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Anjali Pant, Samuel Scott, S.K. Singh, Rakesh Sarwal, Neena Bhatia, Robert Johnston, William Joe, Esha Sarswat, Purnima Menon, Phuong Hong Nguyen
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No. 41 | SEPTEMBER 2021
State Nutrition Profile: Bihar
ABOUT THIS DATA NOTE
Figure 1. Trends in undernutrition outcomes
2005-2006, 2015-2016, 2019-2020
2005-2006 2015-2016 2019-2020 India average
28
2
14
2
NA
3
554843 282123 989 574441 786469 453026 686064 605863
0
20
40
60
80
100
Low birth weightStunting WastingSevere wastingUnderweight Anemia Underweight Anemia
(non-pregnant)
Anemia
(pregnant)
%
Undernutrition among children (<5y)Undernutrition among women (15-49y)
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state factsheets (2019-2020).
Note: Adult nutrition outcomes are based on the woman dataset, while child nutrition outcomes are based on all child data.
1
WHO. Nutrition Landscape Information System (NLiS). Help Topic: Malnutrition in children. Stunting, wasting, overweight and underweight.
(https://apps.who.int/nutrition/landscape/help.aspx?menu=0&helpid=391&lang=EN).
2
In NFHS-3, 83.8% of data was missing, while 38.7% of data was missing in NFHS-4.
3
NA refers to the unavailability of data for a particular indicator in the specified NFHS round.
BIHAR
This Data Notedescribes the trends for a set of key
nutrition and health outcomes, determinants, and
coverage of interventions. The findings here are based
on data from the National Family Health Survey (NFHS)
3 (2005-2006), 4 (2015-2016), and 5 (2019-2020). In
addition to standard prevalence-based analyses, this
Data Noteincludes headcount-based analyses aligned
to the POSHAN Abhiyaanmonitoring framework and
uses data from NFHS-5 to provide evidence that helps
identify priority districts and number of districts in the
state with public health concern as per the WHO
guidelines.
1
The Data Noteincludes a color-coded
dashboard to compare the coverage of nutrition
interventions across all the districts in the state. It
concludes with key takeaways for children, women, and
men and identifies areas where the state has potential
to improve. No. of districts with public health concern
1
: 38 of 38
Map 1 & 2. Number of stunted & anemic children <5y, 2019-2020
Source: IFPRI estimates -The headcount was calculated as the product of the undernutrition prevalence and the total eligible projected population for each district
in 2019. Prevalence estimates were obtained from NFHS-5 (2019-2020; all child data) and projected population for 2019 was estimated using Census 2011.
1
Public health concern is defined as ≥20% for stunting, ≥40% for anemia, ≥10% for wasting, and ≥2% for severe wasting (WHO 2011).
2
The total number of children <5 years is 14,700,960.
Map 1. Stunting
Map 3. Wasting
Map 2. Anemia
Highest burden districts
1PurbaChamparan381,534
2Gaya283,396
3Muzaffarpur279,824
4Sitamarhi277,649
5Samastipur274,258
Highest burden districts
1Patna199,360
2Saran148,293
3Gaya145,285
4Samastipur132,766
5Purnia132,549
Highest burden districts
1Patna425,899
2PurbaChamparan425,799
3Gaya411,941
4Madhubani397,599
5Muzaffarpur381,181
No. of districts with public health concern
1
: 38 of 38
No. of districts with public health concern
1
: 38 of 38
No. of districts with public health concern
1
: 38 of 38
Number of stunted
children
2
= 6,294,938
Number of wasted
children
2
= 3,376,118
Number of anemic
children
2
= 9,157,349
Map 3 & 4. Number of wasted children <5y, 2019-2020
Map 4. Severe Wasting
Number of severely wasted
children
2
= 1,317,014
Highest burden districts
1Patna76,844
2Rohtas69,090
3Aurangabad63,897
4Gaya55,603
5Muzaffarpur53,206
Note: Number in ‘000s in the above figureNote: Number in ‘000s in the above figure
Note: Number in ‘000s in the above figureNote: Number in ‘000s in the above figure Map 5 & 6. Number of underweight children (<5y)
& women (15-49y), 2019-2020
Source: IFPRI estimates -The headcount was calculated as the product of the undernutrition prevalence and the total eligible projected population for each district
in 2019. Prevalence estimates were obtained from NFHS-5 (2019-2020; all child/woman data) and projected population for 2019 was estimated using Census
2011.
1
Public health concern is defined as≥20% for underweight (children), ≥10% for underweight (women), ≥40% for anemia among non-pregnant women, and
≥40% for anemia among pregnant women (WHO 2011).
2
The total number of children <5 years is 14,700,960, pregnant women 15-49 years is 3,408,592, and non-
pregnant women 15-49 years is 27,254,036.
Map 6. Underweight women
Map 7. Anemia among non-pregnant women Map 8. Anemia among pregnant women
Highest burden districts
1Patna414,951
2Muzaffarpur354,837
3Gaya351,821
4PurbaChamparan336,661
5Madhubani331,917
Highest burden districts
1Patna110,090
2PurbaChamparan105,464
3Samastipur96,448
4Muzaffarpur96,354
5PashchimChamparan95,483
Highest burden districts
1Patna1,235,673
2Gaya844,108
3Muzaffarpur826,544
4PurbaChamparan821,511
5Madhubani805,328
No. of districts with public health concern
1
: 38 of 38
No. of districts with public health concern
1
: 38 of 38 No. of districts with public health concern
1
: 37 of 38
Number of underweight
women
2
= 7,835,772
Number of non-pregnant
anemic women
2
= 19,516,988
Number of pregnant anemic
women
2
= 2,135,286
Map 5. Underweight children
Highest burden districts
1PurbaChamparan294,504
2Patna287,078
3Samastipur266,779
4Gaya260,079
5Purnia241,980
No. of districts with public health concern
1
: 38 of 38
Number of underweight
children
2
= 6,018,740
Map 7 & 8. Number of anemic women (15-49y), 2019-2020
Note: Number in ‘000s in the above figureNote: Number in ‘000s in the above figure
Note: Number in ‘000s in the above figureNote: Number in ‘000s in the above figure Category Outcomes
Worst performing
districts (pp)
Best performing
districts (pp)
Highest burden
districts
(thousands)
4
No of districts
with public
health concern
5
(total=38)
Difference between
(2019-2020) & (2015-
2016)
3
Difference between
(2019-2020) & (2015-
2016)
3
2019-2020 2019-2020
Children
<5 years
Overweight/
obesity
Sheikhpura: +4.5
Buxar: +3.6
Purnia: -1.6
2 Districts
6
: -1.5
Pu Champ
9
: 30
Gaya: 22
0
Women
(15-49 years)
Overweight/
obesity
Begusarai: +7.8
2 Districts
7
: +7.3
Aurangabad: -2.2
2 Districts
8
: -2.0
Patna: 395
Siwan: 242
6
High blood
pressure
Banka: +10.0
Munger: +8.3
Araria: -0.6
Madhepura: -0.1
Muzaffarpur: 208
Gaya: 202
0
High blood
sugar
Munger: +5.9
Samastipur: +5.4
Sheohar: -2.2
Kaimur: -2.2
Patna: 140
Samastipur: 98
0
Men
(15-54 years)
Overweight
/obesity
Data not available at district-level
High blood
pressure
Siwan: +14.2
Banka: +11.7
Buxar: -5.0
Samastipur: -1.0
Muzaffarpur: 303
Pu Champ
9
: 300
6
High blood
sugar
Darbhanga: +7.0
Madhubani: +6.1
Muzaffarpur: -9.1
Aurangabad: -8.5
Patna: 186
Madhubani: 122
0
Figure 2. Trends in overweight/obesity & NCDs
1
2005-2006, 2015-2016, 2019-2020
Table 1. Overweight/obesity & NCDs
2
at district-level
2015-2016, 2019-2020
2005-2006 2015-2016 2019-2020 India average
02
2 51216 NA
1
812 NA
1
4
6 61315 NA
1
1116 NA
1
78
0
20
40
60
80
100
Overweight/
obesity
Overweight/
obesity
High blood
pressure
High blood
sugar
Overweight/
obesity
High blood
pressure
High blood
sugar
%
Children (<5y)Women (15-49y)Men (15-54y)
pp: percentage points
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state and district factsheets (2019-2020).
Note: Adult nutrition outcomes are based on the woman/man dataset, while child nutrition outcomes are based on all child data.
1
NA refers to the unavailability of data for a particular indicator in the specified NFHS round.
2
NCDs : non communicable diseases
3
The difference is calculated only between districts that are comparable between 2015-2016 and 2019-2020. All 38 districts in Bihar are comparable between the
two time periods.
4
Burden: The headcount was calculated as the product of the overweight/obesity and NCDs prevalence and the total eligible projected population for each district
in 2019. Prevalence estimates were obtained from NFHS-5 (2019-2020) and projected population for 2019 was estimated using Census2011.
5
Public health concern is defined as prevalence ≥15% for overweight/obesity (children), ≥20% for overweight/obesity (women andmen), ≥ 20% high blood
pressure (women and men), and ≥20% high sugar (women and men). Source: WHO (2011).
6
2 Districts: Darbhanga and Nawada;
7
2 Districts: Banka and Khagaria;
8
2 Districts: Kaimurand Sheohar
9
District codes: Pu Champ-PurbaChamparan Category
Immediate
determinants
Worst performing
districts (pp)
Best performing
districts (pp)
Top coverage
districts (%)
2
Difference between
(2019-2020) & (2015-2016)
1
Difference between
(2019-2020) & (2015-2016)
1
2019-2020
IYCF
practices
Early initiation of
breastfeeding
Nalanda: -27.4
Katihar: -21.2
Gaya: +11.9
Begusarai: +10.5
Kaimur: 48.5
Jehanabad: 45.1
Exclusive
breastfeeding
Katihar: -26.3
Saran: -26.1
Sheikhpura: +40.4
Gaya: +38.6
Gopalganj: 83.5
Sheohar: 83.5
Timely introduction of
complementary foods
0
Pu Champ
3
: -12.5
Kishanganj: -11.1
Saharsa: +28.5
Katihar: 26.0
Arwal: 61.7
Saran: 58.7
Adequate diet
0
Sheikhpura: -12.8
Nawada: -12.3
Samastipur: +11.9
Supaul: +9.6
Samastipur: 17.7
Muzaffarpur: 17.2
Maternal
determinants
Women with BMI<18.5
kg/m2
0
Arwal: +0.4
Pa Champ
3
: +0.2
Sheikhpura: -15.6
Muzaffarpur: -12.3
Siwan: 18.1
Sheohar: 20.0
Consumed IFA 100+
days
Pa Champ
3
: -4.5
Patna: -0.5
Munger: +22.8
Lakhisarai: +16.6
Munger: 33.0
Bhagalpur: 28.0
Diseases
Diarrhea in the last two
weeks
0
Supaul: +27.9
Madhubani: +18.0
Gopalganj: -15.4
Sheohar: -9.5
Jamui: 2.1
Kaimur: 3.1
ARI in the last two
weeks
0
Pa Champ
3
: +4.9
Siwan: +4.9
Gopalganj: -4.3
Purnia: -3.8
Patna: 0.7
Bhagalpur: 1.1
Figure 3. Trends in immediate determinants (%)
2005-2006, 2015-2016, 2019-2020
Table 2. Immediate determinants at district-level
2015-2016, 2019-2020
pp: percentage points
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state and district factsheets (2019-2020).
