Peer-reviewed article
Evaluating Changes in Determinants of Stunting among Children Under 2 Years and Assessing Their Contribution to Socioeconomic Disparity in Child Nutritional Status across India
Deboshree Das ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed data from two national surveys in India to understand what factors caused stunting (poor growth) to decrease in children under 2 years old between surveys. The researchers found that more children being born in hospitals, mothers receiving more education, and mothers being healthier were the main reasons stunting decreased. However, despite overall improvement, children from poorer families remain much more likely to be stunted than children from wealthier families.
Key points
- Institutional deliveries (hospital births) accounted for 19% of the decrease in stunting
- Increased maternal schooling contributed 14% to the reduction in stunting
- Improvements in maternal body mass index contributed 10% to reduced stunting
- Overall stunting decreased over the decade but socioeconomic disparities in stunting levels remained largely unchanged
- Stunting continues to show high variation in distribution across India
Limitations
This is an observational study using survey data, so it cannot prove cause-and-effect relationships, only associations. The study cannot explain why socioeconomic disparities persist despite overall improvements in stunting rates.
Abstract
Background: Despite concentrated global efforts to bring about reduction in malnutrition among children, it continues to remain a public health concern, especially in developing countries such as India. While substantial reduction in the levels of stunting has taken place over the years, high levels of variation exist in distribution of stunting across the country. Objective: The study aimed to identify the determinants of stunting in early childhood and their contribution to change in levels of stunting across India. It also compared the socioeconomic disparity in the levels of stunting and changes therein over the last decade. Methods: The study utilizes data from the National Family Health Survey (NFHS-3 and NFHS-4) on children aged under-2 years. Bivariate and multivariate logistic regression identified determinants of early childhood stunting followed by Oaxaca decomposition model to assess the contribution of each of the factors to reduction in levels of stunting over the years. Concentration index was used to study the socioeconomic disparity in early childhood stunting. Results: Nearly 19% decrease in early childhood stunting can be attributed to increase in institutional deliveries, 14% to increase in maternal schooling, and 10% to improvement in maternal body mass index. In spite of an overall decrease, very little change is seen in socioeconomic disparity of childhood stunting. Conclusions: The study identifies institutional deliveries, maternal schooling, and maternal health as major contributors of decrease in early childhood stunting. It identifies persisting socioeconomic disparity in childhood stunting over the last decade.