Analysis of anthropometric outcomes in Indian children during the COVID-19 pandemic using National Family Health Survey data.

ABSTRACT

BACKGROUND: Disruptions in food, health, and economic systems during the COVID-19 pandemic may have adversely affected child health. There is currently limited research on the potential effects of the COVID-19 pandemic on stunting, wasting, and underweight status of young children. METHODS: We examine the short-term associations between the pandemic and anthropometric outcomes of under-5 children (n = 232,920) in India, using data from the National Family Health Survey (2019-2021). Children surveyed after March 2020 are considered as the post-COVID group, while those surveyed earlier are considered as pre-COVID. Potential biases arising from differences in socioeconomic characteristics of the two groups are mitigated using propensity score matching methods. RESULTS: Post-COVID children surveyed in 2020 and 2021 have 1.2% higher underweight rates, 1.2% lower wasting rates, 0.1 lower height-for-age z-scores (HAZ), and 0.04 lower weight-for-height z-scores as compared with matched pre-COVID children. Post-COVID children surveyed in 2020 have 1.6%, 4.6%, and 2.4% higher stunting, underweight, and wasting rates, respectively, and 0.07 lower HAZ, as compared with matched pre-COVID children. Reductions in nutritional status are largest among children from households in the poorest wealth quintiles. CONCLUSIONS: These findings indicate a trend towards a recovery in child anthropometric outcomes in 2021 after the initial post-pandemic reductions. The resilience of health and food systems to shocks such as COVID-19 should be strengthened while immediate investments are required to decrease child malnutrition and improve broader child health outcomes.

This study examined how the COVID-19 pandemic affected the health of children under five years of age in India. We compared children surveyed before and after the pandemic. We find that children surveyed after the pandemic began in 2020 had decreased height and weight when compared to pre-pandemic measurements. In 2021, these outcomes improved but some outcomes, primarily weight, did not recover completely. These effects were most pronounced in the poorest households. Overall, our findings suggest that some of the effects of the pandemic may be short-term, but these require further study. Investments are required to reduce child malnutrition and improve the resilience of health and foods systems to shocks.