Note: Immediate determinants are based on the last child data; data on continued breastfeeding at 2 years, egg and/or flesh foods consumption, sweet beverage
consumption, and bottle feeding of infants not available in NFHS-5 factsheets (2019-20)/state report
0
Indicator definition differs slightly between NFHS-4 and NFHS-5.
1
The difference is calculated only between districts that are comparable between 2015-2016 and 2019-2020. All 38 districts in Bihar are comparable between the
two time periods.
2
For all indicators, top coverage districts refer to the districts with the highest prevalence in immediate determinants, except for women with a BMI of 18.5 kg/m2,
diarrhea in the last two weeks, and ARI in the last two weeks, for which it refers to the districts with the lowest prevalence in coverage.
3
District codes: Pu Champ: PurbaChamparan, Pa Champ: Paschim Champaran. Category
Underlying
determinants
Worst performing
districts (pp)
Best performing
districts (pp)
Top coverage
districts (%)
2
Difference between
(2019-2020) & (2015-2016)
1
Difference between
(2019-2020) & (2015-2016)
1
2019-2020
Maternal
determinants
Women who are literate
0
Not applicable
3
Madhepura: +24.7
Sitamarhi: +24.3
Rohtas: 76.5
Siwan: 70.9
Women with ≥10 years
education
0
Not applicable
3
Munger: +17.6
Begusarai: 16.7
Munger: 44.4
Patna: 43.6
Girls 20-24 years married
before age of 18 years
0
Not applicable
3
Sheohar: -30.1
Rohtas: -28.9
Siwan: 21.3
Saran: 26.2
Women 15-19 years with
child or pregnant
Saharsa: +11.7
Purnia: +9.1
Sheohar: -10.7
Gaya: -7.7
Kaimur: 2.6
Siwan: 2.6
Household
determinants
HHs with improved
drinking water source
0
Khagaria: -0.6
Purnia: -0.4
Jamui: +12.7
Munger: +6.8
6 Districts
4
:
100.0
HHs with improved
sanitation facility
0
Not applicable
3
Rohtas: +43.9
Kaimur: +40.3
Rohtas: 69.0
Khagaria: 65.0
HHs with electricity
0
Not applicable
3
Katihar: +65.0
Samastipur: +57.5
Jehanabad: 99.3
Patna: 99.0
Figure 4. Trends in underlying determinants (%)
2005-2006, 2015-2016, 2019-2020
Table 3. Underlying determinants at district-level
2015-2016, 2019-2020
pp: percentage points
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state and district factsheets and state reports (2019-2020).
Note: Underlying determinants are based on the last child data; safe disposal of feces not available in NFHS-5 factsheets (2019-20)/state report and data on HHs
with hand washing facility not available in NFHS-3 (2005-06) and NFHS-5 factsheets (2019-20)/state report. Data on open defecation and HHs with BPL card for
2019-2020 are taken from NFHS-5 state reports.
0
Indicator definition differs slightly between NFHS-4 and NFHS-5.
1
The difference is calculated only between districts that are comparable between 2015-2016 and 2019-2020. All 38 districts in Bihar are comparable between the
two time periods.
2
For all indicators, top coverage districts refer to the districts with the highest prevalence in underlying determinants, exceptfor girls 20-24 years married before age
of 18 years and women 15-19 years with child or pregnantfor which it refers to the districts with the lowest prevalence in coverage.
3
Prevalence did not increase or decrease in any of the districts.
4
6 Districts: Araria, Aurangabad, Kishanganj, Madhubani, Saharsa, and Sheohar. Figure 5. Trends in coverage of interventions across the first
1,000 days (%), 2005-2006, 2015-2016, 2019-2020
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016) & NFHS-5 state factsheets and state reports (2019-2020).
0
Indicator comparable between NFHS-3 and NFHS-4 but differs slightly from NFHS-5.
Note 1 : Interventions’ coverage is based on the last child data.
Note 2: The following information is not available in the NFHS-5 factsheets and state reports (2019-20): receipt of at least one ANC visit, birth preparedness
counselling, malaria prevention and food supplementation (6-35m). Information on use of bed nets during pregnancy is not available in NFHS-3 data (2006).
Note 3: Data on food supplementation and health and nutrition education during pregnancy and post-natal care, and weight measurement during childhood and
counselling on child growth for 2019-2020 are taken from NFHS-5 state reports.
Note 4: Refer to district dashboard for the inter-district variability in the coverage of interventions. Intervention coverage at district level, 2019-2020
Note 1: The following information is not available in the NFHS
-
5 factsheets and state reports (2019
-
20): (1) Information on pre
conception and pregnancy
-
related indicators including demand for FP satisfied,
receipt of at least one ANC visit, weighing, birth preparedness and breastfeeding counselling, counselling on keeping baby wa
rm,
cord care counselling, food supplementation, health and nutrition education and
malaria prevention; (2) Lactation
-
related indicators including, food supplementation and health and nutrition education; and (3)
early childhood
-
related indicators including pediatric IFA, deworming, food
supplementation (6
-
35m), weighing and counselling on child growth. Information on use of bed nets during pregnancy not available
in NFHS
-
3 data (2005
-
2006).
Note 2: Food supplementation during early childhood is for children aged 6
-
35 months; counselling on child growth during early c
hildhood is conducted after taking weight measurement.
Source: NFHS
-
5
district factsheets and
state reports (2019
-
20). District name
Demand for FP
satisfied
Iodized salt
Any ANC visits
ANC first trimester
≥4 ANC
Received MCP card
Received IFA
tab/syrup
Tetanus injection
Deworming
Weighing
Birth preparedness
counselling
Breastfeeding
counselling
Counselling on
keeping baby warm
Cord care counselling
Food supplementation
Health & nutrition
education
Malaria prevention-
use of bed nets
Institutional birth
Financial assistance
(JSY)
Skilled birth attendant
Postnatal care for
mothers
Postnatal care for
babies
Food supplementation
Health & nutrition
education
Full immunization
Vitamin A
Paediatric IFA
Deworming
Care seeking for ARIORS during diarrheaZinc during diarrhea
Food supplementation
(6-35 months)
Weighing
Counselling on child
growth
BIHAR93.3 52.925.289.573.989.519.176.242.179.057.359.371.056.069.458.225.6
Araria93.7 41.625.890.677.986.416.166.246.670.346.448.261.657.157.950.59.2
Arwal90.1 57.434.595.577.094.223.379.252.183.170.170.184.257.886.357.551.2
Aurangabad92.4 53.629.392.378.193.225.977.556.884.671.572.089.763.984.464.436.9
Banka90.1 70.731.784.086.093.620.879.854.780.472.374.788.142.872.663.841.4
Begusarai89.2 46.521.687.878.488.629.686.040.285.658.660.965.857.275.461.831.6
Bhagalpur85.2 53.327.685.476.989.923.877.236.077.554.060.566.846.269.573.723.6
Bhojpur92.2 42.733.593.357.893.814.286.936.287.556.162.461.940.381.949.245.3
Buxar93.5 61.527.492.272.793.421.089.535.990.666.968.375.050.481.649.226.8
Darbhanga96.0 51.824.987.673.891.917.569.938.875.950.550.966.360.465.461.919.6
Gaya94.9 63.225.193.481.194.922.476.652.477.772.575.485.047.179.0
Gopalganj96.6 53.227.989.673.890.122.085.935.988.053.954.275.869.161.569.29.1
Jamui91.0 73.837.987.882.195.222.473.444.072.766.769.866.430.263.7
Jehanabad91.0 58.417.495.878.494.216.289.143.388.377.771.270.368.478.049.625.3
Kaimur (Bhabua)93.7 62.425.697.282.093.526.883.352.686.081.677.088.967.577.5
Katihar96.7 40.915.391.771.484.418.366.949.673.841.744.373.750.266.060.417.1
Khagaria88.0 44.617.489.574.483.96.074.232.282.354.252.264.762.981.255.627.4
Kishanganj94.8 37.617.184.771.679.216.754.633.364.940.742.167.353.267.764.54.2
Lakhisarai84.2 66.128.087.179.492.823.375.848.576.266.774.168.941.879.344.330.0
Madhepura95.4 53.820.995.675.587.716.375.074.077.149.558.972.055.858.252.136.2
Madhubani91.9 67.534.991.574.494.017.973.742.678.558.961.074.174.766.564.630.4
Munger92.6 68.736.889.888.290.523.093.241.892.380.783.473.444.669.958.724.4
Muzaffarpur96.1 55.928.284.169.893.817.072.534.178.255.955.974.957.880.366.327.9
Nalanda89.1 64.729.387.671.594.217.280.345.485.177.573.075.244.184.372.651.7
Nawada98.2 69.531.688.179.394.812.679.947.279.574.180.574.537.384.4
Pashchim Champaran97.7 55.025.483.959.989.719.279.538.778.457.364.162.162.460.256.816.4
Patna92.9 51.717.988.871.983.010.589.127.781.459.063.156.658.468.843.820.7
Purba Champaran96.9 45.421.783.559.986.414.461.527.767.443.741.868.351.559.840.719.7
Purnia92.6 26.311.193.478.683.617.368.934.274.241.041.562.765.263.741.225.9
Rohtas97.4 64.934.291.280.195.030.189.141.791.385.080.786.871.583.1
Saharsa94.6 34.811.795.165.182.712.770.458.572.938.540.872.257.475.550.321.2
Samastipur91.9 53.423.590.481.390.424.083.450.083.752.151.571.464.178.760.230.3
Saran92.9 44.430.794.361.488.116.473.039.279.154.158.372.050.271.451.536.8
Sheikhpura90.3 68.828.487.772.295.819.789.255.891.877.178.782.842.869.059.352.8
