A spatial analysis of childhood stunting and its contextual correlates in India

Abstract

Introduction: Despite various programmes aiming to improve the nutritional status of children, nearly 38% of children under age five are still stunted in India, and there is huge spatial variation across the states. Objectives: The present study first examines the spatial clustering of childhood stunting and then investigates the contextual determinants including meteorological factors, poverty and crop production affecting childhood stunting. Methods: The percentage of stunted children under 5 years of age is taken from the district factsheets of National Family Health Survey 2015-16 (NFHS-4). Other data are taken from Census of India (2011) and Ministry of Agriculture and Farmers Welfare. To fulfil the set objectives, the spatial analysis including Moran-I index and spatial regressions models are used.Results: The spatial analysis shows a high degree of clustering (Moran's I: 0.65) in childhood stunting in districts of India. Extreme temperature of districts reveals a positive association with childhood stunting as nearly 40% of children from districts with maximum temperature above 40°C were stunting. After controlling for socioeconomic factors, spatial regression reveals that a 1°C increase in average annual temperature would lead to 0.134 increase in the percentage of stunted children. The study reveals a negative effect of district-level percapita crop production, wealth and education levels on the childhood stunting. Conclusion: The paper manifests the gigantic variations and clustering in the childhood malnutrition across districts of India. The study recommends to target the districts in hot spot areas, districts with extreme temperature and with low levels of crop production to fight against malnutrition under the umbrella of sustainable development goals.Poverty is a main cause of malnourishment because it confines the amount of food available to children causing wasting and a lack of micronutrients value leading to stunting and low weight. 6 Similarly, a study 7 exhibited household wealth, and the condition of women was related to both stunting and wasting. Further, overpopulation is a serious problem linked with the competition for food, shelter and medical facilities, and lead to malnutrition amongst children, particularly in the rural areas where access to food and medical facilities were limited. 6 Also, poverty and malnutrition enhance the risk of infants and children to various kinds of infectious diseases, like diarrhoea and pneumonia, and also increases the possibility of death. 8 International Food Policy Research Institute (IFPRI) reported that poverty, water, sanitation and hygiene, education, food systems, climate change, social protection, and agriculture all have the vital effect on nutrition outcomes. 9 Another study conducted by Pathak and Singh (2009) 10 showed that poverty might not solely be the determinant of child malnutrition. Rather, https://doi.

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Proximal and contextual correlates of childhood stunting in India: A geo-spatial analysis

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