Abstract
Relative to its economic growth and poverty levels, Indian children suffer from higher levels of malnutrition than children in many other low- and middle-income countries. Research presented in this article examined the links between infant and young child feeding practices among Indian children and their rates of stunting, underweight, wasting, and anaemia, with a particular focus on the types of semisolid complementary food consumed. It did so through a comprehensive analysis of data on more than 57,000 6-to-23-month-old children obtained from the nationally representative National Family Health Survey IV (2015–2016). One of the key findings was that especially feeding children animal-sourced and vitamin-A-rich food was associated with lower malnutrition rates. The study further interrogated whether livestock ownership and participation in the Integrated Child Development Services programme could be supportive of better complementary child feeding and concluded that daily food receipts from the programme and poultry ownership were indeed linked with significantly higher rates of children following the recommended feeding practices as well as with somewhat lower children’s malnutrition rates.
Highlights
On the 2020 Global Hunger Index (GHI, 2020), where three of the four composite indicators relate to child-malnourishment rates, India ranked 94th out of the 107 countries included, well below many economically poorer countries, including neighbouring Nepal (73rd) and Bangladesh (75th)
Noted no significant impact of the programme on calorie or protein intake among children under 3 years old (Mittal & Meenakshi, 2019). This study finds both livestock ownership and Integrated Child Development Services (ICDS) participation to be at least partially helpful—with children living in districts with a greater ownership of poultry and receiving ICDS benefits consuming more varied diets and more animal-sourced food (ASF) than their counterparts
Other studies of Demographic Health Survey (DHS) datasets such as the National Family Health Survey (NFHS) (e.g. Haile et al, 2016, Tassew et al, 2019) noted that the use of multilevel hierarchical models to analyse nested survey data was preferable to the use of standard logistic regression models given that the assumptions of independence among individuals living in the same area and of equal variance across the areas were violated in the case of grouped data (Haile et al, 2016, p. 2)
Summary
On the 2020 Global Hunger Index (GHI, 2020), where three of the four composite indicators relate to child-malnourishment rates, India ranked 94th out of the 107 countries included, well below many economically poorer countries, including neighbouring Nepal (73rd) and Bangladesh (75th). India has managed to reduce child malnourishment in the past few decades, but the rate of progress has been slow and most recent data indicate that it has stalled. From the 22 Indian states whose results from the National Family Health Survey (NFHS) V (2019–2020) have been released by the time of writing, over the past 5 years only 9 (41%) states experienced a decline in child stunting (too short for age) and only 6 (27%) a decline in child underweight (too light for age). Infant and young child feeding (IYCF) has been identified, alongside demographic, socio-economic, and water, sanitation, and hygiene (WASH) factors, as a key determinant of children’s nutrition outcomes during their first 1000 days, which are crucial for health outcomes later in life. The key contribution of this study lies in its detailed exploration of the links between dietary diversity in children’s complementary feeding and their nutrition status, with a particular focus on the children’s intake of animal-sourced food (ASF)
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