Sheohar95.6 62.825.393.274.094.017.074.358.377.061.158.762.959.273.349.833.3
Sitamarhi95.0 57.820.391.174.087.624.164.445.269.651.157.366.660.067.769.618.3
Siwan94.1 61.030.382.979.196.615.986.434.186.963.963.076.148.371.656.714.2
Supaul94.3 59.030.996.183.089.826.980.463.179.460.764.273.650.562.959.525.9
Vaishali86.2 46.724.588.579.180.819.081.633.684.857.464.371.055.861.454.918.2
Pre-
pregnancy
PregnancyDelivery & postnatalEarly childhood <20%60-<80% >=80% Not Available20-<40% 40-<60% Category Interventions
Worst performing
districts (pp)
Best performing
districts (pp)
Top coverage
districts (%)
Difference between
(2019-2020) & (2015-2016)
1
Difference between
(2019-2020) & (2015-2016)
1
2019-2020
ANC first trimester
Purnia: -9.2
Saharsa: -0.9
Madhubani: +40.1
Jamui: +37.3
Jamui: 73.8
Banka: 70.7
Pregnancy
≥4 ANC visits
Patna: -3.8
Purnia: -1.1
Jamui: +27.5
Arwal: +23.0
Jamui: 37.9
Munger: 36.8
Received MCP Card Not applicable
2
Pu Champ
3
: +68.0
Muzaffarpur: +62.0
Kaimur: 97.2
Supaul: 96.1
Tetanus injection
Patna: -8.4
Vaishali: -7.5
Pa Champ
3
: +12.4
Darbhanga: +11.8
Siwan: 96.6
Sheikhpura: 95.8
Delivery and
post-natal
Institutional birth°
Nalanda: -0.4
Vaishali: -0.2
Sitamarhi: +22.8
Darbhanga: +20.4
Munger: 93.2
Buxar: 89.5
Skilled birth attendant°
Patna: -4.7
Bhagalpur: -1.2
Sitamarhi: +19.5
Sheohar: +15.2
Munger: 92.3
Sheikhpura: 91.8
Postnatal care for
mothers
Purnia: -5.8
Patna: -4.2
Muzaffarpur: +32.3
Pa Champ
3
: +28.9
Rohtas: 85.0
Kaimur: 81.6
Postnatal care for
babies°
Not applicable
2
Kaimur: +71.5
Banka: +67.4
Munger: 83.4
Rohtas: 80.7
Early
childhood
Full immunization
Patna: -12.3
Begusarai: -10.4
Pa Champ
3
: +30.2
Madhubani: +25.5
Aurangabad: 89.7
Kaimur: 88.9
Vitamin A
supplementation°
Bhojpur: -23.6
Bhagalpur: -23.1
Kaimur: +21.0
Madhubani: +17.7
Madhubani: 74.7
Rohtas: 71.5
Care seeking for ARI°
Gopalganj: -9.7
Munger: -6.3
Bhojpur: +48.2
Arwal: +36.8
Arwal: 86.3
2 Districts
4
: 84.4
ORS treatment during
diarrhea°
Lakhisarai: -18.6
Buxar: -12.9
Aurangabad: +51.7
Sitamarhi: +33.9
Bhagalpur: 73.7
Nalanda: 72.6
Zinc treatment during
diarrhea°
Kishanganj: -28.2
Saharsa: -23.8
Nalanda: +34.7
Sheikhpura: 34.3
Sheikhpura: 52.8
Nalanda: 51.7
Table 4. Intervention coverage at district-level
2015-2016, 2019-2020
Key takeaways
Children: Stunting and wasting prevalence declined by 7 percentage points (pp) from 2006 to 2016; stunting continued to
decline by 5pp but wasting increased by 2pp from 2016 to 2020. Underweight declined by 13pp from 2006 to 2016 and
continued to decline by 3pp from 2016 to 2020. Anemia declined by 14pp from 2006 to 2016 but increased by 5pp from
2016 to 2020.
Women: Underweight declined by 15 pp from 2006 to 2016 and continued to decline by 4pp from 2016 to 2020. Anemia
in non-pregnant and pregnant women declined by 8pp and 2pp, respectively, from 2006 to 2016, but increased by 4-5pp
among both groups of women from 2016 to 2020. Overweight/obesity increased by 7pp from 2006 to 2016 and continued
to increase by 4pp from 2016 to 2020.
Men:Overweight/obesity increased by 7pp from 2006 to 2016 and continued to increase by 2pp from 2016 to 2020.
Attention is needed to improve (%s in 2020):
•Outcomes: Stunting (43%) and anemia in children (69%); anemia in non-pregnant (64%) and pregnant (63%) women
•Immediate determinants:Early initiation of breastfeeding (31%); adequate diet (11%); 100+ IFA (18%)
•Underlying determinants:Women with 10 years education (29%); households with improved sanitation (49%)
•Coverage of interventions:4 ANC visits (25%),food supplementation (42-44%), and health and nutrition education
for women (32-35%); growth monitoring of children (35%)
pp: percentage points.
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state and district factsheets (2019-2020)
Note: Interventions’ coverage are based on the last child data.
0
Indicator definition differs slightly between NFHS-4 and NFHS-5.
1
The difference is calculated only between districts that are comparable between 2015-2016 and
2019-2020. All 38 districts in Bihar are comparable between the two time periods.
2
Prevalence did not increase or decrease in any of the districts.
3
District codes:
Pu Champ: PurbaChamparan, Pa Champ: Paschim Champaran.
4
2 Districts: Aurangabad and Nawada. Indicator definition
Nutrition outcomesDefinition
Low birth weight
Percentage of live births in the five years preceding the survey with a reported birth weight less than 2.5 kg, based on
either a written record or the mother's recall
Stunting among children Percentage of children aged 0-59 months who are stunted i.e., height-for-age z score < -2SD
Wasting among children Percentage of children aged 0-59 months who are wasted i.e., weight-for-height z score < -2SD
Severe wasting among children Percentage of children aged 0-59 months who are wasted i.e., weight-for-height z score < -3SD
Underweight childrenPercentage of children aged 0-59 months who are underweight i.e., weight-for-age z score < -2SD
Anemia among children Percentage of children aged 6-59 months who are anemic i.e., (Hb <11.0 g/dl)
Underweight womenPercentage of women aged 15-49 whose Body Mass Index (BMI) is below normal (BMI <18.5 kg/m2)
Anemia among non-pregnant
women
Percentage of non-pregnant women aged 15-49 who are anemic (<12.0 g/dl)
Anemia among pregnant women Percentage of pregnant women aged 15-49 who are anemic (<11.0 g/dl)
Overweight/obesity -children Percentage of children aged 0-59 months who are overweight i.e., weight-for-height z score > 2SD
Overweight/obesity -women Percentage of men aged 15-54 who are overweight or obese (BMI ≥25.0 kg/m2)
Overweight/obesity -men Percentage of men aged 15-54 who are overweight or obese (BMI ≥25.0 kg/m2)
High blood pressure among women^Percentage of women aged 15-49 with elevated blood pressure (Systolic >140 mm Hg or diastolic >90 mm Hg)
High blood pressure among men^ Percentage of men aged 15-54 with elevated blood pressure (Systolic >140 mm Hg or diastolic >90 mm Hg)
High sugar level among women^ Percentage of women aged 15-49 with elevated blood pressure (Systolic >140 mm Hg or diastolic >90 mm Hg)
High sugar level among men^ Percentage of men aged 15-54 with high blood sugar levels (141-160 mg/dl)
Immediate determinants
Early initiation of breastfeeding
Percentage of children under aged 3 years breastfed within one hour of birth for the last child born in the 3 years
before the survey
Exclusive breastfeeding Percentage of youngest children under age 6 months living with mother who were exclusively breastfed
Timely introduction of
complementary foods
0
1
Percentage of youngest children aged 6-8 months living with mother who received solid or semi-solid food during the
previous day;
2
Percentage of youngest children aged 6-8 months living with mother who received solid or semi-solid
food and breastmilk
Continued breastfeeding at 2 years
$
Percentage of youngest children 12–23 months of age who were fed breast milk during the previous day
Adequate diet
Percentage of youngest children 6–23 months of age who consumed a minimum acceptable diet during the previous
day
Eggs and/or flesh foods
consumption
$
Percentage of youngest children 6–23 months of age who consumed egg and/or flesh food during the previous day
Sweet beverage
$
Percentage of youngest children 6–23 months of age who consumed a sweet beverage during the previous day
Bottle feeding for infants
$
Percentage of youngest children 0–23 months of age who were fed from a bottle with a nipple during the previous day
Women with body mass index
<18.5 kg/m
2 0
1
Percentage of women aged 15-49 with a youngest child < 5 years who have BMI below normal (BMI <18.5 kg/m2) ;
2
Percentage of women aged 15-49 whose BMI is below normal (BMI <18.5 kg/m
2
)
Consumed IFA 100+ days
Percentage of mothers aged 15-49 who consumed iron folic acid for 100 days or more during the last pregnancy in
last five years preceding the survey
Diarrhea in the last two weeks
0
1
Percentage of youngest children under age five who had diarrhea in the two weeks preceding the survey;
2
Percentage of children under age 5 who had diarrhea in the 2 weeks preceding the survey
ARI in the last two weeks
0
1
Percentage of youngest children under age five who had symptoms of acute respiratory infection (ARI) in the two
weeks preceding the survey;
2
Percentage of children under age five who had symptoms of acute respiratory
infection (ARI) in the two weeks preceding the survey
Underlying determinants
Women who are literate
0
1
Percentage of women aged 15-49 with a birth in five years preceding the survey who are literate i.e., those who
completed standard 6 or higher and can read a whole sentence;
2
Percentage of women aged 15-49 who are literate
i.e., those who completed standard 9 or higher and can read a whole sentence or part of a sentence.
