Wealth related inequality in women and children malnutrition in the state of Chhattisgarh and Tamil Nadu

Abstract

Background Child and maternal malnutrition are the most serious health risks in India, accounting for 15% of the country’s total disease burden. Malnutrition in children can manifest as ‘stunting’ (low height in relation to age) or ‘wasting’ (low weight in relation to height) or both and underweight or obesity among women. Other nutritional indicators show that India lags behind, with high levels of anaemia in women of reproductive age. The study aims to analyse the wealth related inequalities in the nutrition status among women and children of different wealth quintiles in a high focus state (Chhattisgarh; CG) and a non-high focus state (Tamil Nadu; TN) in India. Methods We used National Family Health Survey-3rd (2005–06) & 4th (2015–16) to study the trends and differentials of inequalities in the nutrition status. We have used two summary indices. - absolute inequalities using the slope index of inequality (SII), and relative inequalities using the concentration index (CIX). Results There is reduction in wealth related inequality in nutrition status of women and children from all wealth quintiles between 2005–06 and 2015–16. However the reduction in inequality in some cases such as that of severe stunting among children was accompanied by increase among children from better off households The values of SII and CIX imply that malnutrition except obesity is still concentrated among the poor. The prevalence of anaemia (mild, moderate and severe) has reduced among women and children in the past decade. The converging pattern observed with respect to prevalence of mild and moderate anaemia is not only due to reduction in prevalence of anaemia among women from poor households but an increase in prevalence in rich households. Conclusion Malnutrition remains a major challenge in India, despite encouraging progress in maternal and nutrition outcomes over the last decade. Our study findings indicate the importance of looking at the change in inequalities of nutrition status of women and children of different wealth quintiles sub nationally. Given the country’s rapidly changing malnutrition profile, with progress across several indicators of under nutrition but rapidly rising rates of overweight/obesity, particularly among adults, appropriate strategies needs to be devised to tackle the double burden of malnutrition.

Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016

“…The richest wealth group accounts for 13.5%–18.1% of the burden of AF. These findings are in line with the previous literature ( Kanjilal et al, 2010 ; Karlsson et al, 2021 ; Khadse & Bansod, 2021 ; Kumar et al, 2015 ; Kumar & Paswan, 2021 ; Mokalla & Mendu, 2020 ; Mukhopadhyay & Chakraborty, 2020 ; Nguyen et al, 2021 ; Pathak & Singh, 2011 ; Shirisha et al, 2022 ; Singh et al, 2020 ; Subramanian et al, 2008 ; Subramanyam et al, 2010 ) documenting the wealth inequality in AF. Third, among children with similar NMRF and MRF, children from poor and poorest backgrounds have a higher prevalence of stunting, severe stunting, underweight, and severely underweight compared to children from the richest backgrounds.…”

“…Despite the country's substantial economic growth at an annual average growth rate of more than six percent during the last two decades, India hasn't made significant progress in reducing anthropometric failure (AF) ( Chatterjee, 2021 ). Equally alarming is the persistent poor-rich gap in AF among children within India ( Porwal et al, 2021 ) as its detrimental effects have long-lasting implications that hinder social progress and equality across multiple generations ( Shirisha et al, 2022 ). However, what contributes to this poor-rich gap in AF remains unclear.…”

“…Few studies have examined the poor-rich gap in AF and its correlates in India ( Kanjilal et al, 2010 ; Karlsson et al, 2021 ; Khadse & Bansod, 2021 ; Kumar et al, 2015 ; Kumar & Paswan, 2021 ; Mokalla & Mendu, 2020 ; Mukhopadhyay & Chakraborty, 2020 ; Nguyen et al, 2021 ; Pathak & Singh, 2011 ; Shirisha et al, 2022 ; Singh et al, 2020 ; Subramanian et al, 2008 ; Subramanyam et al, 2010 ). However, the small number of studies exploring this issue are either outdated ( Kanjilal et al, 2010 ; Kumar et al, 2015 ; Pathak & Singh, 2011 ; Subramanian et al, 2008 ; Subramanyam et al, 2010 ) or haven't focused on identifying risk factors that contribute to the poor-rich gap in AF using data from all the states and regions of India ( Karlsson et al, 2021 ; Khadse & Bansod, 2021 ; Kumar & Paswan, 2021 ; Mokalla & Mendu, 2020 ; Mukhopadhyay & Chakraborty, 2020 ; Nguyen et al, 2021 ; Shirisha et al, 2022 ; Singh et al, 2020 ). One recent study ( Porwal et al, 2021 ) has documented the poor-rich gap in AF using the Comprehensive National Nutrition Survey (2016–18) data.…”

Double burden of malnutrition among women of reproductive age: Trends and determinants over the last 15 years in India

“…A systematic review and meta-analysis in southeast Asia indicated a higher prevalence of underweight in rural areas compared to urban areas, and a higher prevalence of overweight in urban areas than in rural areas which co-relates with our study [ 29 , 30 ]. In line with the present study, several studies have highlighted higher age, poor women and women with less education as risk factors for undernutrition and anaemia [ 30 , 38 , 39 ]. Geographically, compared to the northern region of India, eastern, western, and southern zonal regions had higher risk for underweight and anaemia which is contrary to earlier reports where southern states such as Kerala and Tamil Nadu were documented as “positive deviants” in some nutrition-related studies compared to northern states [ 40 ].…”

Innovation of M-Health-Based Prosa-Hi Application for Early Detection of Child Growth and Development

“…In fact, follow-up is essential to do to be able to deal quickly and appropriately with growth and development deviations. If deviations are found, then early intervention is carried out so that the growth and development return to normal or the variations do not get heavier 13 . The child's growth and development system is still slow and inaccurate 14 ; No specific and comprehensive data.…”