Malnutrition and Health Burden Among Urban Indian Schoolchildren: Evidence from Digital Health Records

School-going children in Indian cities have to contend with the co-existence of undernutrition and new non-communicable diseases. Well-informed real-world evidence is essential to design specific and sustainable interventions in school health. Electronic health record (EHR) data analysis was conducted on 4,848 students (ages 3 to 17 years) in a large private school in the city of Pune, India, in the academic years 2023–2024, which operated on the Health Promoting School (HPS) model. The outcomes measured were Body Mass Index (BMI) groups, dental, visual, ENT, and pediatric problems. The analysis was conducted by age groups, sex, and grade. A large number of students were underweight, representing 71.2%. The most common morbidity was related to dental problems at 50.9%, followed by pediatric/systemic problems at 27.8%, and vision problems at 26.6%. The prevalence of vision problems was significantly higher in girls than in boys (28.6% vs. 24.9%, p = 0.004). The pattern of diseases varied significantly according to age, grade, and BMI. There is a high prevalence of undernutrition and other morbidities among school children in the city. Dental problems and vision problems were the most common morbidities. There is a need for school health programs that are grade- and gender-sensitive using electronic health records to address the changing health needs of school children in India.