Malnutrition in childhood : maternal, household and community determinants

The paper addresses the impact child ‘dysnutrition’ (a child that is both stunted and overweight) has on the understanding of the Household Double Burden of Malnutrition (HHDBM - stunted child overweight mother pairs), by assessing the definition of a HHDBM as well as exploring the socioeconomic explanatory pattern of its development. In addition pre and post-natal hypotheses for the development of a HHDBM are explored. A cross-sectional analysis of nationally representative samples from 2000 onwards will be conducted. 72 Demographic and Health Surveys for low and middle income countries are used, containing anthropometric data on weight and height for both mothers and under-fives. Multinomial multilevel regression models are used to explore the HHDBM and its determinants.

Though empirical research has established the household wealth and maternal characteristics as significant predictors of child malnutrition, little is known about the role of community and parental attributes in explaining child malnutrition in India. The aim of this paper is to examine the role of community and household factors in explaining malnutrition among children under five in the Empowered Action Group (EAG) states of India. The eight EAG states constitute about half of India’s population and lag behind in key demographic and socioeconomic indicators.
The unit data from National Family Health Survey (NFHS) 3 is used in the analyses. Bi-variate analyses, concentration curves and multilevel models are used to understand the patterning and contextual effects of child malnutrition in the EAG states. The dependent variables, weight-for-age, height-for-age and weight-for-height are analysed with respect to three composite indices; community socioeconomic status (SES), household wealth and household social status. Results indicate that in EAG states half of children in poor communities and households were underweight, stunted

Reduction in child malnutrition is central to economic and social development in any country as it has dire ramifications to physical, psychological and mental development of individuals over the life course. Child malnutrition is also associated with higher morbidity and mortality incidence. Therefore, it is imperative to have knowledge of its correlates and determinants. Examination of determinants of child nutrition at different points of its distribution has better policy implications than investigating predictors on average value. Using NFHS-III (2005-06) data, this study investigates determinants of nutritional status -measured by standard anthropometric indicators- of children aged 0-59 months in India using quantile regression approach. Results show that age and birth order is negatively associated with height for age and weight for age z-scores but these are positively associated with the weight-for-height z-scores. Mothers’ nutrition, educational level and better household environment are positively associated with the nutrition z-scores but these factors differential effects at different points of the conditional distribution of the anthropometric z-scores.

This study assesses the trends in child malnutrition by older surviving sibling composition during 1992-2007 in three South Asian countries, namely Bangladesh, India and Nepal. This study utilizes data from three rounds of Demographic and Health Surveys and considers weight-for-age as an indicator of child malnutrition based on 2006 WHO Standards. Combinations of sex composition of surviving older siblings were constructed. Cochran-Armitage and Chi squared statistics were applied to test linear and nonlinear trends respectively. Although child malnutrition declined during 1992-2007, result show an unacceptably higher prevalence of malnutrition in India (40%), followed by Bangladesh (37%) and Nepal (35%). Malnutrition has been lowest among boys and girls who did not have any older surviving siblings. However, the highest malnutrition was observed among those boys and girls who had at least one older surviving brother and sister. Findings confirm that not all girls and boys are treated equally, and there is a clear pattern of selective neglect in child malnutrition during 1992-2007.