Mapping changes in district level prevalence of childhood stunting in India 1998-2016: An application of small area estimation techniques

Abstract

The four rounds of National Family Health Survey (NFHS) conducted during 1992–93, 1998–99, 2005-06 and 2015-16 is main source to track the health and development related indicators including nutritional status of children at national and state level in India. Except NFHS-4, first three rounds of NFHS were unable to provides district-level estimates of childhood stunting due to the insufficient sample sizes. The small area estimation (SAE) techniques offer a viable solution to overcome the problem of small sample size. Therefore, this study uses SAE techniques to derive district level prevalence of childhood stunting corresponding to NFHS-2 (1998–99). Study further estimated GIS maps, univariate Local indicator of spatial autocorrelation (LISA) and Moran's I to understand the trend in district level childhood stunting between NFHS-2 and NFHS-4. Estimates obtained by SAE techniques suggest that prevalence of childhood stunting ranges from 20.7% (95% CI: 18.8–22.7) in South Goa district of Goa to 64.4% (95%CI: 63.1–65.7) in Dhaulpur district of Rajasthan during 1998–99. The diagnostic measures used to validate the reliability of estimates obtained by SAE techniques indicate that the model-based estimates are reliable and representative at district level. Results of geospatial analysis indicates substantial reduction in childhood stunting between 1998 and 2016. Out of 640 district,about 81 district experience reduction of more than 50%. At the same time 60 district experience less than 10% of reduction between 1998 and 2016. Spatial clustering of childhood stunting remains same over the study period except few additional cluster in Maharashtra, Andhra and Meghalaya in 2016. The district level estimates obtained from this study might be helpful in framing decentralized policies and implementation of vertical programs to enhance the efficacy of various nutrition interventions in priority districts of the country.

Gestational Age, Exclusive Breastfeeding, Attitude Complementary Foods Associated with Stunting Infants

“…Nurses, in this case, are also tasked with providing health education to mothers of toddlers to avoid giving instant food and preferring to prepare their food to be given to their babies by utilizing food ingredients around the house or buying them at the market. This is also in line with previous research, which detected the risk of stunting by using the application of small area estimation techniques (31)…”

Low Birth Weight, the Differentiating Risk Factor for Stunting among Preschool Children in India

“…The challenge has been to understand the underlying determinants of stunting in India [ 8 ]. Many studies in different disciplines have indicated that the stunting problem in India is complex [ 9 , 10 , 11 ]. The possible explanations include economic growth and agricultural production [ 5 , 12 , 13 ], poor hygiene [ 5 , 12 , 13 , 14 ], discrimination against women and female children [ 15 ], anaemia before and during pregnancy [ 16 ], and very poor feeding practices among infants and children [ 11 ].…”

Analysis of Factors that affect Events and Interventions of Stunting through the E-Stunting Android Application

“…Preparation of a food menu with several types of food is a method of introducing texture, taste, and adaptation of nutrients to the body. Restrictions on the number of certain types of food reduce the ability to adapt, recognize texture, and taste so that there is a risk of a decrease in body immunity and trigger the outbreak of a disease [24], [25], [26], [27]. Infectious conditions can inhibit the growth process in children.…”

“…Moraeus et al [11], [31], [32], [10], [30], [31], [8], [28], [29], [8], [27], [28] which provides an explanation that eating culture in the family affects minimal dietary diversity so that it reduces the Z score and body mass index of children [8], [27], [28], [29].…”