Management of Children with Severe Acute Malnutrition in India: We Know Enough to Act, and We Should Act Now.

The fourth round of National Family Health Survey (NFHS-4) conducted in 2015-16 provides an intriguing and disturbing trend on malnutrition in India. Over a ten year period since 2005-06, the proportion of under-five children suffering from Severe Acute Malnutrition (SAM), as measured by Weight-for-height Z score (WHZ) <–3, based on the WHO standards has increased from an already high proportion of 6.4% to 7.5% [1]. It is well established that malnutrition increases the risk of death in a dose-dependent fashion. For children with WHZ <–3, the mortality risk is 10 times higher than non-wasted children, and for those with WHZ <–4, it increases to 20 times! There is a reasonable homogeneity in these risk estimates across countries and over time periods [2].