Stunting in India: Role of Education, Behaviour and Social Identity

Abstract

India is home to more than 30 percent of all stunted children. Understanding the evolution of stunting in India, and the factors affecting it, are key to reducing the global incidence of stunting. Using nationally representative data, we provide the first comprehensive overview of the changes in stunting by national, region and caste categories between 1998-99 and 2015-16. We contribute to the understanding of how social identity (specifically the caste system in India) interacts with stunting. In the existing literature on India, the role of the caste system has been explored in terms of caste norms that result in high rates of open defecation, which are associated with high rates of stunting among children. However, the differential burden borne by the disadvantaged groups such as the lower castes (the Schedule Castes and Tribes) has remained unexplored due to earlier studies not separating the Other Backward classes, who comprise 40 percent of the population, from the upper castes, as well as not distinguishing between the Hindus and non-Hindus. We make this distinction and show that the overall trends in stunting mask significant differences by caste, as well as regions in the country. We then identify factors that would eliminate these caste gaps. We find that while access to toilets (one element of WASH) is necessary, it is not sufficient to eliminate inter-caste differences. Improved sanitation behavior (another dimension of WASH) specifically, appropriate disposal of faecal matter, is a critical factor, which in turn is driven by mother's education. Thus we find that accounting for all three factors completely eliminates inter-caste differences in stunting at the state level. Our results point towards externalities in provision of the different elements of WASH. Funding Statement: This study is based on publicly available secondary data, and was done by the authors without any external sources of funding. Declaration of Interests: The authors have no competing interests.