Changes in Child Nutrition in India: A Decomposition Approach

Abstract

Background: Improvements in child health are a key indicator of progress towards the third goal of the United Nations' Sustainable Development Goals. Poor nutritional outcomes of Indian children are occurring in the context of high economic growth rates. The aim of this paper is to conduct a comprehensive analysis of the demographic and socio-economic factors contributing to changes in the nutritional status of children aged 0-5 years in India using data from the 2004-2005 and 2011-2012 Indian Human Development Survey.

Methods: To identify how much the different socio-economic conditions of households contribute to the changes observed in stunting, underweight and the Composite Index of Anthropometric Failure (CIAF), we employ both linear and non-linear decompositions, as well as the unconditional quantile technique.

Results: We find the incidence of stunting and underweight dropping by 7 and 6 percentage points, respectively. Much of this remarkable improvement is encountered in the Central and Western regions. A household's economic situation, as well as maternal body mass index and education, account for much of the change in child nutrition. The same holds for CIAF in the non-linear decomposition. Although higher maternal autonomy is associated with a decrease in stunting and underweight, the contribution of maternal autonomy to improvements is relatively small.

Conclusions: Household wealth consistently makes the largest contribution to improvements in undernutrition. Nevertheless, maternal autonomy and education also play a relatively important role.

Keywords: India; child undernutrition; decomposition.

Figure 1

Kernel density estimates for HAZ and WAZ by year. Notes: Kolmogrov–Smirnov test p-value: HAZ: Combined K–S 0.098; p-value = 0.000; WAZ: Combined K–S 0.062; p-value = 0.000.