TY - JOUR
T1 - Nutritional status of children in India
T2 - Household socio-economic condition as the contextual determinant
AU - Kanjilal, Barun
AU - Mazumdar, Papiya Guha
AU - Mukherjee, Moumita
AU - Rahman, M. Hafizur
N1 - Funding Information:
The authors acknowledge the scientific support extended by ‘Future Health Systems: Innovations for equity’ (http://www.futurehealthsystems.org) a research program consortium of researchers from Johns Hopkins University Bloomberg School of Public Health (JHSPH), USA; Institute of Development Studies (IDS), UK; Center for Health and Population Research (ICDDR, B), Bangladesh; Indian Institute of Health Management Research (IIHMR), India; Chinese Health Economics Institute (CHEI), China; The Institute of Public Health (IPS), Makerere University, Uganda; and University of Ibadan (UI), College of Medicine, Faculty of Public Health, Nigeria. Thanks are also due to Dr. Sumit Mazumdar, Research Consultant, Centre for Studies in Social Sciences, Kolkata, for his valuable comments on the previous drafts. The authors are grateful to the three referees for their comments and suggestions on this paper. Appreciation is expressed for the financial support (Grant # H050474) provided by the UK Department for International Development (DFID) for the Future Health Systems research programme consortium. This document is an output from a project funded by DFID for the benefit of developing countries. The views expressed are not necessarily those of DFID.
PY - 2010
Y1 - 2010
N2 - Background. Despite recent achievement in economic progress in India, the fruit of development has failed to secure a better nutritional status among all children of the country. Growing evidence suggest there exists a socio-economic gradient of childhood malnutrition in India. The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children. Methods. Using National Family Health Survey-3 data, an attempt is made to estimate socio-economic inequality in childhood stunting at the state level through Concentration Index (CI). Multi-level models; random-coefficient and random-slope are employed to study the impact of SES on long-term nutritional status among children, keeping in view the hierarchical nature of data. Main findings. Across the states, a disproportionate burden of stunting is observed among the children from poor SES, more so in urban areas. The state having lower prevalence of chronic childhood malnutrition shows much higher burden among the poor. Though a negative correlation (r = -0.603, p < .001) is established between Net State Domestic Product (NSDP) and CI values for stunting; the development indicator is not always linearly correlated with intra-state inequality in malnutrition prevalence. Results from multi-level models however show children from highest SES quintile posses 50 percent better nutritional status than those from the poorest quintile. Conclusion. In spite of the declining trend of chronic childhood malnutrition in India, the concerns remain for its disproportionate burden on the poor. The socio-economic gradient of long-term nutritional status among children needs special focus, more so in the states where chronic malnutrition among children apparently demonstrates a lower prevalence. The paper calls for state specific policies which are designed and implemented on a priority basis, keeping in view the nature of inequality in childhood malnutrition in the country and its differential characteristics across the states.
AB - Background. Despite recent achievement in economic progress in India, the fruit of development has failed to secure a better nutritional status among all children of the country. Growing evidence suggest there exists a socio-economic gradient of childhood malnutrition in India. The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children. Methods. Using National Family Health Survey-3 data, an attempt is made to estimate socio-economic inequality in childhood stunting at the state level through Concentration Index (CI). Multi-level models; random-coefficient and random-slope are employed to study the impact of SES on long-term nutritional status among children, keeping in view the hierarchical nature of data. Main findings. Across the states, a disproportionate burden of stunting is observed among the children from poor SES, more so in urban areas. The state having lower prevalence of chronic childhood malnutrition shows much higher burden among the poor. Though a negative correlation (r = -0.603, p < .001) is established between Net State Domestic Product (NSDP) and CI values for stunting; the development indicator is not always linearly correlated with intra-state inequality in malnutrition prevalence. Results from multi-level models however show children from highest SES quintile posses 50 percent better nutritional status than those from the poorest quintile. Conclusion. In spite of the declining trend of chronic childhood malnutrition in India, the concerns remain for its disproportionate burden on the poor. The socio-economic gradient of long-term nutritional status among children needs special focus, more so in the states where chronic malnutrition among children apparently demonstrates a lower prevalence. The paper calls for state specific policies which are designed and implemented on a priority basis, keeping in view the nature of inequality in childhood malnutrition in the country and its differential characteristics across the states.
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U2 - 10.1186/1475-9276-9-19
DO - 10.1186/1475-9276-9-19
M3 - Article
C2 - 20701758
AN - SCOPUS:77955382111
SN - 1475-9276
VL - 9
JO - International journal for equity in health
JF - International journal for equity in health
M1 - 19
ER -