Social Inequalities in Child Nutrition in Uttar Pradesh, India

Abstract

Background: The various maternal and childhood well-being programs have been designed to address childhood malnutrition in India. The levels and the inequality in child nutrition are higher among economically poor and socially backward communities within the state. Objective: To estimate and compare the inequality in child nutrition status across socio-demographic characteristics in the Uttar Pradesh state of India. Methods: Data from the National Family Health Surveys (NFHS-4 & NFHS-3) was used for Uttar Pradesh – the most populous state of India. The nutrition status was assessed in terms of undernutrition (weight-forage), stunted (height-for-age), wasted (weight-for-height) and anaemia level. Health inequalities indices, the absolute difference, Ratio, Population Attributed Risk, and Population Associated Fraction were calculated using WHO HEAT 2.0 software. Results: The nutrition and anaemia levels vary according to background characteristics; however, the levels of undernutrition and anaemia among children were high in all groups. The wasting and anaemia levels were higher among younger children, whereas the proportion of underweight and stunted was higher in older children. The inequality indices showed a substantially higher burden of undernutrition among socially backward scheduled castes and tribes, and those residing in rural areas. Conclusion: The study illustrated that despite the declining trend of childhood malnutrition in Uttar Pradesh, the socially backwards have a disproportionately higher burden of malnutrition. There is a need to reassess the ongoing nutritional programs concerning pervasive social inequality in child nutrition and anaemia level.