Women with ≥10 years education
0
1
Percentage of women aged 15-49 with a birth in five years preceding the survey with 10 or more years of schooling;
2
Percentage of women aged 15-49 with 10 or more years of schooling
Girls 20-24 years married before
age of 18 years
0
1
Percentage of women aged 20-24 years with a birth in five years preceding the survey who were married before age
18 years;
2
Percentage of women aged 20-24 years who were married before age 18 years
Women 15-19 years with child or
pregnant
Percentage of currently married women aged 15-49 who had their first birth before age 20 years and in the five years
preceding the survey
HHs with improved drinking water
source
0
1
Percentage of youngest children under age 5 living in household that use an improved source of drinking water;
2
Population living in households that use an improved sanitation facility
HHs with improved sanitation
facility
0
1
Percentage of youngest children under age 5 living in household that uses improved toilet facility;
2
Population living
in households that use an improved sanitation facility
HHs with hand washing facility
^$
Percentage of youngest children under age 5 living in household that had soap and water for washing hands
Open defecation
@
Percentage of youngest children under age 5 living in household that has no toilet facility/defecates in open
Safe disposal of feces
$
Percentage of youngest children living with mother whose stools were disposed of safely
HHs with BPL card
@
Percentage of youngest children under age 5 living in households with BPL card
HHs with electricity
0
1
Percentage of youngest children under age 5 living in household that has electricity;
2
Population living in households
with electricity
^
Indicator not available in NFHS-3.
$
Indicator not available in NFHS-5 factsheets/state reports
0
Indicator comparable between NFHS-3 and NFHS-4
but differs slightly from NFHS-5.
@
Indicator not available in NFHS-5 factsheets but available in NFHS-5 states reports.
1
Definition per NFHS-3/NFHS-4.
2
Definition as per NFHS-5 factsheet. Indicator definition
InterventionsDefinition
Demand for FP satisfied
@
Percentage of currently married women aged 15-49 with demand for family planning satisfied by modern methods
Iodized salt
01
Percentage of women aged 15-49 living in HHs that use iodized salt;
2
Percentage of households using iodized salt
Any ANC visits
$
Percentage of women aged 15-49 with a live birth in the five years who received at least one ANC for the last birth
ANC first trimesterPercentage of women (15-49 years of age) attended by any provider during the first trimester of pregnancy that led to
the birth of the youngest child in the last 2 years
≥ 4ANCPercentage of mothers aged 15-49 who had at least 4 antenatal care visits for last birth in the 5 years before the
survey
Received MCP cardPercentage of mothers who registered last pregnancy in the 5 years preceding the survey for which she received a
Mother and Child Protection (MCP) card
Received IFA tab/syrup
@
Percentage of women who received IFA (given or purchased) tablets during the pregnancy for their most recent live
birth in the 5 years preceding the survey
Tetanus injectionPercentage of women whose last birth was protected against neonatal tetanus (for last birth in the five years
preceding the survey )
Deworming-pregnancy
@
Percentage of women who took an intestinal parasite drug during the pregnancy for their most recent live birth in the
5 years preceding the survey
Weighing-pregnancy
@
Percentage of women aged 15-49 with a live birth in the five years preceding the survey who were weighed during
ANC for the last birth
Birth preparedness counselling
$
Percentage of women who had at least one contact with a health worker in the three months preceding the survey
and were counselled on birth preparedness; calculated among women aged 15-49 who gave birth in the five years
preceding the survey
Breastfeeding counselling
@
Percentage of women who met with a community health worker in the last three months of pregnancy and received
advice on breastfeeding (for the last pregnancy in the five years preceding the survey)
Counselling on keeping baby
warm
@
Percentage of women who met with a community health worker in the last three months of pregnancy and received
advice on keeping the baby warm for their most recent live birth in the five years preceding the survey
Cord care counselling
^@
Percentage of women who met with a community health worker in the last three months of pregnancy and received
advice on cord care for their most recent live birth in the five years preceding the survey
Food supplementation -
pregnancy
@
1
Percentage of youngest children under age 5 whose mother received supplementary food from AWC during
pregnancy;
3
Among children under 6 years, percentage whose mother received specific benefits from AWC during
pregnancy: supplementary food
Health & nutrition education –
pregnancy
@
1
Percentage of mothers who received health and nutrition education from an Anganwadi Centre (AWC) during last
pregnancy in the five years preceding the survey;
3
Among children under 6 years, percentage whose mother received
specific benefits from AWC during pregnancy: health and nutrition education
Malaria prevention-use of bed
nets
^$
Percentage of women who used mosquito net during the pregnancy for their most recent live birth in the 5 years
preceding the survey
Institutional birth
01
Percentage of women aged 15-49 who gave birth in health/institutional facility for their most recent live birth in the 5
years preceding the survey;
2
Percentage of live births to women aged 15-49 in the five years preceding the survey
that took place in a health/institutional facility
Financial assistance (JSY)
@
Percentage of women who received financial assistance under JSY for their most recent live birth that took place in
institutional facility in the 5 years preceding the survey
Skilled birth attendant
01
Percentage of women whose last delivery was attended by a skilled health personnel for their most recent live birth
in the 5 years preceding the survey;
2
Percentage of births attended by skilled health personnel for births in the 5
years before the survey
Postnatal care for mothers Percentage of mothers who received postnatal care from a doctor/nurse/LHV/ANM/midwife/other health personnel
within 2 days of delivery for their most recent live birth in the five years preceding the survey
Postnatal care for babies Percentage of children who received postnatal care from a doctor /nurse /LHV /ANM /midwife /other health personnel
within 2 days of delivery for last birth in the 5 years before the survey
Food supplementation –postnatal
@ 1
Percentage of youngest children under age 5 whose mother received supplementary food from AWC while
breastfeeding;
3
Among children under 6 years, percentage whose mother received specific benefits from AWC while
breastfeeding: supplementary food
Health & nutrition education –
postnatal
@
1
Percentage of youngest children under age 5 whose mother received health check-ups from AWC while
breastfeeding;
3
Among children under 6 years, percentage whose mother received specific benefits from AWC while
breastfeeding: health and nutrition education
Full immunization
01
Percentage of youngest living children aged 12-23 months fully vaccinated based on information from either
vaccination card or mother's recall;
2
Percentage of children aged 12-23 months fully vaccinated based on information
from either vaccination card or mother's recall
Vitamin A –early childhood
01
Percentage of youngest children aged 6-59 months who received Vitamin A supplementation in the last 6 months
preceding the survey; 2 Percentage of children aged 9-35 months who received a vitamin A dose in the last 6 months
Pediatric IFA
0@
Percentage of youngest children aged 6-59 months who received iron supplements in the past 7 days preceding the
survey
Deworming –early childhood
0@
Percentage of youngest children aged 6-59 months who received deworming tablets in the last 6 months preceding
the survey
Care seeking for ARI
01
Percentage of youngest children under age 5 years with fever or symptoms of ARI in the 2 weeks preceding the
survey taken to a health facility or health provider;
2
Percentage of children under age 5 years with fever or symptoms
of ARI in the 2 weeks preceding the survey taken to a health facility or health provider
ORS during diarrhea
01
Percentage of youngest children under age 5 years with diarrhea in the 2 weeks preceding the survey who received
oral rehydration salts (ORS); 2Percentage of children under age 5 years with diarrhea in the 2 weeks preceding the
survey who ORS
Zinc during diarrhea
01
Percentage of youngest children under age 5 years with diarrhea in the 2 weeks preceding the survey who
received zinc;
2
Percentage of children under age 5 years with diarrhea in the 2 weeks preceding the survey who
received zinc
Food supplementation (children 6-
35 months)
$
Percentage of youngest children aged 6-35 months who received food supplements from AWC in the 12 months
preceding the survey
Weighing –early childhood
@
Percentage of youngest children under age 5 who were weighed at AWC in the 12 months preceding the survey
Counselling on child growth
@
Percentage of youngest children under age 5 whose mother received counselling from an AWC after child was
weighed in the 12 months preceding the survey
^
Indicator not available in NFHS-3.
$
Indicator not available in NFHS-5 factsheets/state reports.
@
Indicator not available in NFHS-5 factsheets but available in
NFHS-5 states reports.
0
Indicator comparable between NFHS-3 and NFHS-4 but differs slightly from NFHS-5.
1
Definition per NFHS-3/NFHS-4.
2
Definition as per NFHS-5 factsheet.
3
Definition as per NFHS-5 state reports. ABOUT POSHAN
Partnerships and Opportunities to
Strengthen and Harmonize Actions
for Nutrition in India (POSHAN) is a
multi-year initiative that aims to
support the use of data and evidence
in decision-making for nutrition in
India. It is supported by the Bill &
Melinda Gates Foundation and led by
IFPRI in India.
http://poshan.ifpri.info/
ABOUT DATA NOTES
POSHAN Data Notes focus on data
visualization to highlight geographic
and/or thematic issues related to
nutrition in India. They draw on
multiple sources of publically
available data.
CONTACT US
Email: IFPRI-POSHAN@cgiar.org
IFPRI-NEW DELHI
INTERNATIONAL FOOD POLICY
RESEARCH INSTITUTE
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Dev Prakash Shastri Road,
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www.ifpri.org
This publication has been prepared by
POSHAN. It has not been peer
reviewed. Any opinions stated herein
are those of the author(s) and do not
necessarily reflect the policies of the
International Food Policy Research
Institute.
Copyright © 2021 International Food
Policy Research Institute. All rights
reserved. For permission to republish,
contact ifpri-copyright@cgiar.org.
AUTHORS
Anjali Pant,Research Analyst, IFPRI
Samuel Scott,Research Fellow, IFPRI
S.K. Singh,Professor, IIPS
Rakesh Sarwal, NITI Aayog
Neena Bhatia, Senior Specialist, NITI Aayog
Robert Johnston, Nutrition Specialist UNICEF
William Joe, Assistant Professor, IEG
Esha Sarswat, Communications Specialist, IFPRI
Purnima Menon, Senior Research Fellow, IFPRI
Phuong Hong Nguyen, Senior Research Fellow, IFPRI
SUGGESTED CITATION
Pant, A., S. Scott, S.K. Singh, R. Sarwal, N. Bhatia, R.
Johnston, W. Joe, E. Sarswat, P. Menon, and P.H.
Nguyen. 2021. State Nutrition Profile: Bihar. POSHAN Data
Note 41. New Delhi, India: International Food Policy
Research Institute.
ACKNOWLEDGEMENTS
Financial support for this Policy Note was provided by
the Bill & Melinda Gates Foundation through POSHAN,
led by the International Food Policy Research Institute.
The funder played no role in decisions about the scope of
the analysis or the contents of the Note.
We thank Long Quynh Khuong(Independent Researcher)
for creating the maps, Nishmeet Singh (IFPRI) for
working with the dataset and Julie Ghostlaw (IFPRI) &
Abhilasha Vaid (Consultant) for editing and reviewing the
Note.
