India recorded the highest number of under-five deaths in 2018 leaving behind its poorer neighbours Nepal, Bangladesh and even Pakistan in UNICEF's State of the World's Children (SOWC) report 2019 released on 1st November.

However, the under five mortality rate stood at around 37 per thousand live births. According to the report, out of 882000 children below the age of five died in India during the study period. Pakistan ranked third with 409000 deaths, while Bangladesh stood 10th and Nepal 47th with 89000 and 18000 deaths, respectively. Malnutrition was the leading cause of the below five deaths, accounting for 69% of the deaths in the age group, the SOWC report said. The study also included the findings of Comprehensive National Nutrition Survey(CNNS) conducted by the government of India in collaboration with UNICEF from 2016-18.

With one in two children under five suffering from some form of malnutrition, CNNS presented an equally gloomy picture about the state of health of children in the age group in the country. At least 35% of the children below the age of five were stunted while wasting has been reported in 17% of the population. Interestingly, 2% of the children were found overweight.

Indian children in the age group under five are affected by several micronutrient deficiencies, with one in five suffering from vitamin A deficiency, one in three vitamin B12 deficiency and two in five were found anemic, the UNICEF report said citing CNNS findings.

"Poor diets are damaging children's health, and poverty, urbanisation, climate change and poor eating choices are driving unhealthy diets," UNICEF said in its annual flagship report on children, food and nutrition. "At present, the world is facing a triple burden of malnutrition:acute and chronic undernutrition, overweight and hidden hunger- or deficiencies of vitamins and minerals," the State of the World's Children (SOWC) report noted. The UNICEF said SOWC was a comprehensive assessment of 21st century child malnutrition in all its forms. "In the 21st century, children's malnutrition must be understood against a backdrop of rapid change, including the growth of urban populations and the globalisation of food systems, which is leading to increased availability of food high in calorie but low in nutrients," it added.