Socio-biomedical predictors of child nutrition in India: an ecological analysis from a nationally representative Demographic and Health Survey, 2015–2016

Abstract

Background Despite significant economic growth and development, undernutrition among children remains a major public health challenge for low- and middle-income countries in the twenty-first century. In Millennium Development Goals, India committed halving the prevalence of underweight children by 2015. This study aimed to explain the geographical variation in child malnutrition level and understand the socio-biomedical predictors of child nutrition in India. Methods We used the data from India’s National Family Health Survey 2015–2016. The survey provided estimates of stunting, wasting, and underweight at the national, state, and district level to measure nutritional status of under-five children. Level of stunting, wasting and underweight at the district level are considered as outcome variables. We have used variance inflation factor to check the multicollinearity between potential predictors of nutrition. In this study, we performed spatial analysis using ArcGIS and multiple linear regression analysis using Stata version 15. Results Five states (Uttar Pradesh, Bihar, Madhya Pradesh, Jharkhand and Meghalaya) had very high prevalence of stunting (40% and above). High prevalence of wasting was documented in Jharkhand, Madhya Pradesh, Chhattisgarh, and Karnataka (23 to 29%). Jharkhand, Madhya Pradesh, Maharashtra, and Chhattisgarh had the highest proportion of underweight children in the country. We found that electricity and clean fuel use in the household, use of iodized salt, and level of exclusive breastfeeding had significantly negative influence on the stunting level in the districts. The use of iodized salt has similar effect on the wasting status of under-five children in the districts (b: − 0.27, p < 0.10). Further, underweight level had a negative association with clean fuel use for cooking (b: − 0.17, p < 0.01), use of iodized salt (b: − 0.36, p < 0.10), breastfeeding within one hour (b: − 0.18, p < 0.10), semisolid/solid food within 6–8 months (b: − 0.11, p < 0.05) and Gross Domestic Product of the districts (b: − 0.53, p < 0.10). Conclusion In the study, a variety of factors including electricity and clean fuel use in the household, use of iodized salt, level of exclusive breastfeeding, breastfeeding within one hour, semisolid/solid food within 6–8 months and Gross Domestic Product of the districts have a significant association with nutritional status of children.

Role of seasonality variation in prevalence and trend of childhood wasting in India: An empirical analysis using National Family Health Surveys, 2005–2021

“…29 Negative correlation has been found between the availability of food, exclusive breast feeding status, and wasting among children. 30 Food availability differs across the states and so does the nutrition status of children. The Indian State Hunger Index (ISHI) 2009 estimated food insecurity across 17 major states of India and found that 12 of the states fell in the "alarming" category and one state, that is, Madhya Pradesh fell into the "extremely alarming" category.…”

“…Another study conducted in the African region also discusses the association between variation in season and the wasting prevalence among children 29 . Negative correlation has been found between the availability of food, exclusive breast feeding status, and wasting among children 30 . Food availability differs across the states and so does the nutrition status of children.…”