Regional Distribution of the Anthropometric Failure among Under-five Children and Its Determinants in India.

Background: Undernutrition in children seems to be one of the major health issues in developing nations including India. Stunting, underweight, and wasting are the three most often used anthropometric indicators to evaluate childhood undernutrition. Children who exhibit one or more indicators of undernutrition are considered as anthropometric failure (AF). The present study aims to determine the distribution and determinants of anthropometric failure in children under the age of five in different regions of India. Methods: NFHS-5 data, collected between 2019 and 2021, were utilized for the study. Pearson's chi-square (χ2) test was used to look into the association between categorical variables. Binary logistic regression was used to find the explanatory factors that influence anthropometric failure. Results: More than half of the under-five children (52.18%) in India are suffering from anthropometric failure, out of these West (57.88%), East (56.58%), and Central (53.94%) regions have covered half of the total occurrence. State-wise, Bihar (61.66%), followed by Gujarat (60.26%), and Jharkhand (58.05%) have recorded the highest rates of anthropometric failure. Anthropometric failure is higher among anemic children, boys, parent not alives, the higher number of birth order, lower educated mothers, rural dwellers, belonging to scheduled tribes and scheduled castes communities, living in nuclear families, and having lower household wealth indexes than their other counterparts. Conclusion: These aspects imply that regional determinants should be taken into consideration when implementing child nutrition development programs.

Prevalence of anaemia among 6- to 59-month-old children in India: the latest picture through the NFHS-4.

India is the highest contributor to child anaemia among developing countries. To see the latest picture of child anaemia in India, data for 6- to 59-month-old children were taken from the fourth round of the National Family Health Survey conducted in 2015-16 (NFHS-4). The study sample consisted of 1,37,347 children. The dependent variable was the anaemia status of the child. The objectives of the study were to assess (i) the distribution of anaemia prevalence by child age group, (ii) the prevalence of child anaemia by zone and state and (iii) the relation of child anaemia prevalence with social, demographic and economic variables, including maternal nutritional status and low birth weight. The study found that in India in 2015-16, 56% of 6- to 59-month-old children were anaemic - a decrease of only 13.5 percentage points since the NFHS-3 study conducted in 2005-06. It is well known that iron supplementation is necessary for child growth and brain development. This study suggests that, in addition, the socioeconomic conditions of households in India need to be improved to prevent child anaemia. Low birth weight and low maternal nutritional status are also responsible for the high prevalence of anaemia among children in India.

Malnutrition and anaemia among adult women in India.

The latest National Family Health Survey conducted in 2015-16 (NFHS-4) showed that malnutrition and anaemia still pose huge health challenges in India. Data on 651,642 adult non-pregnant women aged 15-49 years were taken from the survey to study the nutritional and anaemia statuses of adult women by Indian zone and state. The relationships of these two variables with the women's urban/rural place of residence, education level, religion and eating habits, and wealth index of the family, were assessed. Body Mass Index (BMI) and haemoglobin level were used to assess nutritional status and level of anaemia, respectively. The results show that in 2015-16 in India the percentages of underweight and obese/overweight people were 22.4% and 18.4%, respectively. The percentages of undernutrition and overnutrition were more or less same. The percentage of underweight people was higher in the middle belt region of India. Zones with high levels of overweight or obesity were concentrated in the West, North and South zones. A comparison of the two national-level data sets, i.e. NFHS-4 and NFHS-3, showed that the prevalences of undernutrition and anaemia reduced by 13 and 5 percentage points, respectively, from NFHS-3 to NFHS 4, i.e. over the 10-year period from 2004-05 to 2015-16, whereas overnutrition increased by 4 percentage points during this period. Analysis of possible socio-demographic factors and eating habits thought to influence underweight, obesity and anaemia revealed substantive causal relations. More specifically, education and eating habit were found to influence underweight, overweight or obesity and anaemia significantly. The nutritional status of a woman was also found to depend on household income.

Socioeconomic determinants of iron-deficiency anemia among children aged 6 to 59 months in India.

The extent of anemia and its socioeconomic determinants among the preschool children (6-59 months old) in India have been studied in this article. Relevant data are taken from the third round of the National Family Health Survey. The initial analysis reveals some interesting features. The most affected children are in the age-group of 6 to 23 months. Beyond this age a decreasing trend is observed up to the age of 48 to 59 months. The highest and the lowest prevalence of anemia have been found to be in the central and the northeast zones, respectively. The vulnerable groups are the children of illiterate parents and those belonging to the poor families in the rural areas. Categorical logistic regression also confirms that status of literacy and wealth of parents have strong negative association with the status of anemia of the children.

