ARCHIVES
Severe Acute Malnutrition among Under-Five Children in India: Burden, Determinants, Clinical Outcomes, and Public Health Interventions – A Systematic Review
1 Public Health Researcher and Healthcare Professional, Jauhar University, Uttar Pradesh, India.
Published Online: May-August 2026
Pages: 06-10
Background Severe Acute Malnutrition (SAM) remains one of the leading causes of morbidity and mortality among children under five years of age worldwide. Despite substantial improvements in healthcare services and nutrition programs, India continues to carry a significant proportion of the global burden of childhood malnutrition. SAM contributes to impaired physical growth, cognitive deficits, increased susceptibility to infections, and premature mortality. Objective to systematically review the epidemiology, determinants, clinical manifestations, management strategies, and public health interventions related to Severe Acute Malnutrition among under-five children in India. Methods A systematic review of literature published between 2015 and 2026 was conducted using peer-reviewed journals, government reports, WHO publications, UNICEF reports, and national health databases. Evidence related to prevalence, determinants, diagnosis, management, and outcomes of SAM was synthesized. Results The review identified poverty, maternal undernutrition, food insecurity, inadequate breastfeeding and complementary feeding practices, recurrent infections, and poor sanitation as major determinants of SAM. Community-based management programs and Nutritional Rehabilitation Centers have improved treatment outcomes; however, substantial challenges remain in ensuring universal coverage and long-term recovery. Conclusion SAM continues to be a major public health challenge in India. Sustainable reduction requires integrated approaches involving nutrition-specific interventions, maternal and child healthcare, sanitation improvements, food security measures, and socioeconomic development.
