  Expenditure,  National  Sample  Survey  Office  (NSSO)  68th  Round,  2011-­‐12.  Ministry  of  Statistics  and  Program   Implementation.  Government  of  India. 11. Planning  Commission.  2013.  Press  note  on  poverty  estimates,  2011-­‐12.  Government  of  India.  Accessed  October  28,  2015.   http://planningcommission.nic.in/news/pre_pov2307.pdf 12. Government   of  Odisha.  Economic  Survey  (2014-­‐15).  Accessed  October  28,  2015,  http://www.odisha.gov.in/pc/Download/Economic_Survey_2014-­‐15.pdf 13. Us-­‐India  Policy  Institute.  2015.  District  Development  and  Diversity  Index.  Accessed  October  28,  2015, http://www.usindiapolicy.org/updates/general-­‐news/225-­‐district-­‐ development-­‐and-­‐diversity-­‐index-­‐report This  District  Nutrition  Profile  was  developed  by  XXXXXX  for  POSHAN.    This  version,  dated  XX-­‐XX-­‐XXXX  is  a   draft  intended  for  use  in  a  district-­‐level  workshop  in  Sambalpur,  and  will  be  revised  following  workshop   discussions. WHAT  WILL  IT  TAKE  TO  IMPROVE  NUTRITION  IN  SAMBALPUR? Possible  district-­‐level  actions  to  support  nutrition: Source:  POSHAN/IFPRI-­‐NDO e