Temporal trend of anemia among reproductive-aged women in India.

BACKGROUND: Anemia is one of the major leading nutritional deficiencies in India, and the most vulnerable groups are preschool and adolescent children and pregnant and lactating women. AIM: The main objective of the study is to determine the temporal trend of anemia among reproductive-aged women of age 15-49 years. METHODOLOGY: The study uses data from second and third rounds of the National Family Health Surveys (NFHS-2, 1998-1999, and NFHS-3, 2005-2006), conducted by the International Institute for Population Sciences. The dependent variable was the status of anemia of women. The determining variables were type of residence, age group, religion and castes, educational status, marital status, and household standard of living index. RESULTS: Anemia was most prevalent in the east zone for both the periods. The changes at the all India level were not much, but the north-east zone improved very well, whereas the south zone deteriorated drastically. The occurrence of severely anemic women in India varied between 1% and 2%. The highest prevalence rates were observed among women who were 15 to 24 years of age, illiterate, from non-Christian scheduled tribes (STs), unmarried, and whose standard of living was low. Rates of anemia have increased over time except in the case of Buddhists, Parsees, Jains, and the STs. CONCLUSION: From the viewpoint of our study, illiteracy and low standard of living may be the main causes of anemia among women in India. It is also necessary to take appropriate steps to curb anemia in women in their early adulthood.

Variation in height and BMI of adult Indians.

It is well known that height and weight are interrelated, and that both are related to socioeconomic variables. The objective of this study was to assess the effect of socioeconomic variables on the heights and weights of different groups of people, formed according to different levels of heights and weights, and to see whether there are sex differences in the variations in heights and weights. Data for adults aged 15-49 years were taken from the India National Family Health Survey-3 and descriptive studies and multiple linear regression analyses carried out. A clear positive association was found for height and BMI with economic level (except for overweight females in the case of BMI). In the case of BMI, it is age that seems to be the most influential factor. Surprisingly, the observed changes in height and BMI are not as expected for short and tall or underweight and overweight people; these sometimes behave in the opposite directions to that of normal height and weight people. The basic assumption of multivariate normality is not valid due to changing relations at different height and BMI levels.

Growth and nutritional status of preschool children in India: a study of two recent time periods.

BACKGROUND: Preschool children call for focused attention in India because India has the highest percentage of undernourished children in the world. OBJECTIVE: To compare the growth and nutritional status of Indian preschool children for the periods 1998/99 and 2005/06, SUBJECTS AND METHODS: Using data on weight and length/height as well as the sociodemographic background of preschool children from the National Family Health Surveys (NFHS) from 1998/99 and 2005/06, we determined the distribution of weight and length/height and their association with sociodemographic variables. RESULTS: The distributions of weight and length/height around the mean remained remarkably stable over age but were much greater in India than the international norms. The rates of growth of mean weight and length/ height were far lower in India than the international norms up to the age of 2 years. The temporal trend indicates declines in the percentages of undernourished (low weight-for-age) and stunted (low height-for-age) children over the 7-year period, although the degree of improvement was far better for stunting than for underweight. Mother's educational status is the only variable that has been found to influence child nutrition. CONCLUSION: The level of mothers' education needs urgent attention with top priority to reduce the prevalence of underweight and stunting of children. This also implies that, for future benefit, girls should be given more facilities for better education. Breastfeeding and weaning practices also need special attention.

Trends in socioeconomic and nutritional status of children younger than 6 years in India.

The main aims of this study are to find out the trends in the (a) prevalence of undernutrition and severe anemia and (b) degree of association of undernutrition and severe anemia in children younger than 6 years in India with some socioeconomic variables. Using the Reproductive and Child Health Survey data, z score of weight for age and hemoglobin status were analyzed to understand the state and agewise variation and their association with the sociodemographic variables through logistic regression. The prevalence of malnutrition according to both the criteria was first seen to increase, attain a maximum value at some age between 12 and 48 months, and then decrease. Statewise distribution showed a close link between the stage of development and the prevalence of malnutrition-prevalence rate being less for developed states. The rates were also less for the Northeastern states of India. The regression analysis clearly points out that children with illiterate mothers, of lower age groups, or from low standard of living households are more prone to become malnourished. The economic growth alone is not sufficient for substantially reducing malnutrition. It is necessary to improve the rate of literacy, especially of women, to reduce the prevalence of malnutrition and anemia among children. It is not only economic development but also overall human development that is needed in India.

