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Decoding Factors Contributing to Socio-Economic Inequalities in Malnutrition among Children in India

Shri Kant Singh and Swati Srivastava

Sluggish progress in the nutritional status of children in India is a matter of concern for the government, as well as civil society. The present study examines the changes in the likelihood of childhood malnutrition and also analyses the factors contributing to socio-economic inequality in malnutrition between 2005 and 2016, using data from the third (2005-06) and fourth (2015-16) rounds of the National Family Health Survey. Over the last decade, there has been a decline of 10 percentage points in the level of stunting and seven percentage points in underweight. However, the pace of the decline is more pronounced in the non-Empowered Action Group (non-EAG) states than the Empowered Action Group (EAG) states. The adjusted effect of various predictors of childhood malnutrition indicates that the most significant predictors of stunting and underweight are mother's education, being from scheduled caste households and belonging to the lowest wealth quintile. These findings are also confirmed by the predicted probability of stunting and underweight, which shows that the probability of stunting has declined by 8 and 13 percent among the poorer and richer wealth quintiles, respectively, from 2005-2016. There was also a substantial decrease in the predicted probability of stunting by the mothers’ educational attainment, even among those with no education. Decomposition analysis indicates that the largest contributions to inequality in childhood stunting come from household wealth (46%), followed by parental education (11%). Similarly, those characteristics are responsible for 47 and 23 percent, respectively, of the likelihood of children being underweight. Existing inequalities in malnutrition among children highlight the importance of focusing on maternal nutrition as a strategy to minimise malnutrition among their children, promoting improvements in child feeding practices, and enhancing the effectiveness of child health programmes. Programmes should focus on promoting exclusive breastfeeding, timely supplementary feeding, and growth monitoring, as well as adopting different approaches to interventions in EAG states and other states.