Abstract

Child undernutrition remains high in India with far-reaching consequences for child health and development. Anthropometry reflects undernutrition. We examined the state-level trends in underweight, stunting, and wasting prevalence and inequality by living standards using four rounds of the National Family Health Surveys in 26 states in India, conducted in 1992–1993, 1998–1999, 2005–2006, and 2015–2016. The average annual reduction (AAR) for underweight ranged from 0.04 percentage points (pp) (95% CI − 0.12, 0.20) in Haryana to 1.05 pp (95% CI 0.88, 1.22) in West Bengal for underweight; 0.35 pp (95% CI 0.11, 0.59) in Manipur to 1.47 (95% CI 1.19, 1.75) in Himachal Pradesh for stunting; and − 0.65 pp (95% CI − 0.77, − 0.52) in Haryana to 0.36 pp (95% CI 0.22, 0.51) in Bihar & Jharkhand for wasting. We find that change in the pp difference between children with the poorest and richest household living standards varied by states: statistically significant decline (increase) was observed in 5 (3) states for underweight, 5 (4) states for stunting, and 2 (1) states for wasting. Prevalence of poor anthropometric outcomes as well as disparities by states and living standards remain a problem in India.

Highlights

  • Several initiatives aim to reduce the prevalence of underweight, stunting, and wasting in India: the Integrated Child Development Services Scheme (ICDS) provides education, food, and healthcare for mothers and children; The Targeted Public Distribution System (1997) subsidizes the price of food grains for the poor; The National Food Security Act (2013) enabled a shift from welfare to a rights-based approach to food security; and, more recently, the POSHAN Abhiyaan (2017) aims to improve nutrition among children and m­ others[8]

  • This paper studied trends in levels and disparities by household living standards in the prevalence of underweight, stunting, and wasting in Indian states between 1993 and 2016

  • The annual reduction (AAR) in the prevalence of underweight was 0.6 pp per year

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Summary

Introduction

Several initiatives aim to reduce the prevalence of underweight, stunting, and wasting in India: the Integrated Child Development Services Scheme (ICDS) provides education, food, and healthcare for mothers and children; The Targeted Public Distribution System (1997) subsidizes the price of food grains for the poor; The National Food Security Act (2013) enabled a shift from welfare to a rights-based approach to food security; and, more recently, the POSHAN Abhiyaan (2017) aims to improve nutrition among children and m­ others[8]. This paper studied trends in levels and disparities by household living standards in the prevalence of underweight, stunting, and wasting in Indian states between 1993 and 2016.

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