Abstract

BackgroundDespite a fast-growing economy and the largest anti-malnutrition programme, India has the world’s worst level of child malnutrition. Despite India’s 50% increase in GDP since 1991, more than one third of the world’s malnourished children live in India. Among these, half of the children under age 3 years are underweight and a third of wealthiest children are over-nutrient. One of the major causes for malnutrition in India is economic inequality. Therefore, using the data from the fourth round of National Family Health Survey (2015–16), present study aims to examine the socio-economic inequality in childhood malnutrition across 640 districts of India.MethodConcentration curve and generalized concentration index were used to examine the socioeconomic inequalities in malnutrition. However, regression-based decomposition methodology was used to decomposes the causes of inequality in childhood malnutrition.ResultResult shows that about 38% children in India were stunted and 35% were underweight during 2015–16. Prevalence of stunting and underweight children varies considerably across Indian districts (13 to 65% and 7 to 67% respectively). Districts having the higher share of undernourished children is coming from the particular regions like central, east and west part of the country. On an average about 35% of household in a district having the access of safe drinking water and 42% of household in a district exposed to open defecation. The study found the inverse relationship between district’s economic development with childhood stunting and underweight. The concentration of stunted as well as underweight children were found in least developed districts of India. Decomposition approach found that practice of open defecation is positively influenced the inequality in stunting and underweight. Further, inequality in undernutrition is accelerated by the height and education of the mother, and availability of safe drinking water in a district.ConclusionsThe districts that lied out in a spectrum of developmental diversity are required some specific set of information’s that covering socio-economic, demographic and health-related quality of life of people in those backward districts. More generally, policies to avail improved water and sanitation facility to public and female literacy should be continued. It is also important to see that the benefits of both infrastructure and more general economic development are spread more evenly across districts.

Highlights

  • Despite a fast-growing economy and the largest anti-malnutrition programme, India has the world’s worst level of child malnutrition

  • Using data from the fourth round of National Family Health Survey (NFHS), the present study examined the socioeconomic inequalities in childhood stunting and underweight across 640 Indian districts

  • Using the data from fourth round of NFHS present study examined the socioeconomic inequalities in childhood malnutrition at district level in India

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Summary

Introduction

Despite a fast-growing economy and the largest anti-malnutrition programme, India has the world’s worst level of child malnutrition. Estimates from the United Nations Children’s Fund (Unicef) suggest that, globally about 165 million children under the age of 5 years were found to be stunted (low height for age), 101 million children were found to be underweight (low weight for age), and 52 million children were found to be wasted (weight for height) [1]. Estimates from the National Family and Health Survey (2015–16) shows that in India, about 38% of the children under the age of five year are stunted (low height for age), 36% of the children are underweight (low weight for age), and 18% children are wasted (weight for height) [3]. Poor health of the children erodes social and economic gains, put countries in a vicious cycle of poor nutritional status, high disease burden and increases poverty. The long-term effects include high blood pressure, obesity, diabetes, and heart disease during adulthood

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