Peer-reviewed article
Unveiling subgroup trends of stunting and wasting in Indian children: a serial cross-sectional analysis from National Family Health Surveys 3-5.
Drishti Sharma, Pandara Purayil Vijin, Rajat Goyal, Saif Ul Hadi, Rajesh Kumar ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed data from three Indian national health surveys between 2005 and 2020 to track changes in child stunting and wasting across different population groups. Disparities by wealth decreased over the period, but gaps by caste, tribe, and rural-urban residence persisted. Overall, India has made progress against stunting, but wasting remains a serious problem, especially among marginalized populations.
Key points
- Wealth-related disparities in stunting and wasting decreased significantly over 15 years (HAZ: 0.27 improvement, WHZ: 0.11 improvement)
- Disparities by caste and tribe showed no meaningful improvement (HAZ: 0.07, WHZ: 0.02)
- Rural-urban and tribal disparities persist despite overall progress
- Wasting remains an acute problem in early childhood across India
- The study emphasizes need for targeted interventions for vulnerable populations, particularly addressing maternal nutrition and newborn care
Limitations
This is a descriptive trend analysis based on cross-sectional survey data; it cannot establish causation or explain why disparities by caste and tribe have not improved despite policy efforts. The analysis does not evaluate specific interventions or their mechanisms.
Abstract
BACKGROUND: India grapples with a dual burden of child wasting and stunting and stark socio-economic and regional disparities. OBJECTIVES: We aimed to better understand trends in the prevalence of childhood stunting and wasting, with an emphasis on its disproportionate effects on marginalized populations, by analyzing National Family Health Surveys (NFHS) data from 2005 to 2020. METHODS: We analyzed trends in the distribution of childhood height-for-age Z (HAZ) and weight-for-height Z (WHZ) scores using anthropometric data from 3 surveys, NFHS 3, 4, and 5. We examined disparities by wealth, caste, tribe, area of residence (rural compared with urban), and sex and mapped trends against India's evolving policy landscape. We also conducted a regression analysis of HAZ and WHZ risk factors. RESULTS: In the context of an evolving nutrition-centered policy landscape, disparities by level of wealth in both HAZ and WHZ decreased in the study period (HAZ: estimate = 0.27, confidence interval [CI]: 0.16, 0.38; and WHZ: estimate = 0.11, CI: 0.01, 0.22), though there were no improvements in disparities for marginalized castes (HAZ: estimate = 0.07, CI: 0.00, 0.13; and WHZ: estimate = 0.02, CI: -0.04, 0.08). Though they have narrowed, disparities by wealth, caste, tribe, and area of residence persist, with undernutrition at birth, as measured by HAZ and WHZ, a particularly acute problem. CONCLUSIONS: Although there have been significant reductions in disparities by wealth in mean HAZ and WHZ scores in India, persistent disparities by caste, tribe, and area of residence necessitate reinvestments in targeted interventions. Further, despite this narrowing of disparities and overall progress against stunting, anthropometric scores in early childhood continue to be low in India, especially with regard to wasting, indicating the importance of not only maternal nutrition and care for newborns but more comprehensive efforts to address poverty and other factors that contribute to undernutrition, with a focus on vulnerable populations.