PARTNERS
Institute of Economic Growth (IEG)
International Institute for Population Science (IIPS)
NITI Aayog
UNICEF
Disclaimer: The maps used in this Data Note are based on the districts in NFHS-5
factsheets/reports . The boundaries shown do not imply any official endorsement or
acceptance by IFPRI.
State Nutrition Profile: Bihar
ABOUT THIS DATA NOTE
Figure 1. Trends in undernutrition outcomes
2005-2006, 2015-2016, 2019-2020
2005-2006 2015-2016 2019-2020 India average
28
2
14
2
NA
3
554843 282123 989 574441 786469 453026 686064 605863
0
20
40
60
80
100
Low birth weightStunting WastingSevere wastingUnderweight Anemia Underweight Anemia
(non-pregnant)
Anemia
(pregnant)
%
Undernutrition among children (<5y)Undernutrition among women (15-49y)
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state factsheets (2019-2020).
Note: Adult nutrition outcomes are based on the woman dataset, while child nutrition outcomes are based on all child data.
1
WHO. Nutrition Landscape Information System (NLiS). Help Topic: Malnutrition in children. Stunting, wasting, overweight and underweight.
(https://apps.who.int/nutrition/landscape/help.aspx?menu=0&helpid=391&lang=EN).
2
In NFHS-3, 83.8% of data was missing, while 38.7% of data was missing in NFHS-4.
3
NA refers to the unavailability of data for a particular indicator in the specified NFHS round.
BIHAR
This Data Notedescribes the trends for a set of key
nutrition and health outcomes, determinants, and
coverage of interventions. The findings here are based
on data from the National Family Health Survey (NFHS)
3 (2005-2006), 4 (2015-2016), and 5 (2019-2020). In
addition to standard prevalence-based analyses, this
Data Noteincludes headcount-based analyses aligned
to the POSHAN Abhiyaanmonitoring framework and
uses data from NFHS-5 to provide evidence that helps
identify priority districts and number of districts in the
state with public health concern as per the WHO
guidelines.
1
The Data Noteincludes a color-coded
dashboard to compare the coverage of nutrition
interventions across all the districts in the state. It
concludes with key takeaways for children, women, and
men and identifies areas where the state has potential
to improve. No. of districts with public health concern
1
: 38 of 38
Map 1 & 2. Number of stunted & anemic children <5y, 2019-2020
Source: IFPRI estimates -The headcount was calculated as the product of the undernutrition prevalence and the total eligible projected population for each district
in 2019. Prevalence estimates were obtained from NFHS-5 (2019-2020; all child data) and projected population for 2019 was estimated using Census 2011.
1
Public health concern is defined as ≥20% for stunting, ≥40% for anemia, ≥10% for wasting, and ≥2% for severe wasting (WHO 2011).
2
The total number of children <5 years is 14,700,960.
Map 1. Stunting
Map 3. Wasting
Map 2. Anemia
Highest burden districts
1PurbaChamparan381,534
2Gaya283,396
3Muzaffarpur279,824
4Sitamarhi277,649
5Samastipur274,258
Highest burden districts
1Patna199,360
2Saran148,293
3Gaya145,285
4Samastipur132,766
5Purnia132,549
Highest burden districts
1Patna425,899
2PurbaChamparan425,799
3Gaya411,941
4Madhubani397,599
5Muzaffarpur381,181
No. of districts with public health concern
1
: 38 of 38
No. of districts with public health concern
1
: 38 of 38
No. of districts with public health concern
1
: 38 of 38
Number of stunted
children
2
= 6,294,938
Number of wasted
children
2
= 3,376,118
Number of anemic
children
2
= 9,157,349
Map 3 & 4. Number of wasted children <5y, 2019-2020
Map 4. Severe Wasting
Number of severely wasted
children
2
= 1,317,014
Highest burden districts
1Patna76,844
2Rohtas69,090
3Aurangabad63,897
4Gaya55,603
5Muzaffarpur53,206
Note: Number in ‘000s in the above figureNote: Number in ‘000s in the above figure
Note: Number in ‘000s in the above figureNote: Number in ‘000s in the above figure Map 5 & 6. Number of underweight children (<5y)
& women (15-49y), 2019-2020
Source: IFPRI estimates -The headcount was calculated as the product of the undernutrition prevalence and the total eligible projected population for each district
in 2019. Prevalence estimates were obtained from NFHS-5 (2019-2020; all child/woman data) and projected population for 2019 was estimated using Census
2011.
1
Public health concern is defined as≥20% for underweight (children), ≥10% for underweight (women), ≥40% for anemia among non-pregnant women, and
≥40% for anemia among pregnant women (WHO 2011).
2
The total number of children <5 years is 14,700,960, pregnant women 15-49 years is 3,408,592, and non-
pregnant women 15-49 years is 27,254,036.
Map 6. Underweight women
Map 7. Anemia among non-pregnant women Map 8. Anemia among pregnant women
Highest burden districts
1Patna414,951
2Muzaffarpur354,837
3Gaya351,821
4PurbaChamparan336,661
5Madhubani331,917
Highest burden districts
1Patna110,090
2PurbaChamparan105,464
3Samastipur96,448
4Muzaffarpur96,354
5PashchimChamparan95,483
Highest burden districts
1Patna1,235,673
2Gaya844,108
3Muzaffarpur826,544
4PurbaChamparan821,511
5Madhubani805,328
No. of districts with public health concern
1
: 38 of 38
No. of districts with public health concern
1
: 38 of 38 No. of districts with public health concern
1
: 37 of 38
Number of underweight
women
2
= 7,835,772
Number of non-pregnant
anemic women
2
= 19,516,988
Number of pregnant anemic
women
2
= 2,135,286
Map 5. Underweight children
Highest burden districts
1PurbaChamparan294,504
2Patna287,078
3Samastipur266,779
4Gaya260,079
5Purnia241,980
No. of districts with public health concern
1
: 38 of 38
Number of underweight
children
2
= 6,018,740
Map 7 & 8. Number of anemic women (15-49y), 2019-2020
Note: Number in ‘000s in the above figureNote: Number in ‘000s in the above figure
Note: Number in ‘000s in the above figureNote: Number in ‘000s in the above figure Category Outcomes
Worst performing
districts (pp)
Best performing
districts (pp)
Highest burden
districts
(thousands)
4
No of districts
with public
health concern
5
(total=38)
Difference between
(2019-2020) & (2015-
2016)
3
Difference between
(2019-2020) & (2015-
2016)
3
2019-2020 2019-2020
Children
<5 years
Overweight/
obesity
Sheikhpura: +4.5
Buxar: +3.6
Purnia: -1.6
2 Districts
6
: -1.5
Pu Champ
9
: 30
Gaya: 22
0
Women
(15-49 years)
Overweight/
obesity
Begusarai: +7.8
2 Districts
7
: +7.3
Aurangabad: -2.2
2 Districts
8
: -2.0
Patna: 395
Siwan: 242
6
High blood
pressure
Banka: +10.0
Munger: +8.3
Araria: -0.6
Madhepura: -0.1
Muzaffarpur: 208
Gaya: 202
0
High blood
sugar
Munger: +5.9
Samastipur: +5.4
Sheohar: -2.2
Kaimur: -2.2
Patna: 140
Samastipur: 98
0
Men
(15-54 years)
Overweight
/obesity
Data not available at district-level
High blood
pressure
Siwan: +14.2
Banka: +11.7
Buxar: -5.0
Samastipur: -1.0
Muzaffarpur: 303
Pu Champ
9
: 300
6
High blood
sugar
Darbhanga: +7.0
Madhubani: +6.1
Muzaffarpur: -9.1
Aurangabad: -8.5
Patna: 186
Madhubani: 122
0
Figure 2. Trends in overweight/obesity & NCDs
1
2005-2006, 2015-2016, 2019-2020
Table 1. Overweight/obesity & NCDs
2
at district-level
2015-2016, 2019-2020
2005-2006 2015-2016 2019-2020 India average
02
2 51216 NA
1
812 NA
1
4
6 61315 NA
1
1116 NA
1
78
0
20
40
60
80
100
Overweight/
obesity
Overweight/
obesity
High blood
pressure
High blood
sugar
Overweight/
obesity
High blood
pressure
High blood
sugar
%
Children (<5y)Women (15-49y)Men (15-54y)
pp: percentage points
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state and district factsheets (2019-2020).
Note: Adult nutrition outcomes are based on the woman/man dataset, while child nutrition outcomes are based on all child data.
1
NA refers to the unavailability of data for a particular indicator in the specified NFHS round.
2
NCDs : non communicable diseases
3
The difference is calculated only between districts that are comparable between 2015-2016 and 2019-2020. All 38 districts in Bihar are comparable between the
two time periods.
4
Burden: The headcount was calculated as the product of the overweight/obesity and NCDs prevalence and the total eligible projected population for each district
in 2019. Prevalence estimates were obtained from NFHS-5 (2019-2020) and projected population for 2019 was estimated using Census2011.
5
Public health concern is defined as prevalence ≥15% for overweight/obesity (children), ≥20% for overweight/obesity (women andmen), ≥ 20% high blood
pressure (women and men), and ≥20% high sugar (women and men). Source: WHO (2011).
6
2 Districts: Darbhanga and Nawada;
7
2 Districts: Banka and Khagaria;
8
2 Districts: Kaimurand Sheohar
9
District codes: Pu Champ-PurbaChamparan Category
Immediate
determinants
Worst performing
districts (pp)
Best performing
districts (pp)
Top coverage
districts (%)
2
Difference between
(2019-2020) & (2015-2016)
1
Difference between
(2019-2020) & (2015-2016)
1
2019-2020
IYCF
practices
Early initiation of
breastfeeding
Nalanda: -27.4
Katihar: -21.2
Gaya: +11.9
Begusarai: +10.5
Kaimur: 48.5
Jehanabad: 45.1
Exclusive
breastfeeding
Katihar: -26.3
Saran: -26.1
Sheikhpura: +40.4
Gaya: +38.6
Gopalganj: 83.5
Sheohar: 83.5
Timely introduction of
complementary foods
0
Pu Champ
3
: -12.5
Kishanganj: -11.1
Saharsa: +28.5
Katihar: 26.0
Arwal: 61.7
Saran: 58.7
Adequate diet
0
Sheikhpura: -12.8
Nawada: -12.3
Samastipur: +11.9
Supaul: +9.6
Samastipur: 17.7
Muzaffarpur: 17.2
Maternal
determinants
Women with BMI<18.5
kg/m2
0
Arwal: +0.4
Pa Champ
3
: +0.2
Sheikhpura: -15.6
Muzaffarpur: -12.3
Siwan: 18.1
Sheohar: 20.0
Consumed IFA 100+
days
Pa Champ
3
: -4.5
Patna: -0.5
Munger: +22.8
Lakhisarai: +16.6
Munger: 33.0
Bhagalpur: 28.0
Diseases
Diarrhea in the last two
weeks
0
Supaul: +27.9
Madhubani: +18.0
Gopalganj: -15.4
Sheohar: -9.5
Jamui: 2.1
Kaimur: 3.1
ARI in the last two
weeks
0
Pa Champ
3
: +4.9
Siwan: +4.9
Gopalganj: -4.3
Purnia: -3.8
Patna: 0.7
Bhagalpur: 1.1
Figure 3. Trends in immediate determinants (%)
2005-2006, 2015-2016, 2019-2020
Table 2. Immediate determinants at district-level
2015-2016, 2019-2020
pp: percentage points
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state and district factsheets (2019-2020).
