Early life migration and undernutrition among circular migrant children: An observational study in the brick kilns of Bihar, India

Abstract

Background India holds the world's largest burden of chronic and acute child undernutrition. Poverty and systemic inequities are basic causes of undernutrition that also drive households to engage in circular migration for livelihood. Short-term, temporary movement of the whole family, including young children, is common; yet, the nutritional implications of recurrent movements beginning in early life has not been studied. We sought to estimate the association of repeat and early life migration with stunting and wasting outcomes among circular migrant children under three. Methods Using a stratified cluster design, we conducted two waves of primary data collection among 2564 randomly selected circular migrant children under three years of age temporarily residing across 1156 brick kilns in Bihar, India. We conducted multilevel modeling to estimate the association of the number of migration episodes and age at first migration with stunting (<-2 standard deviations (SD) height-for-age z scores (HAZ)) and wasting (<-2 SD weight-for-height z-scores (WHZ)) and examined the determinants of nutrition status among migrant children, including diet, illness, food security and the health environment. Results The overall prevalence of stunting was 51.6%. Among children who were either born during migration or first migrated before six months of age, those who experienced multiple episodes of migration were more likely to be stunted compared to those who migrated once (adjusted odds ratio (aOR) = 2.10; 95% confidence interval (CI) = 1.30-3.41). Children were over three times as likely to be wasted in the summer compared to the winter (aOR = 3.28; 95% CI = 2.68-4.01); in the summer, the overall prevalence of wasting was 38.8%. Public health access indicators such as interaction with frontline health workers at the destination was low (5.3%), whereas feeding indicators such as exclusive breastfeeding among 0-5 months was high (81.1%). Conclusions Policy efforts should ensure continuity of social protection and welfare entitlements between home and destinations for circular migrant families, with an explicit focus on rural-to-rural movement.

WITHDRAWN: Estimates of Undernutrition among migrant/refugee children in lower-middle-income countries: A meta-analysis of published evidence from 2010-2022

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Inferring the regional distribution of Visceral Leishmaniasis incidence from data at different spatial scales

“…which has been linked to increased VL risk [37,38] and other health concerns for the worker and their accompanying family [39,40]. It may be the case that VL outbreaks are more often triggered by human migration and translocation from outbreaks, as opposed to infected sand flies.…”

Brick kiln pollution and its impact on health: A systematic review and meta-analysis

“…Three studies examined the role of brick kiln pollution on child linear growth (e.g., stunting). 7,85,90 Nasir et al 7 examined 383 children aged 5-12 years from Pakistan, measured their height and calculated Z-scores using the 2007 World Health Organization (WHO) international reference. Mean height-for-age Z-score was -0.50 (prevalence of stunting not reported).…”

“…Z-scores were -0.43 and -0.42 lower with kernel and stratification matching, albeit not statistically significant. Roshania et al 85 conducted a large cross-sectional study with a cluster design and measured height and in weight in 2564 migrant children (aged 0-11 months and 12-23 months) from 1156 brick kilns in India. Z-scores were calculated using the 2006 WHO Multi Growth Reference studies.…”