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. 2024 Jul 26;11(8):902.
doi: 10.3390/children11080902.

Decoding India's Child Malnutrition Puzzle: A Multivariable Analysis Using a Composite Index

Gulzar Shah  1 , Maryam Siddiqa  2 , Padmini Shankar  3 , Indira Karibayeva  1 , Amber Zubair  2 , Bushra Shah  1
Affiliations

Decoding India's Child Malnutrition Puzzle: A Multivariable Analysis Using a Composite Index

Gulzar Shah et al. Children (Basel). .

Abstract

Background: This study examines the levels and predictors of malnutrition in Indian children under 5 years of age.

Methods: Composite Index of Anthropometric Failure was applied to data from the India National Family Health Survey 2019-2021. A multivariable logistic regression model was used to assess the predictors.

Results: 52.59% of children experienced anthropometric failure. Child predictors of lower malnutrition risk included female gender (adjusted odds ratio (AOR) = 0.881) and average or large size at birth (AOR = 0.729 and 0.715, respectively, compared to small size). Higher birth order increased malnutrition odds (2nd-4th: AOR = 1.211; 5th or higher: AOR = 1.449) compared to firstborn. Maternal predictors of lower malnutrition risk included age 20-34 years (AOR = 0.806), age 35-49 years (AOR = 0.714) compared to 15-19 years, normal BMI (AOR = 0.752), overweight and obese BMI (AOR = 0.504) compared to underweight, and secondary or higher education vs. no education (AOR = 0.865). Maternal predictors of higher malnutrition risk included severe anemia vs. no anemia (AOR = 1.232). Protective socioeconomic factors included middle (AOR = 0.903) and rich wealth index (AOR = 0.717) compared to poor, and toilet access (AOR = 0.803). Children's malnutrition risk also declined with paternal education (primary: AOR = 0.901; secondary or higher: AOR = 0.822) vs. no education. Conversely, malnutrition risk increased with Hindu (AOR = 1.258) or Islam religion (AOR = 1.369) vs. other religions.

Conclusions: Child malnutrition remains a critical issue in India, necessitating concerted efforts from both private and public sectors. A 'Health in All Policies' approach should guide public health leadership in influencing policies that impact children's nutritional status.

Keywords: India; children; composite index of anthropometric failure; malnutrition; social determinants; stunting; underweight; wasting.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Receiver operating curve of CIAF model.
See this image and copyright information in PMC

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