Note: Immediate determinants are based on the last child data; data on continued breastfeeding at 2 years, egg and/or flesh foods consumption, sweet beverage
consumption, and bottle feeding of infants not available in NFHS-5 factsheets (2019-20)/state report
0
Indicator definition differs slightly between NFHS-4 and NFHS-5.
1
The difference is calculated only between districts that are comparable between 2015-2016 and 2019-2020. All 38 districts in Bihar are comparable between the
two time periods.
2
For all indicators, top coverage districts refer to the districts with the highest prevalence in immediate determinants, except for women with a BMI of 18.5 kg/m2,
diarrhea in the last two weeks, and ARI in the last two weeks, for which it refers to the districts with the lowest prevalence in coverage.
3
District codes: Pu Champ: PurbaChamparan, Pa Champ: Paschim Champaran. Category
Underlying
determinants
Worst performing
districts (pp)
Best performing
districts (pp)
Top coverage
districts (%)
2
Difference between
(2019-2020) & (2015-2016)
1
Difference between
(2019-2020) & (2015-2016)
1
2019-2020
Maternal
determinants
Women who are literate
0
Not applicable
3
Madhepura: +24.7
Sitamarhi: +24.3
Rohtas: 76.5
Siwan: 70.9
Women with ≥10 years
education
0
Not applicable
3
Munger: +17.6
Begusarai: 16.7
Munger: 44.4
Patna: 43.6
Girls 20-24 years married
before age of 18 years
0
Not applicable
3
Sheohar: -30.1
Rohtas: -28.9
Siwan: 21.3
Saran: 26.2
Women 15-19 years with
child or pregnant
Saharsa: +11.7
Purnia: +9.1
Sheohar: -10.7
Gaya: -7.7
Kaimur: 2.6
Siwan: 2.6
Household
determinants
HHs with improved
drinking water source
0
Khagaria: -0.6
Purnia: -0.4
Jamui: +12.7
Munger: +6.8
6 Districts
4
:
100.0
HHs with improved
sanitation facility
0
Not applicable
3
Rohtas: +43.9
Kaimur: +40.3
Rohtas: 69.0
Khagaria: 65.0
HHs with electricity
0
Not applicable
3
Katihar: +65.0
Samastipur: +57.5
Jehanabad: 99.3
Patna: 99.0
Figure 4. Trends in underlying determinants (%)
2005-2006, 2015-2016, 2019-2020
Table 3. Underlying determinants at district-level
2015-2016, 2019-2020
pp: percentage points
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state and district factsheets and state reports (2019-2020).
Note: Underlying determinants are based on the last child data; safe disposal of feces not available in NFHS-5 factsheets (2019-20)/state report and data on HHs
with hand washing facility not available in NFHS-3 (2005-06) and NFHS-5 factsheets (2019-20)/state report. Data on open defecation and HHs with BPL card for
2019-2020 are taken from NFHS-5 state reports.
0
Indicator definition differs slightly between NFHS-4 and NFHS-5.
1
The difference is calculated only between districts that are comparable between 2015-2016 and 2019-2020. All 38 districts in Bihar are comparable between the
two time periods.
2
For all indicators, top coverage districts refer to the districts with the highest prevalence in underlying determinants, exceptfor girls 20-24 years married before age
of 18 years and women 15-19 years with child or pregnantfor which it refers to the districts with the lowest prevalence in coverage.
3
Prevalence did not increase or decrease in any of the districts.
4
6 Districts: Araria, Aurangabad, Kishanganj, Madhubani, Saharsa, and Sheohar. Figure 5. Trends in coverage of interventions across the first
1,000 days (%), 2005-2006, 2015-2016, 2019-2020
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016) & NFHS-5 state factsheets and state reports (2019-2020).
0
Indicator comparable between NFHS-3 and NFHS-4 but differs slightly from NFHS-5.
Note 1 : Interventions’ coverage is based on the last child data.
Note 2: The following information is not available in the NFHS-5 factsheets and state reports (2019-20): receipt of at least one ANC visit, birth preparedness
counselling, malaria prevention and food supplementation (6-35m). Information on use of bed nets during pregnancy is not available in NFHS-3 data (2006).
Note 3: Data on food supplementation and health and nutrition education during pregnancy and post-natal care, and weight measurement during childhood and
counselling on child growth for 2019-2020 are taken from NFHS-5 state reports.
Note 4: Refer to district dashboard for the inter-district variability in the coverage of interventions. Intervention coverage at district level, 2019-2020
Note 1: The following information is not available in the NFHS
-
5 factsheets and state reports (2019
-
20): (1) Information on pre
conception and pregnancy
-
related indicators including demand for FP satisfied,
receipt of at least one ANC visit, weighing, birth preparedness and breastfeeding counselling, counselling on keeping baby wa
rm,
cord care counselling, food supplementation, health and nutrition education and
malaria prevention; (2) Lactation
-
related indicators including, food supplementation and health and nutrition education; and (3)
early childhood
-
related indicators including pediatric IFA, deworming, food
supplementation (6
-
35m), weighing and counselling on child growth. Information on use of bed nets during pregnancy not available
in NFHS
-
3 data (2005
-
2006).
Note 2: Food supplementation during early childhood is for children aged 6
-
35 months; counselling on child growth during early c
hildhood is conducted after taking weight measurement.
Source: NFHS
-
5
district factsheets and
state reports (2019
-
20). District name
Demand for FP
satisfied
Iodized salt
Any ANC visits
ANC first trimester
≥4 ANC
Received MCP card
Received IFA
tab/syrup
Tetanus injection
Deworming
Weighing
Birth preparedness
counselling
Breastfeeding
counselling
Counselling on
keeping baby warm
Cord care counselling
Food supplementation
Health & nutrition
education
Malaria prevention-
use of bed nets
Institutional birth
Financial assistance
(JSY)
Skilled birth attendant
Postnatal care for
mothers
Postnatal care for
babies
Food supplementation
Health & nutrition
education
Full immunization
Vitamin A
Paediatric IFA
Deworming
Care seeking for ARIORS during diarrheaZinc during diarrhea
Food supplementation
(6-35 months)
Weighing
Counselling on child
growth
BIHAR93.3 52.925.289.573.989.519.176.242.179.057.359.371.056.069.458.225.6
Araria93.7 41.625.890.677.986.416.166.246.670.346.448.261.657.157.950.59.2
Arwal90.1 57.434.595.577.094.223.379.252.183.170.170.184.257.886.357.551.2
Aurangabad92.4 53.629.392.378.193.225.977.556.884.671.572.089.763.984.464.436.9
Banka90.1 70.731.784.086.093.620.879.854.780.472.374.788.142.872.663.841.4
Begusarai89.2 46.521.687.878.488.629.686.040.285.658.660.965.857.275.461.831.6
Bhagalpur85.2 53.327.685.476.989.923.877.236.077.554.060.566.846.269.573.723.6
Bhojpur92.2 42.733.593.357.893.814.286.936.287.556.162.461.940.381.949.245.3
Buxar93.5 61.527.492.272.793.421.089.535.990.666.968.375.050.481.649.226.8
Darbhanga96.0 51.824.987.673.891.917.569.938.875.950.550.966.360.465.461.919.6
Gaya94.9 63.225.193.481.194.922.476.652.477.772.575.485.047.179.0
Gopalganj96.6 53.227.989.673.890.122.085.935.988.053.954.275.869.161.569.29.1
Jamui91.0 73.837.987.882.195.222.473.444.072.766.769.866.430.263.7
Jehanabad91.0 58.417.495.878.494.216.289.143.388.377.771.270.368.478.049.625.3
Kaimur (Bhabua)93.7 62.425.697.282.093.526.883.352.686.081.677.088.967.577.5
Katihar96.7 40.915.391.771.484.418.366.949.673.841.744.373.750.266.060.417.1
Khagaria88.0 44.617.489.574.483.96.074.232.282.354.252.264.762.981.255.627.4
Kishanganj94.8 37.617.184.771.679.216.754.633.364.940.742.167.353.267.764.54.2
Lakhisarai84.2 66.128.087.179.492.823.375.848.576.266.774.168.941.879.344.330.0
Madhepura95.4 53.820.995.675.587.716.375.074.077.149.558.972.055.858.252.136.2
Madhubani91.9 67.534.991.574.494.017.973.742.678.558.961.074.174.766.564.630.4
Munger92.6 68.736.889.888.290.523.093.241.892.380.783.473.444.669.958.724.4
Muzaffarpur96.1 55.928.284.169.893.817.072.534.178.255.955.974.957.880.366.327.9
Nalanda89.1 64.729.387.671.594.217.280.345.485.177.573.075.244.184.372.651.7
Nawada98.2 69.531.688.179.394.812.679.947.279.574.180.574.537.384.4
Pashchim Champaran97.7 55.025.483.959.989.719.279.538.778.457.364.162.162.460.256.816.4
Patna92.9 51.717.988.871.983.010.589.127.781.459.063.156.658.468.843.820.7
Purba Champaran96.9 45.421.783.559.986.414.461.527.767.443.741.868.351.559.840.719.7
Purnia92.6 26.311.193.478.683.617.368.934.274.241.041.562.765.263.741.225.9
Rohtas97.4 64.934.291.280.195.030.189.141.791.385.080.786.871.583.1
Saharsa94.6 34.811.795.165.182.712.770.458.572.938.540.872.257.475.550.321.2
Samastipur91.9 53.423.590.481.390.424.083.450.083.752.151.571.464.178.760.230.3
Saran92.9 44.430.794.361.488.116.473.039.279.154.158.372.050.271.451.536.8
Sheikhpura90.3 68.828.487.772.295.819.789.255.891.877.178.782.842.869.059.352.8
Sheohar95.6 62.825.393.274.094.017.074.358.377.061.158.762.959.273.349.833.3
