Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18

International Journal for Equity in Health

Robert Johnston¹  Nizamuddin Khan²  Sowmya Ramesh²  Rajib Acharya²  Sana Ashraf²  Avina Sarna²  Akash Porwal²  Praween Agarwal³ 

[1] Nutrition Specialist, UNICEF, UNICEF House, 73 Lodi Estate, New Delhi, India;Population Council, Zone 5A, Ground Floor India Habitat Centre, Lodi Road, 110003, New Delhi, Delhi, India;Senior Monitoring, Evaluation and Learning Expert, IPE Global Limited, New Delhi, India;

关键词: Child undernutrition;    CIAF;    Inequality;    CNNS;    India;   

DOI  :  10.1186/s12939-021-01512-4

来源: Springer

【 摘 要 】

BackgroundConventional indicators used to access the nutritional status of children tend to underestimate the overall undernutrition in the presence of multiple anthropometric failures. Further, factors contributing to the rich-poor gap in the composite index of anthropometric failure (CIAF) have not been explored. This study aims to estimate the prevalence of CIAF and quantify the contribution of factors that explain the rich-poor gap in CIAF.MethodsThe present study used data of 38,060 children under the age of five years and their biological mothers, drawn from the nationally representative Comprehensive National Nutrition Survey of children and adolescents aged 0–19 years in India. The CIAF outcome variable in this study provide an overall prevalence of undernutrition, with six mutually exclusive anthropometric measurements of height-for-age, height-for-weight, and weight-for-age, calculated using the World Health Organization (WHO) Multicenter Growth Reference Study. Multivariate regression and decomposition analysis were used to examine the association between covariates with CIAF and to estimate the contribution of different covariates in the existing rich-poor gap.ResultsAn overall CIAF prevalence of 48.2% among children aged aged under 5 years of age was found in this study. 6.0% children had all three forms of anthropometric failures. The odds of CIAF were more likely among children belonging to poorest households (AOR: 2.41, 95% CI: 2.12–2.75) and those residing in urban area (AOR: 1.06, 95% CI 1.00–1.11). Children of underweight mothers and those with high parity were at higher risk of CIAF (AOR: 1.51, 95% CI: 1.42–1.61) and (AOR: 1.15, 95% CI: 1.08–1.22), respectively. Children of mother exposed to mass media were at lower risk of CIAF (AOR: 0.87, 95% CI: 0.81–0.93).ConclusionThis study estimated a composite index to assess the overall anthropometric failure, which also provides a broader understanding of the extent and pattern of undernutrition among children. Findings show that maternal covariates contribute the most to the rich-poor gap. As well, the findings suggest that intervention programs with a targeted approach are crucial to reach the most vulnerable groups and to reduce the overall burden of undernutrition.

【 授权许可】

CC BY