Childhood undernutrition and its determinants: a cross-sectional study among under-five children in a slum of Kolkata, West Bengal, India

Background: Undernutrition is an important risk for premature deaths and almost 45% of deaths in the under-five population are linked to undernutrition globally, where low- and middle-income countries (LMIC) bear a major share of it. This study aimed to measure the burden of such undernutrition and its determinants among the under-five children in a slum of Kolkata. Methods: A community-based cross-sectional study was conducted between Oct 2022-February 2023 among 164 children aged between 6-59 months. Participants were selected by probabilistic sampling method; Mothers were interviewed and anthropometry of the children were measured. Prevalence of undernutrition was assessed by the composite index of anthropometric failure (CIAF). Logistic regression analysis was done to find out the associates of undernutrition. Results: Median age of the study participants was 26.5 months, 54.3% of the participants being boy children. Regarding feeding of the child, 26.2% given prelecteal feeding, 17.7% didn’t receive colostrum, 33.5% had delayed initiation of breast feeding, only 57.9% child received exclusive breastfeeding. Of the participants, 11% child delivered by home delivery and 32.9% had low-birth-weights. According to CIAF 68.9% had undernutrition, while underweight, stunting, and wasting were reported as per conventional index 44.5%, 56.7%, and 16.5% respectively. In multivariable logistic analysis undernutrition have significant association with low birth weight and repeated episode of cough and running nose [aOR= 0.99(0.98-0.99). aOR=2.32(1.06-5.09)] respectively. Conclusions: Considerable proportion of children (two out of three) had undernutrition with CIAF. Preventive measures should include improvement in antenatal care, child feeding counselling and social determinants of health.