Sitamarhi95.0 57.820.391.174.087.624.164.445.269.651.157.366.660.067.769.618.3
Siwan94.1 61.030.382.979.196.615.986.434.186.963.963.076.148.371.656.714.2
Supaul94.3 59.030.996.183.089.826.980.463.179.460.764.273.650.562.959.525.9
Vaishali86.2 46.724.588.579.180.819.081.633.684.857.464.371.055.861.454.918.2
Pre-
pregnancy
PregnancyDelivery & postnatalEarly childhood <20%60-<80% >=80% Not Available20-<40% 40-<60% Category Interventions
Worst performing
districts (pp)
Best performing
districts (pp)
Top coverage
districts (%)
Difference between
(2019-2020) & (2015-2016)
1
Difference between
(2019-2020) & (2015-2016)
1
2019-2020
ANC first trimester
Purnia: -9.2
Saharsa: -0.9
Madhubani: +40.1
Jamui: +37.3
Jamui: 73.8
Banka: 70.7
Pregnancy
≥4 ANC visits
Patna: -3.8
Purnia: -1.1
Jamui: +27.5
Arwal: +23.0
Jamui: 37.9
Munger: 36.8
Received MCP Card Not applicable
2
Pu Champ
3
: +68.0
Muzaffarpur: +62.0
Kaimur: 97.2
Supaul: 96.1
Tetanus injection
Patna: -8.4
Vaishali: -7.5
Pa Champ
3
: +12.4
Darbhanga: +11.8
Siwan: 96.6
Sheikhpura: 95.8
Delivery and
post-natal
Institutional birth°
Nalanda: -0.4
Vaishali: -0.2
Sitamarhi: +22.8
Darbhanga: +20.4
Munger: 93.2
Buxar: 89.5
Skilled birth attendant°
Patna: -4.7
Bhagalpur: -1.2
Sitamarhi: +19.5
Sheohar: +15.2
Munger: 92.3
Sheikhpura: 91.8
Postnatal care for
mothers
Purnia: -5.8
Patna: -4.2
Muzaffarpur: +32.3
Pa Champ
3
: +28.9
Rohtas: 85.0
Kaimur: 81.6
Postnatal care for
babies°
Not applicable
2
Kaimur: +71.5
Banka: +67.4
Munger: 83.4
Rohtas: 80.7
Early
childhood
Full immunization
Patna: -12.3
Begusarai: -10.4
Pa Champ
3
: +30.2
Madhubani: +25.5
Aurangabad: 89.7
Kaimur: 88.9
Vitamin A
supplementation°
Bhojpur: -23.6
Bhagalpur: -23.1
Kaimur: +21.0
Madhubani: +17.7
Madhubani: 74.7
Rohtas: 71.5
Care seeking for ARI°
Gopalganj: -9.7
Munger: -6.3
Bhojpur: +48.2
Arwal: +36.8
Arwal: 86.3
2 Districts
4
: 84.4
ORS treatment during
diarrhea°
Lakhisarai: -18.6
Buxar: -12.9
Aurangabad: +51.7
Sitamarhi: +33.9
Bhagalpur: 73.7
Nalanda: 72.6
Zinc treatment during
diarrhea°
Kishanganj: -28.2
Saharsa: -23.8
Nalanda: +34.7
Sheikhpura: 34.3
Sheikhpura: 52.8
Nalanda: 51.7
Table 4. Intervention coverage at district-level
2015-2016, 2019-2020
Key takeaways
Children: Stunting and wasting prevalence declined by 7 percentage points (pp) from 2006 to 2016; stunting continued to
decline by 5pp but wasting increased by 2pp from 2016 to 2020. Underweight declined by 13pp from 2006 to 2016 and
continued to decline by 3pp from 2016 to 2020. Anemia declined by 14pp from 2006 to 2016 but increased by 5pp from
2016 to 2020.
Women: Underweight declined by 15 pp from 2006 to 2016 and continued to decline by 4pp from 2016 to 2020. Anemia
in non-pregnant and pregnant women declined by 8pp and 2pp, respectively, from 2006 to 2016, but increased by 4-5pp
among both groups of women from 2016 to 2020. Overweight/obesity increased by 7pp from 2006 to 2016 and continued
to increase by 4pp from 2016 to 2020.
Men:Overweight/obesity increased by 7pp from 2006 to 2016 and continued to increase by 2pp from 2016 to 2020.
Attention is needed to improve (%s in 2020):
•Outcomes: Stunting (43%) and anemia in children (69%); anemia in non-pregnant (64%) and pregnant (63%) women
•Immediate determinants:Early initiation of breastfeeding (31%); adequate diet (11%); 100+ IFA (18%)
•Underlying determinants:Women with 10 years education (29%); households with improved sanitation (49%)
•Coverage of interventions:4 ANC visits (25%),food supplementation (42-44%), and health and nutrition education
for women (32-35%); growth monitoring of children (35%)
pp: percentage points.
Source: NFHS-3 (2005-2006), NFHS-4 (2015-2016), and NFHS-5 state and district factsheets (2019-2020)
Note: Interventions’ coverage are based on the last child data.
0
Indicator definition differs slightly between NFHS-4 and NFHS-5.
1
The difference is calculated only between districts that are comparable between 2015-2016 and
2019-2020. All 38 districts in Bihar are comparable between the two time periods.
2
Prevalence did not increase or decrease in any of the districts.
3
District codes:
Pu Champ: PurbaChamparan, Pa Champ: Paschim Champaran.
4
2 Districts: Aurangabad and Nawada. Indicator definition
Nutrition outcomesDefinition
Low birth weight
Percentage of live births in the five years preceding the survey with a reported birth weight less than 2.5 kg, based on
either a written record or the mother's recall
Stunting among children Percentage of children aged 0-59 months who are stunted i.e., height-for-age z score < -2SD
Wasting among children Percentage of children aged 0-59 months who are wasted i.e., weight-for-height z score < -2SD
Severe wasting among children Percentage of children aged 0-59 months who are wasted i.e., weight-for-height z score < -3SD
Underweight childrenPercentage of children aged 0-59 months who are underweight i.e., weight-for-age z score < -2SD
Anemia among children Percentage of children aged 6-59 months who are anemic i.e., (Hb <11.0 g/dl)
Underweight womenPercentage of women aged 15-49 whose Body Mass Index (BMI) is below normal (BMI <18.5 kg/m2)
Anemia among non-pregnant
women
Percentage of non-pregnant women aged 15-49 who are anemic (<12.0 g/dl)
Anemia among pregnant women Percentage of pregnant women aged 15-49 who are anemic (<11.0 g/dl)
Overweight/obesity -children Percentage of children aged 0-59 months who are overweight i.e., weight-for-height z score > 2SD
Overweight/obesity -women Percentage of men aged 15-54 who are overweight or obese (BMI ≥25.0 kg/m2)
Overweight/obesity -men Percentage of men aged 15-54 who are overweight or obese (BMI ≥25.0 kg/m2)
High blood pressure among women^Percentage of women aged 15-49 with elevated blood pressure (Systolic >140 mm Hg or diastolic >90 mm Hg)
High blood pressure among men^ Percentage of men aged 15-54 with elevated blood pressure (Systolic >140 mm Hg or diastolic >90 mm Hg)
High sugar level among women^ Percentage of women aged 15-49 with elevated blood pressure (Systolic >140 mm Hg or diastolic >90 mm Hg)
High sugar level among men^ Percentage of men aged 15-54 with high blood sugar levels (141-160 mg/dl)
Immediate determinants
Early initiation of breastfeeding
Percentage of children under aged 3 years breastfed within one hour of birth for the last child born in the 3 years
before the survey
Exclusive breastfeeding Percentage of youngest children under age 6 months living with mother who were exclusively breastfed
Timely introduction of
complementary foods
0
1
Percentage of youngest children aged 6-8 months living with mother who received solid or semi-solid food during the
previous day;
2
Percentage of youngest children aged 6-8 months living with mother who received solid or semi-solid
food and breastmilk
Continued breastfeeding at 2 years
$
Percentage of youngest children 12–23 months of age who were fed breast milk during the previous day
Adequate diet
Percentage of youngest children 6–23 months of age who consumed a minimum acceptable diet during the previous
day
Eggs and/or flesh foods
consumption
$
Percentage of youngest children 6–23 months of age who consumed egg and/or flesh food during the previous day
Sweet beverage
$
Percentage of youngest children 6–23 months of age who consumed a sweet beverage during the previous day
Bottle feeding for infants
$
Percentage of youngest children 0–23 months of age who were fed from a bottle with a nipple during the previous day
Women with body mass index
<18.5 kg/m
2 0
1
Percentage of women aged 15-49 with a youngest child < 5 years who have BMI below normal (BMI <18.5 kg/m2) ;
2
Percentage of women aged 15-49 whose BMI is below normal (BMI <18.5 kg/m
2
)
Consumed IFA 100+ days
Percentage of mothers aged 15-49 who consumed iron folic acid for 100 days or more during the last pregnancy in
last five years preceding the survey
Diarrhea in the last two weeks
0
1
Percentage of youngest children under age five who had diarrhea in the two weeks preceding the survey;
2
Percentage of children under age 5 who had diarrhea in the 2 weeks preceding the survey
ARI in the last two weeks
0
1
Percentage of youngest children under age five who had symptoms of acute respiratory infection (ARI) in the two
weeks preceding the survey;
2
Percentage of children under age five who had symptoms of acute respiratory
infection (ARI) in the two weeks preceding the survey
Underlying determinants
Women who are literate
0
1
Percentage of women aged 15-49 with a birth in five years preceding the survey who are literate i.e., those who
completed standard 6 or higher and can read a whole sentence;
2
Percentage of women aged 15-49 who are literate
i.e., those who completed standard 9 or higher and can read a whole sentence or part of a sentence.
