Peer-reviewed article

Determinants of Stunting, Wasting, and Underweight Among Children Under 5 Years in India: Evidence From 2019 to 2021 Demographic Health Survey.

Sk R, Banu N · 26 May 2026

Abstract

Background Early childhood malnutrition is a serious public health issue in India, contributing to stunting, wasting, and underweight among children under 5 years. The study aims to explore the factors influencing these conditions and highlight the region most affected. Methods This study uses secondary data collected from National Family Health Survey 2019-21. Multivariate logistic regression has been run to identify the risk factors associated with malnutrition conditions among children under age five including stunting, wasting, and underweight based on Composite Index of Anthropometric Failure (CIAF) measures. To explore the hot spot zone for stunting, wasting and underweight, cluster analysis has been done applying univariate local Moran's I. Results The study explores a significant proportion of children in India suffering from malnutrition, particularly stunting is more prevalent than of underweight and wasting. Out of 25 indicators, age, sex, birth size of child and the mother's body mass index and current employment status have been identified as key predictors of malnutrition status. The children aged 25 to 36 months are more likely to be stunted, wasted and underweight than the other age groups which is consistent with CIAF with adjusted odds ratio (AOR) of 3.92 (95% confidence interval [CI]: 1.92-7.99, p < 0.01). A sex-based analysis shows females are less likely to be malnourished than male child which is also evident in CIAF (AOR: 0.66; 95% CI: 0.55-0.80, p < 0.01). The children having normal or larger sized at birth are less likely to suffer from stunting, wasting and underweight and even in CIAF than the small size children at birth. The children of underweight mother are more likely to be malnourished than the children of mother having normal body mass index which is also reported in CIAF (AOR: 1.34; 95% CI: 1.05-1.72, p = 0.02). Additionally, economic status and geographical region significantly impact malnutrition with children with wealthier households faring better which is consistent in CIAF (AOR: 0.63; 95% CI: 0.45-0.88 for richest). Univariate local indicators of spatial association cluster analysis reveals that the western, eastern, and central zones are particularly vulnerable to child malnutrition. Conclusion Combating prevailing malnutrition in India requires collective responsibility and collaboration among policymakers, geographers, healthcare professionals, and communities.