Rajasthan's Child Nutrition Gains Have Slipped. The Anganwadi Is Where That Can Change.

The sixth National Family Health Survey (NFHS-6), carried out in 2023-24 and released in 2026, is the most recent picture of child nutrition in India. For Rajasthan, it is a worrying one. Two key measures of child undernutrition have moved in the wrong direction, after a period of real progress.

The progress before

Between NFHS-4 (2015-16) and NFHS-5 (2019-21), Rajasthan made some of its largest nutrition gains in a generation. The share of children under five who were stunted, meaning too short for their age, fell from 39 per cent to 32 per cent. Wasting and underweight fell sharply too.

Those numbers showed that the state's public systems could move outcomes at scale, through supplementary nutrition, growth monitoring and better maternal care.

What NFHS-6 shows

Between NFHS-5 and NFHS-6, among children under five in Rajasthan:

• Wasting (too thin for their height) rose from 16.8 per cent to 19.8 per cent
• Underweight (too light for their age) rose from 27.6 per cent to 33.3 per cent

Nationally, the picture was steadier. Wasting stayed roughly flat at around 19 per cent, and underweight barely changed. Rajasthan moved against that trend.

Wasting is a sign of recent or acute undernutrition. It responds to what is happening in a child's life now: food at home, illness, feeding practices and access to care. In a state with as many young children as Rajasthan, a rise of three percentage points in a few years means a great many more children who are dangerously thin. It is a warning that something in the delivery system is not reaching them.

Anaemia was already a serious concern. In NFHS-5, it affected 71 per cent of young children in Rajasthan, up from 60 per cent in NFHS-4. Anaemia and undernutrition feed each other, and both are tackled through the same frontline system.

Why the Anganwadi matters

Rajasthan has more than 60,000 Anganwadi centres. Each one is meant to be the first point of contact between the state and a young family. Through the centre, the Anganwadi worker and helper are expected to:

• Provide supplementary nutrition to young children, and to pregnant and breastfeeding women
• Weigh and measure children to track their growth
• Run pre-school education for children aged three to six
• Support immunisation and health check-ups with the local ANM and ASHA
• Counsel mothers on feeding, hygiene and care

No other public worker sees as many young children, as often. Growth monitoring at the Anganwadi is often the first place a wasted child can be spotted, and the first place a family can get help, under programmes such as Saksham Anganwadi and Poshan 2.0 and Anaemia Mukt Bharat.

What stands in the way

One worker, too many tasks

Anganwadi workers carry a long list of duties: nutrition, pre-school teaching, record-keeping, surveys, home visits and, often, extra tasks assigned by other departments. When everything is a priority, careful counselling of a mother about her child's diet is usually the first thing to slip.

Data is collected, but not always used

The national Poshan Tracker app now records attendance, growth monitoring and supplementary nutrition at Anganwadi centres across the country. This is a big step. But data only helps when someone uses it to act: to follow up a child who is losing weight, or to find out why a centre's attendance is falling. That analysis rarely reaches the block and village level in a usable form.

Health and nutrition work in separate lanes

Treating a severely wasted child needs Health, through nutrition rehabilitation and medical care. Preventing wasting needs Women and Child Development, through supplementary nutrition and counselling. When these departments do not plan together, children fall between them.

Children with disabilities are rarely counted

Children with disabilities are more likely to face feeding difficulties and malnutrition. Yet they are often not identified at the Anganwadi, and may not attend the centre at all. Nutrition programmes that do not see them cannot reach them.

What would help

• Give workers time for the work that matters. Reducing non-core tasks would free time for growth monitoring, home visits and counselling.
• Turn data into simple action lists. Each Anganwadi worker and supervisor could get a short monthly list of children who are not gaining weight, drawn from the data they already enter.
• Plan nutrition jointly at the district level. One district plan, owned together by Health and Women and Child Development, with shared targets for wasting and anaemia.
• Find out why the trend reversed. District-level analysis of NFHS-6 and Poshan Tracker data can show where wasting rose most, and what changed there.
• Include children with disabilities. Train workers to identify developmental delays and feeding difficulties, and link families to early intervention services.

Where Sutra comes in

Rajasthan's progress before 2021 shows that its public systems can deliver results at scale. NFHS-6 shows how quickly those gains can slip when delivery weakens. Helping departments work as one system, from district planning to the village centre, is the kind of work Sutra exists to do.

If you work on nutrition or early childhood in Rajasthan, we would welcome a conversation. Write to us at info@sutraindia.org.