Women with ≥10 years education
0
1
Percentage of women aged 15-49 with a birth in five years preceding the survey with 10 or more years of schooling;
2
Percentage of women aged 15-49 with 10 or more years of schooling
Girls 20-24 years married before
age of 18 years
0
1
Percentage of women aged 20-24 years with a birth in five years preceding the survey who were married before age
18 years;
2
Percentage of women aged 20-24 years who were married before age 18 years
Women 15-19 years with child or
pregnant
Percentage of currently married women aged 15-49 who had their first birth before age 20 years and in the five years
preceding the survey
HHs with improved drinking water
source
0
1
Percentage of youngest children under age 5 living in household that use an improved source of drinking water;
2
Population living in households that use an improved sanitation facility
HHs with improved sanitation
facility
0
1
Percentage of youngest children under age 5 living in household that uses improved toilet facility;
2
Population living
in households that use an improved sanitation facility
HHs with hand washing facility
^$
Percentage of youngest children under age 5 living in household that had soap and water for washing hands
Open defecation
@
Percentage of youngest children under age 5 living in household that has no toilet facility/defecates in open
Safe disposal of feces
$
Percentage of youngest children living with mother whose stools were disposed of safely
HHs with BPL card
@
Percentage of youngest children under age 5 living in households with BPL card
HHs with electricity
0
1
Percentage of youngest children under age 5 living in household that has electricity;
2
Population living in households
with electricity
^
Indicator not available in NFHS-3.
$
Indicator not available in NFHS-5 factsheets/state reports
0
Indicator comparable between NFHS-3 and NFHS-4
but differs slightly from NFHS-5.
@
Indicator not available in NFHS-5 factsheets but available in NFHS-5 states reports.
1
Definition per NFHS-3/NFHS-4.
2
Definition as per NFHS-5 factsheet. Indicator definition
InterventionsDefinition
Demand for FP satisfied
@
Percentage of currently married women aged 15-49 with demand for family planning satisfied by modern methods
Iodized salt
01
Percentage of women aged 15-49 living in HHs that use iodized salt;
2
Percentage of households using iodized salt
Any ANC visits
$
Percentage of women aged 15-49 with a live birth in the five years who received at least one ANC for the last birth
ANC first trimesterPercentage of women (15-49 years of age) attended by any provider during the first trimester of pregnancy that led to
the birth of the youngest child in the last 2 years
≥ 4ANCPercentage of mothers aged 15-49 who had at least 4 antenatal care visits for last birth in the 5 years before the
survey
Received MCP cardPercentage of mothers who registered last pregnancy in the 5 years preceding the survey for which she received a
Mother and Child Protection (MCP) card
Received IFA tab/syrup
@
Percentage of women who received IFA (given or purchased) tablets during the pregnancy for their most recent live
birth in the 5 years preceding the survey
Tetanus injectionPercentage of women whose last birth was protected against neonatal tetanus (for last birth in the five years
preceding the survey )
Deworming-pregnancy
@
Percentage of women who took an intestinal parasite drug during the pregnancy for their most recent live birth in the
5 years preceding the survey
Weighing-pregnancy
@
Percentage of women aged 15-49 with a live birth in the five years preceding the survey who were weighed during
ANC for the last birth
Birth preparedness counselling
$
Percentage of women who had at least one contact with a health worker in the three months preceding the survey
and were counselled on birth preparedness; calculated among women aged 15-49 who gave birth in the five years
preceding the survey
Breastfeeding counselling
@
Percentage of women who met with a community health worker in the last three months of pregnancy and received
advice on breastfeeding (for the last pregnancy in the five years preceding the survey)
Counselling on keeping baby
warm
@
Percentage of women who met with a community health worker in the last three months of pregnancy and received
advice on keeping the baby warm for their most recent live birth in the five years preceding the survey
Cord care counselling
^@
Percentage of women who met with a community health worker in the last three months of pregnancy and received
advice on cord care for their most recent live birth in the five years preceding the survey
Food supplementation -
pregnancy
@
1
Percentage of youngest children under age 5 whose mother received supplementary food from AWC during
pregnancy;
3
Among children under 6 years, percentage whose mother received specific benefits from AWC during
pregnancy: supplementary food
Health & nutrition education –
pregnancy
@
1
Percentage of mothers who received health and nutrition education from an Anganwadi Centre (AWC) during last
pregnancy in the five years preceding the survey;
3
Among children under 6 years, percentage whose mother received
specific benefits from AWC during pregnancy: health and nutrition education
Malaria prevention-use of bed
nets
^$
Percentage of women who used mosquito net during the pregnancy for their most recent live birth in the 5 years
preceding the survey
Institutional birth
01
Percentage of women aged 15-49 who gave birth in health/institutional facility for their most recent live birth in the 5
years preceding the survey;
2
Percentage of live births to women aged 15-49 in the five years preceding the survey
that took place in a health/institutional facility
Financial assistance (JSY)
@
Percentage of women who received financial assistance under JSY for their most recent live birth that took place in
institutional facility in the 5 years preceding the survey
Skilled birth attendant
01
Percentage of women whose last delivery was attended by a skilled health personnel for their most recent live birth
in the 5 years preceding the survey;
2
Percentage of births attended by skilled health personnel for births in the 5
years before the survey
Postnatal care for mothers Percentage of mothers who received postnatal care from a doctor/nurse/LHV/ANM/midwife/other health personnel
within 2 days of delivery for their most recent live birth in the five years preceding the survey
Postnatal care for babies Percentage of children who received postnatal care from a doctor /nurse /LHV /ANM /midwife /other health personnel
within 2 days of delivery for last birth in the 5 years before the survey
Food supplementation –postnatal
@ 1
Percentage of youngest children under age 5 whose mother received supplementary food from AWC while
breastfeeding;
3
Among children under 6 years, percentage whose mother received specific benefits from AWC while
breastfeeding: supplementary food
Health & nutrition education –
postnatal
@
1
Percentage of youngest children under age 5 whose mother received health check-ups from AWC while
breastfeeding;
3
Among children under 6 years, percentage whose mother received specific benefits from AWC while
breastfeeding: health and nutrition education
Full immunization
01
Percentage of youngest living children aged 12-23 months fully vaccinated based on information from either
vaccination card or mother's recall;
2
Percentage of children aged 12-23 months fully vaccinated based on information
from either vaccination card or mother's recall
Vitamin A –early childhood
01
Percentage of youngest children aged 6-59 months who received Vitamin A supplementation in the last 6 months
preceding the survey; 2 Percentage of children aged 9-35 months who received a vitamin A dose in the last 6 months
Pediatric IFA
0@
Percentage of youngest children aged 6-59 months who received iron supplements in the past 7 days preceding the
survey
Deworming –early childhood
0@
Percentage of youngest children aged 6-59 months who received deworming tablets in the last 6 months preceding
the survey
Care seeking for ARI
01
Percentage of youngest children under age 5 years with fever or symptoms of ARI in the 2 weeks preceding the
survey taken to a health facility or health provider;
2
Percentage of children under age 5 years with fever or symptoms
of ARI in the 2 weeks preceding the survey taken to a health facility or health provider
ORS during diarrhea
01
Percentage of youngest children under age 5 years with diarrhea in the 2 weeks preceding the survey who received
oral rehydration salts (ORS); 2Percentage of children under age 5 years with diarrhea in the 2 weeks preceding the
survey who ORS
Zinc during diarrhea
01
Percentage of youngest children under age 5 years with diarrhea in the 2 weeks preceding the survey who
received zinc;
2
Percentage of children under age 5 years with diarrhea in the 2 weeks preceding the survey who
received zinc
Food supplementation (children 6-
35 months)
$
Percentage of youngest children aged 6-35 months who received food supplements from AWC in the 12 months
preceding the survey
Weighing –early childhood
@
Percentage of youngest children under age 5 who were weighed at AWC in the 12 months preceding the survey
Counselling on child growth
@
Percentage of youngest children under age 5 whose mother received counselling from an AWC after child was
weighed in the 12 months preceding the survey
^
Indicator not available in NFHS-3.
$
Indicator not available in NFHS-5 factsheets/state reports.
@
Indicator not available in NFHS-5 factsheets but available in
NFHS-5 states reports.
0
Indicator comparable between NFHS-3 and NFHS-4 but differs slightly from NFHS-5.
1
Definition per NFHS-3/NFHS-4.
2
Definition as per NFHS-5 factsheet.
3
Definition as per NFHS-5 state reports. ABOUT POSHAN
Partnerships and Opportunities to
Strengthen and Harmonize Actions
for Nutrition in India (POSHAN) is a
multi-year initiative that aims to
support the use of data and evidence
in decision-making for nutrition in
India. It is supported by the Bill &
Melinda Gates Foundation and led by
IFPRI in India.
http://poshan.ifpri.info/
ABOUT DATA NOTES
POSHAN Data Notes focus on data
visualization to highlight geographic
and/or thematic issues related to
nutrition in India. They draw on
multiple sources of publically
available data.
CONTACT US
Email: IFPRI-POSHAN@cgiar.org
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This publication has been prepared by
POSHAN. It has not been peer
reviewed. Any opinions stated herein
are those of the author(s) and do not
necessarily reflect the policies of the
International Food Policy Research
Institute.
Copyright © 2021 International Food
Policy Research Institute. All rights
reserved. For permission to republish,
contact ifpri-copyright@cgiar.org.
AUTHORS
Anjali Pant,Research Analyst, IFPRI
Samuel Scott,Research Fellow, IFPRI
S.K. Singh,Professor, IIPS
Rakesh Sarwal, NITI Aayog
Neena Bhatia, Senior Specialist, NITI Aayog
Robert Johnston, Nutrition Specialist UNICEF
William Joe, Assistant Professor, IEG
Esha Sarswat, Communications Specialist, IFPRI
Purnima Menon, Senior Research Fellow, IFPRI
Phuong Hong Nguyen, Senior Research Fellow, IFPRI
SUGGESTED CITATION
Pant, A., S. Scott, S.K. Singh, R. Sarwal, N. Bhatia, R.
Johnston, W. Joe, E. Sarswat, P. Menon, and P.H.
Nguyen. 2021. State Nutrition Profile: Bihar. POSHAN Data
Note 41. New Delhi, India: International Food Policy
Research Institute.
ACKNOWLEDGEMENTS
Financial support for this Policy Note was provided by
the Bill & Melinda Gates Foundation through POSHAN,
led by the International Food Policy Research Institute.
The funder played no role in decisions about the scope of
the analysis or the contents of the Note.
We thank Long Quynh Khuong(Independent Researcher)
for creating the maps, Nishmeet Singh (IFPRI) for
working with the dataset and Julie Ghostlaw (IFPRI) &
Abhilasha Vaid (Consultant) for editing and reviewing the
Note.
PARTNERS
Institute of Economic Growth (IEG)
International Institute for Population Science (IIPS)
NITI Aayog
UNICEF
Disclaimer: The maps used in this Data Note are based on the districts in NFHS-5
factsheets/reports . The boundaries shown do not imply any official endorsement or
acceptance by IFPRI.