Explaining Cross-State Disparities in Child Nutrition in Rural India

Abstract

What drives the large disparities in height-for-age distributions among Indian states -variation in observed nutrition-related endowments, such as wealth or maternal education, or differential strengths of relationships across states between endowments and height-for-age? We explore this question by comparing a set of states with poor nutrition outcomes with the benchmark of Tamil Nadu, a good performer. Applying counterfactual decomposition methods to National Family Health Survey data, we find that surprisingly modest proportions of HAZ differences are attributable to endowment differences. We discuss our results in light of the superior track record of food and nutrition policies in Tamil Nadu.

Dietary and nutritional change in India: implications for strategies, policies, and interventions

“…A need also exists for a coordinated approach to nutrition‐sensitive policies in areas such as food security, health care, agriculture, water and sanitation, and women's empowerment, all of which have a large role to play in collectively delivering improved nutrition . There is considerable cross‐state variation in nutrition outcomes in India, a significant proportion of which has been attributed to differences in policy making and programmatic quality . High‐level political support for nutrition and health programs and effective cross‐sectoral collaborations between government and development partners have been identified as major drivers of relative success stories, such as Orissa…”

Evaluation of nutritional deficits among adolescents in Tando Muhammad Khan district via anthropometric measures

“…Deranged measurements of midupper arm circumference and waist circumferences were most strongly associated with poor nutritional status among males and deranged measurements of hip circumference, mid-thigh circumference and BMI were most strongly associated with nutritional status among females. Existing literature, although not offering much detail regarding the individual gender specific anthropometric variations with different nutritional status, whereas it does support the connection of healthier anthropometries with better nutrition among children 22 .…”

Gendered Time, Seasonality, and Nutrition: Insights from Two Indian Districts

“…Additionally, they bear almost the entire burden of domestic and care work. Variations by social group (caste/ethnicity) and location are significant (Panter-Brick 1993;Miller 1997;Carson 2014), pointing to the role of differential access as well as differences in institutional and infrastructural support (Cavatorta, Shankar, and Flores-Martinez 2015), on both work and consumption patterns.…”

“…While giving an idea about energy intakes on a particular day, this data, however, cannot be directly associated with an individual's nutritional status, which denotes a balance between nutritional intakes and the claims against it (Floud et al 2011). Status is shaped by multiple factors, including the level of physical activity, exposure to disease, and institutional variables reflecting access to public health and sanitation (Fogel 1997;Floud et al 2011;Cavatorta, Shankar, and Flores-Martinez 2015), over a longer period of time. Given the small sample size of thirty households in each location, and that data was collected only on one day in each season, we are cautious in using it for statistical analysis, or claiming causality between dietary intakes and seasonal weight losses.…”

“…Given women's central role in reproduction -childbearing, childcare, and childrearing -nutritional studies in India, and globally, give considerable attention to women's work, alongside their education, health, and status (Smith et al 2003;Cavatorta, Shankar, and Flores-Martinez 2015). Employment data similarly acknowledge women's high work participation in agriculture, a phenomenon referred to as the feminization of agriculture, albeit as laborers and family workers, rather than independent cultivators (Srivastava and Srivastava 2010;Majumdar and Neetha 2011;Siddiqui et al 2017).…”