Nutrition among children of migrant construction workers in Ahmedabad, India

Abstract

Background Millions of poor households in India undertake short duration rural to urban migration along with their children to find work in the informal economy in the city. While literature has documented the precarity of such temporary jobs, typically characterized by low wages, insecure jobs, harsh recruitment regimes and economic vulnerability, little is known about its implications for children who migrate with their parents to the city. In this study, we draw attention to children of migrant construction workers and focus on their overall nutritional well-being, which remains under-studied. Our objectives were to categorize the current nutritional status of children under the age of five and determine the underlying causes of poor nutritional outcomes. Methods The field work for this study was undertaken between May 2017 and January 2018 at five construction sites in the city of Ahmedabad. We undertook anthropometric measurements of children under the age of five [N = 131; (male: 46%, female 53%); (mean age: 31.7 months)] and categorized their nutritional status. Using the UNICEF framework on undernutrition, we examined the underlying causes of poor nutritional outcomes among this group of children with the help of qualitative methods such as interviews, focused group discussions and participant observation at the field sites. Results Undernutrition was highly prevalent among the children (N = 131): stunted (40.5%); wasted (22.1%); and underweight (50.4%). We found common factors across parents interviewed such as similar misperceptions of malnutrition, long hours of work and lack of childcare provision at the worksite which resulted in disrupted quality of care. While socio-cultural beliefs and lack of information influenced breastfeeding, other factors such as inability to take breaks or lack of space further impaired infant feeding practices more broadly. Lack of dietary diversity at home, poor hygiene and sanitation, and economic inability to seek healthcare further affected child nutritional status. Conclusions Our study addresses a critical gap in migration literature in India by building a comprehensive narrative of migrant children’s experiences at construction sites. We find that parents’ informal work setting exposes children to a nutritionally challenging environment. Policies and programs seeking to address undernutrition, a critical challenge in India, must pay attention to the specific needs of migrant children.

A Review of Selected Studies on the Factors Associated with the Nutrition Status of Children Under the Age of Five Years in South Africa

“…Singh et al [134] indicated that poor access to clean water often leads to child malnutrition, since the consumption of unpurified water can lead to diarrhea and other waterborne infections. This finding is also validated by Ravindranath et al [24].…”

“…Therefore, this review paper intends to fill this research gap by assessing the factors that influence the nutritional status of children under five years in South Africa using available literature. The United Nations International Children Emergency Funds' theoretical framework of causes of child malnutrition groups factors that cause child malnutrition into three groups, which are basic, underlying, and immediate causes [24]. The UNICEF theoretical framework of causes of child malnutrition can act as a catalyst in achieving the objective of this review, by providing guidelines on the existing theory about the causes of child malnutrition.…”

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“…McKay et al (51) argue that migrants' health issues and their context are distinct from those of other marginalised communities and the effect of migration itself on their health is complex and varies across migrant groups. Studies have shown that migrant workers in India face multiple challenges like occupational hazards because of unsafe work conditions (52), higher prevalence of chronic diseases compared to those with no history of migration (53) and insufficient nutritional intake (54), subjects that continue to be ignored by the media. The media's narrow focus on infectious diseases outbreaks, preventive care and sanitation issues while covering migration and health could also be because almost all the stories linked to health were filed from the destination states/cities, and newspapers tend to give salience to those aspects of stories that were deemed of interest to their readers (55).…”

A Pandemic-specific ‘Emergency Essentials Kit’ for Children in the Migrant BoP communities

“…In India, 19.8 million children below the age of 6 years are malnourished, where one in every three children suffer from malnutrition [20]. A case study of Migrant workers' children in Ahmedabad, India revealed that out of 131 children, 52 children were stunted, 29 were wasted, and 66 were underweight due to malnutrition [21]. The prevalence of undernutrition leads to deterioration in physical and cognitive abilities.…”