In 2005, an alarming 39 percent of children were stunted in Maharashtra state, the second largest state in India with a population of over 100 million people. By 2012, a survey revealed that this number dropped to 24 percent among children under the age of two. A recent report published by the Institute of Development Studies (IDS) examines why this unprecedented reduction in stunting occurred.

Stunting is a condition that causes irreversible damage and occurs when a child does not receive the right kind of food and nutrients. Stunted children often have weaker immune systems leaving them more susceptible to infections and making them five times more likely to die from diarrhea. Infections caused by neglected tropical diseases (NTDs) are closely linked to malnutrition. Intestinal worms, for example, are among the underlying causes of stunting, anemia, loss of key nutrients like Vitamin A and iron, and overall poor nutritional status. Not only does India have more children suffering from NTDs than any other country in the world, they are home to the highest number of stunted children under the age of five.

Historically, Maharashtra state’s high levels of income inequality have contributed to malnutrition and stunting in children. Even though Maharashtra is one of the wealthiest states in India, children who are stunted are not benefiting from this growth.  Stunting impairs a child’s growth and perpetuates poor health and nutrition, preventing them from growing into their full physical and economic potential. Children who are unhealthy and lack access to proper diets, safe water, healthcare and sanitation facilities are trapped in a perpetual cycle of disease and poverty.

According to the authors, a number of key factors, working in tandem, contributed to Maharashtra state’s reduction in stunting. The launch of the state’s Nutrition Mission and the National Rural Health Mission created strong political will to improve nutritional status of young children. Because NTDs can contribute to malnutrition, Maharashtra state’s Nutrition Mission Action Plan ensured that deworming tablets were distributed to children at risk for intestinal worm infections.  And promisingly, the number of children receiving deworming treatments more than doubled, increasing from 8 percent to 19 percent. Maharashtra’s efforts towards addressing NTDs is a positive step in the right direction to lower the occurrence of stunted children and subsequent malnutrition among young children.

IDS also noted that other important factors in the reduction of stunting include: a favorable political, social and economic environment; strong economic growth; robust poverty reduction performance; and improvements in women’s empowerment and health. In the same manner, addressing NTDs requires a multi-pronged approach. In addition to deworming, creating an enabling environment for children will amplify the possibilities for the future, particularly by simultaneously improving access to clean water, sanitation and hygiene and delivering key nutrition interventions like Vitamin A alongside deworming treatments.

While the rapid decline in stunting in Maharashtra state was unique, we congratulate them on embracing a comprehensive approach to tackling this issue and remain hopeful that other states endemic for NTDs and malnutrition will feel encouraged to follow their lead.