Influence of ethnicity, geography and climate on the variation of stature among Indian populations.

This paper analyzes the variation in the mean stature of adult males of a variety of population groups in India and examines the influence of geographical, climatic and ethnic factors on it. A considerable variation in mean stature has been found with respect to these three attributes. Variation "between" ethnic groups compared with "within" ethnic groups was found to be much more than that of geographical and climatic zones. Scheduled Castes (SC) and Scheduled Tribes (ST) populations have much low average height than that of General Castes (GC). Climatically dry and semiarid zones have a tendency to have higher stature than in the Monsoon areas. The mean height has been found to be the highest in north India. It is closely followed by west India. An interesting feature is that as one goes towards east and south the mean height gradually decreases. It is the lowest in islands. The mean heights have been regressed on geographical, climatic and ethnic factors, after converting these factors into binary variables. The regression analysis has strengthened the findings, that there is a highly significant relationship between height and geographical, climatic and ethnic factors.

Burden of anemia and its socioeconomic determinants among adolescent girls in India.

BACKGROUND: Anemia is still one of India's major public health problems, especially among adolescent girls. OBJECTIVE: To investigate the severity and distribution of anemia among Indian adolescent girls aged 10 to 19 years and its association with socioeconomic and sociodemographic factors. METHODS: The study used data from the District Level Household Survey, round 11, 2002-04, conducted under the Reproductive and Child Health Project. Data were collected on hemoglobin along with socioeconomic and sociodemographic factors of the households. The survey covered rural and urban areas of 35 states or union territories. Data from 177,670 adolescent girls were analyzed. RESULTS: The highest prevalence of anemia (99.9%) was observed in Jharkhand in eastern India. The prevalence in the northeastern states was relatively low. The highest prevalence rates were observed among older girls (15 to 19 years), illiterate girls living in rural areas, girls in illiterate households, girls from households with a low standard of living, non-Christian girls, girls from Scheduled Tribes, girls living in west India, and married girls. The highest percentages of girls with normal hemoglobin were reported among Christian Scheduled Tribes (39.4%) and among girls in northeastern India (40.1%). Analysis by binary ordered logistic regression showed that anemia status did not depend on urban or rural residence or on age. CONCLUSIONS: Enhancement of the economic status of families, especially poor families, is a prerequisite to the amelioration of anemia among adolescent girls. The level of education of the girls is also a major factor.

Growth and nutritional status of pre-school children in India: rural-urban and gender differences.

This cross-sectional study of growth and nutritional status makes an attempt to find the gender and rural-urban differences among Indian preschool children. This study is based on the data of weight and height of children aged 0-35 months taken from 26 States (total 26,369 children; 13784 boys and 12585 girls). The children are found to be lighter and shorter compared to International standards irrespective of age and sex. Boys are heavier and taller than girls. Urban preschool children are heavier and taller compared to rural counterparts. In the urban area, higher percentages of girls are affected by underweight (37.1%) and stunting (35.0%) than boys. In rural areas, the prevalence of underweight is also higher among girls (47.9%) compared to boys (45.7%), which is found to be much significant (p < 0.01). There is a significant rural-urban as well as gender difference in growth and nutritional status of Indian preschool children.

Determinants of nutritional status of pre-school children in India.

The aim of this paper is to assess the spatial distribution of nutritional status of children of less than three years through Z-scores of weight-for-age, height-for-age and weight-for-height using data collected by the National Family Health Survey (NFHS-2, 1998-99), India. The nutritional status of pre-school children was regressed on different socio-demographic factors after eliminating the effect of age. The data show that there are gender differences and spatial variations in the nutritional status of children in India. Gender difference is not very pronounced and almost disappears when the effects of age and socio-demographic variables are removed. The spatial difference, especially the rural-urban difference, was found to be very large and decreased substantially when the effects of age and socioeconomic variables were removed. However, the differences were not close to zero. All the variables were found to affect significantly the nutritional status of children. However, the literacy of mothers did not affect height-for-age significantly. The weight-for-age and height-for-age scores showed a dismal picture of the health condition of children in almost all states in India. The worst affected states are Bihar, Madhya Pradesh, Orissa and Uttar Pradesh. Assam and Rajasthans are also lagging behind. Weight-for-height scores do not give a clear picture of state-wise variation. Goa, Kerala and Punjab are the three most developed states in India and also have the lowest percentages of underweight children according to the Z-scores. Along with these three states come the north-eastern states where women are well educated. Thus overall development, enhancement of level of education and low gender inequality are the key factors for improvement in the health status of Indian children.

