Peer-reviewed article
The Temporal Impact of Socioeconomic Deprivation on Child Health Outcomes in India: Evidence from the Demographic Health Survey 2015-2021.
Charu Tayal, Rajesh Sharma, Kusum Lata ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how water, sanitation, maternal health care, and breastfeeding practices affect child health in India using national survey data from 2015-2016 and 2019-2021. Unsafe water sources, poor sanitation, inadequate antenatal care, and lack of exclusive breastfeeding were associated with increased rates of stunting, wasting, and underweight among children under five. The relationship between these factors and child health outcomes changed over time between the two survey periods. The findings suggest that improving access to clean water, sanitation, maternal health services, and breastfeeding support could enhance child health outcomes.
Key points
- Unprotected drinking water sources were associated with increased under-five wasting in 2019-2021
- Unimproved sanitation facilities increased stunting prevalence but effects on wasting and underweight were inconsistent between survey periods
- Mothers without at least four antenatal care visits were more likely to have stunted and underweight children in 2019-2021
- Early initiation of breastfeeding and exclusive breastfeeding for six months were protective against wasting and underweight
- Temporal changes in associations suggest that the impact of these factors on child health outcomes shifted between 2015-2016 and 2019-2021
Limitations
This is an observational analysis of survey data that can demonstrate associations but cannot establish causation. The study does not evaluate a specific intervention program, only examines relationships between existing practices and health outcomes in the population.
Abstract
In India, poor child health is a pertinacious issue. This article investigates the impact of water and sanitation, maternal health care service utilization (MHCSU) and breastfeeding practices on under-five child health outcomes (CHOs) in India using the two rounds of the Indian Demographic and Health Survey (DHS), 2015-2016 and 2019-2021. In 2019-2021, unprotected sources of drinking water were associated with an increased prevalence of under-five wasting. Unimproved sanitation facilities were likely to increase the prevalence of under-five stunting; however, unlike in DHS 2015-2016, it had no statistically significant effect on wasting and underweight (2019-2021). Mothers who had not received at least four antenatal care visits were more likely to have stunted and underweight children (2019-2021). The absence of early initiation of breastfeeding was associated with an increased prevalence of under-five wasting and underweight but did not influence CHOs (2015-2016). In 2019-2021, the absence of exclusive breastfeeding for the initial six months was associated with increased odds of stunting and underweight among children. To improve CHOs, policymakers must focus on providing financial, material, and human resources along with soft knowledge to provide hygiene education and promote MHCSU, breastfeeding practices, engagement with frontline health workers and women's empowerment.