Water insecurity potentially undermines dietary diversity of children aged 6–23 months: Evidence from India

Abstract

Dietary diversity is a crucial pathway to child nutrition; lack of diversity may deprive children of critical macro and micronutrients. Though water along with hygiene and sanitation is a known driver of child undernutrition, a more direct role of household water in shaping dietary diversity remains unexplored. Existing literature provides a sound theoretical basis to expect that water could affect dietary diversity among young children. Here, we test the proposition that suboptimal household access to water and low regional water availability associate with lower dietary diversity among young children. Using the nationally representative 2015–2016 India Demographic and Health Survey data, we conducted a probit analysis on the sample of 69,841 children aged 6–23 months to predict the probability that a child achieves minimum standards of dietary diversity (MDD). After controlling for relevant socioeconomic and gender‐related covariates, we found that children in household with suboptimal household water access were two percentage points less likely to achieve MDD, when compared with those from households with optimal water access. Children in high water availability regions had nine percentage points greater probability of achieving MDD compared with children from low water availability regions, accounting for household water access. As dietary diversity is central to nutrition, establishing the role of water access in shaping early childhood dietary diversity broadens the framework on how household material poverty shapes child malnutrition—independent of sanitation and hygiene pathways. This provides additional window for nutrition planning and intervention wherein water‐based strategies can be leveraged in multiple ways.

RETRACTED: Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6–23 Months in Malawi

“…Household access to water was ranked among the five most important predictors of children’s attainment of MDD in our dominance analysis, further highlighting the importance of the former on the latter. Our finding is consistent with that of Choudhary et al, who found that suboptimal household water access was associated with a lower probability of a child achieving MDD in India [ 26 ]. Household water access can also affect children’s attainment of MDD through gendered and competing demands on caregivers’ time [ 26 ].…”

“…Our finding is consistent with that of Choudhary et al, who found that suboptimal household water access was associated with a lower probability of a child achieving MDD in India [ 26 ]. Household water access can also affect children’s attainment of MDD through gendered and competing demands on caregivers’ time [ 26 ]. The results from a 19-site cross-cultural study by Schuster and colleagues found that household water insecurity was qualitatively associated with children’s delayed feeding.…”

“…With the emerging trends in water access inequalities [ 20 ], strategies need to be put towards improving access to basic water services in the most vulnerable populations across all geographic and socioeconomic groups in Malawi in an effort to foster the achievement of MDD. Minimally diverse diets would provide infants and young children with vital macro- and micronutrients, thus, positively impacting their nutritional and health outcomes [ 26 ].…”

“…This variable was constructed based on the WHO/United Nations Children’s Fund Joint Monitoring Program ladder for household water services [ 25 ], as well as Choudhary et al’s coding system [ 26 ]. We excluded WASH-related variables from our analyses because the proposed pathways through which household water access affects dietary diversity are distinct from the WASH mechanism [ 26 , 27 ].…”

The toll of household water insecurity on health and human biology: Current understandings and future directions

“…To date, data suggest stronger plausibility that water insecurity is a driver of food insecurity than the other way around (Boateng et al, 2020;Brewis et al, 2020). Additionally, cross-cultural qualitative data support the notion that increased household water insecurity affects maternal and child feeding practices and breastfeeding practices, which may lead to variation in risk of dehydration of children or malnutrition (Schuster et al, 2020). Moreover, one dimension of water insecurity, water access, was associated with meeting minimum dietary diversity guidelines in India among infants aged 6-23 months (Choudhary et al, 2020).…”