Prevalence of anemia and its determinants among nonpregnant and pregnant women in India.

This study investigates the severity and distribution of anemia among nonpregnant and pregnant women aged 15 to 49 years in urban and rural sectors of 26 states in India and its association with certain economic and biosocial factors. A national survey was conducted to collect data on hemoglobin, height, weight, and certain economic and biosocial factors of 72 660 nonpregnant and 5619 pregnant women. Nonpregnant women aged less than 25 years are most affected by anemia. Women's education and standard of living in the households have a vital role in reducing anemia. Urban and well-nourished women also suffer less from anemia. The severity of anemia is higher among pregnant than nonpregnant women. Efforts must be made to educate women and enhance their level of economic status so that the prevalence of anemia can be reduced substantially.

Growth and nutritional status of the Bharia--a primitive tribe of Madhya Pradesh.

This study is an attempt to understand the physical growth and nutritional status of Bharia, a primitive tribe of Central India. A cross sectional study was conducted on 551 children (283 boys and 268 girls) aged 4 to 18 years. Body weight, height, sitting height, head circumference, upper arm circumference, chest circumference, biceps, triceps, sub scapular and calf skin fold thickness were measured. Body Mass Index was calculated as weight/height2 to calculate chronic energy deficiency. All anthropometric measurements except skin fold measurement exhibit uniform increase with age in both the sexes. Age-specific Body Mass Index (BMI) indicated substantial changes and falls during pre-school age and rise in adolescence. The BMI according to the Indian standard was normal, but when the data was compared with the International standard malnutrition in both sexes was noticed in childhood. Boys remained undernourished after adolescence, while girls reached the normal growth patterns.

Obstetric care practice in Birbhum District, West Bengal, India.

BACKGROUND: The study area is the Birbhum district of the State of West Bengal in India. It is one of the backward districts in India. OBJECTIVE: The paper investigates the existing pattern of obstetric health care practices and the factors associated with the utilization of such care. METHOD: The present analysis includes 495 adult married women of both rural and urban areas of nine Blocks of Birbhum district. Besides performing chi2 tests to see the association of the relevant individual and household characteristics, logistic regression was also carried out to measure the effect of these characteristics on the use of obstetric health care. RESULTS: In Birbhum district of West Bengal 65 percent mothers go to doctors for antenatal check-up during their pregnancy, but only 26 percent mothers deliver their babies in institutions and 30 percent mothers get the help of professional health assistants during delivery. Educated women have emphasized role in the practice of obstetric health care. Husband's education and the standard of living of the family also have some effect on the practice of antenatal check up, place of delivery and assistance of health professional. While most of the family background variables have significant effect on the practice of antenatal check up, these variables do not have much effect on the choice of delivery or seeking assistance of health professionals. Contrary to the popular belief the working status of women does not have favourable influence on the obstetric health care practices. In developing countries like India, it is the poverty, which compels the women to take jobs-that too in low paid jobs especially in rural backward areas. CONCLUSION: The status of literacy of mothers and standard of living of the family are of prime importance in improving the obstetric health care practices.

Socioeconomic differentials in nutritional status of children in the states of West Bengal and Assam, India.

Malnutrition among children is prevalent in almost all the states in India. This study assesses the extent and causes of malnutrition in two eastern Indian states with similar climates, namely West Bengal and Assam, using data from the National Family Health Survey 1998-99 (NFHS-2). The three indices of malnutrition taken for analysis are weight-for-height (WHZ), height-for-age (HAZ) and weight-for-age (WAZ). These are assumed to depend on birth order, preceding birth interval, parent's educational status, working status of the mother, mother's age at delivery of the children, source of drinking water, toilet facilities and standard of living of the household. Logistic regression was carried out separately for each of the three indices on the explanatory variables for both the states. It was found that not all variables are equally important in determining whether a baby is underweight, or suffering from acute or chronic malnutrition. Also, the importance of variables is not the same in the two states. It was observed that the coefficients associated with the variables in determining weight-for-height are not significant compared with those for weight-for-age and height-for-age.