Bhubaneswar: Odisha has registered notable gains in reducing child stunting and underweight prevalence in several districts since NFHS-5 (2019-21), but acute malnutrition continues to pose a serious challenge in the state’s tribal and KBK regions, according to the district-wise NFHS-6 (2023-24) fact sheets released recently.Data comparing NFHS-6 with NFHS-5 show that stunting declined in Mayurbhanj from 36.7% to 26.5%, Sambalpur from 40.7% to 24.3%, Nabarangpur from 44.1% to 32.1%, Nuapada from 43.1% to 27.5%, Gajapati from 43.4% to 35.3% and Malkangiri from 44.3% to 37.3%.However, some districts continue to struggle. Rayagada recorded the highest stunting prevalence in Odisha at 47.2%, followed by Koraput at 38.7%, Malkangiri at 37.3%, Balangir at 36.4%, Gajapati at 35.3% and Keonjhar at 35.2%.The picture is more worrying for wasting. Several tribal districts saw deterioration between NFHS-5 and NFHS-6. Wasting increased from 19.3% to 30.7% in Malkangiri, 23.8% to 31.6% in Keonjhar, 15.9% to 24.6% in Koraput and 16.1% to 25.3% in Gajapati. Mayurbhanj emerged as the worst-performing district, with a wasting rate of 33%, the highest in the state.Severe wasting improved in several districts. Kandhamal reduced severe wasting from 12.4% to 3.1%, Deogarh from 12.1% to 3.9%, Balangir from 12.7% to 5.2% and Sonepur from 11.7% to 4.3%. However, the indicator worsened in Keonjhar, rising from 6.2% to 10%, Malkangiri from 5.5% to 9.6% and Gajapati from 4.3% to 9.1%.Underweight prevalence remained concentrated in tribal districts. Rayagada reported the highest share of underweight children at 46.8%, followed by Malkangiri at 46.1%, Keonjhar at 45.2%, Mayurbhanj at 44.3%, Koraput at 42.7% and Gajapati at 42.5%. While Nabarangpur, Nuapada and Sambalpur showed improvements over NFHS-5 levels, several districts witnessed deterioration.The survey highlights a clear divide between coastal and tribal Odisha. Puri emerged as the state’s best-performing district, reporting the lowest stunting rate at 9.3%, low wasting at 12.7% and low underweight prevalence at 15.2%. Khurda, Jagatsinghapur, Nayagarh and Ganjam also consistently performed better than the state average across most indicators.At the state level, the proportion of children under five who are stunted declined from 31% in NFHS-5 to 26.8% in NFHS-6, indicating an improvement in long-term nutritional status. However, wasting increased sharply from 18.1% to 22.1%, suggesting worsening acute malnutrition above the national level. The prevalence of severe wasting declined marginally from 6.1% to 5.8%, while underweight prevalence rose from 29.7% to 31.6%.