Peer-reviewed article
Effect of Environmental Factors on Undernutrition Among Children Under 5 Years in Rural Puducherry, Southern Part of India-A Community-Based Cross-Sectional Study.
Mani J, Ramasubramani P, Raj E, Murugan P, Ramasamy N ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined undernutrition in children under 5 in rural Puducherry, India, and its relationship with household environmental conditions. The researchers surveyed 308 children and found that 13.3% were underweight, 17.5% were stunted, and 10.7% were wasted. Indoor air pollution and poor waste disposal were strongly associated with undernutrition, alongside other factors like low birth weight and non-exclusive breastfeeding. The findings suggest that improving household environmental conditions alongside nutrition programmes could help reduce childhood undernutrition.
Key points
- Prevalence of underweight 13.3%, stunting 17.5%, and wasting 10.7% in rural Puducherry
- Indoor air pollution showed strong association with overall undernutrition (adjusted prevalence ratio 2.86) and stunting (2.37)
- Improper waste disposal was associated with underweight (adjusted prevalence ratio 1.77)
- Higher birth order, low birth weight, and non-exclusive breastfeeding were significantly associated with undernutrition
- Environmental factors remain underexplored drivers of childhood undernutrition in developing countries
Limitations
This is a cross-sectional study, so it cannot establish causality—only associations between environmental factors and undernutrition. The study was conducted in one region of India over a short timeframe (March to May 2025), which may limit generalisability to other settings.
Abstract
Background Childhood undernutrition continues to be a major public health concern in low- and middle-income countries, contributing substantially to morbidity and mortality and impairing growth and development among children under 5 years. Although inadequate diet and infections are well-established determinants, the influence of household environmental factors such as indoor air pollution, unsafe drinking water, poor sanitation and improper waste disposal remains underexplored in developing countries. Objectives To estimate the prevalence of undernutrition among children under 5 years in rural Puducherry and to examine its association with selected environmental factors. Methods A community-based cross-sectional study was conducted from March to May 2025 in selected rural areas in Puducherry, India. Using consecutive sampling, 308 children under 5 years were enrolled. Data on socio-demographic characteristics, feeding practices, morbidity and household environmental conditions were collected through a pretested semistructured questionnaire. With anthropometric measures, underweight, stunting and wasting were defined using World Health Organization Child Growth Standards. Data were analysed using STATA v14.0 and WHO Anthro software 3.2.2. The proportions of undernutrition indicators such as stunting, underweight and wasting were presented with a 95% confidence interval (CI). Associations were assessed using log-binomial regression to estimate prevalence ratios (PRs) with 95% CI. Results The prevalence of underweight, stunting and wasting was 13.3%, 17.5% and 10.7%, respectively. Higher birth order, low birth weight, non-exclusive breastfeeding, indoor air pollution and improper waste disposal were significantly associated with undernutrition. Indoor air pollution showed a strong association with both overall undernutrition (aPR: 2.86) and stunting (aPR: 2.37), whereas unimproved waste disposal was associated with underweight (aPR: 1.77). Conclusion Despite a relatively low burden than national averages, undernutrition among children under 5 years in rural Puducherry remains significantly influenced by adverse household environmental conditions. Strengthening environmental conditions with multisectoral interventions alongside existing nutrition programmes is essential for sustained improvements in child growth and health outcomes.