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Does a geographical context explain regional variation in child malnutrition in India?

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Abstract

Aim

Eradication of child malnutrition is important to ensure the future of children and for its association with morbidity, mortality, and impaired childhood development. This paper investigates the influence of geographical context on child malnutrition by mapping the residual net effect of malnutrition while controlling for bio-demographic and socioeconomic risk factors simultaneously.

Subject and method

We used data from the publically available National Family Health Survey to investigate the important risk factors of childhood diarrhoea, fever and acute respiratory infection using Bayesian geo-additive semi-parametric models.

Results

The results indicate that geoaddative models are needed to adequately assess nonlinear covariates effects and geographic effects within a joint model. With a traditional regression model these effects are difficult to model and to detect. Further, there were considerable geographical variations in child malnutrition across states in India. It is spatially structured and rates remain very high in the central region in comparison to other regions of India. Malnutrition was significantly high for children suffering from diarrhoea, fever and acute respiratory infection. Further, sex, birth order, consumption of Vitamin A, breastfeeding, caste, religion and wealth quintile were found to have significant effects on malnutrition.

Conclusion

The findings suggest that both spatial effect and morbidity, including individual and household factors have significant impact on malnutrition among children. Understanding these relationships can facilitate design of intervention programs. Clearly tackling the problem of malnutrition in India will require multisectoral interventions, targeted at all levels of social organization.

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Acknowledgements

An earlier version of this paper was presented at the Global Public Health Conference held at The School of Public Health, SRS University, India in 2014. The comments of the participants have facilitated in the revision of the paper.

Conflict of interest

The authors declare that there is no conflict of interest.

Contribution of authors

Awdhesh Yadav, Laishram Ladusingh and Ezra Gayawan conceived and designed, performed the experiments, contributed analytical tools and wrote the paper. Awdhesh Yadav analyzed the data.

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Authors and Affiliations

  1. International Institute for Population Sciences, Govandi Station Road, Room No. 14, Old Hostel, Deonar, Mumbai, 400088, Maharashtra, India

    Awdhesh Yadav

  2. Department of Mathematical Demography & Statistics, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, 400088, Maharashtra, India

    Laishram Ladusingh

  3. Department of Mathematical Sciences, Redeemer’s University, Redemption City, Nigeria

    Ezra Gayawan

Authors
  1. Awdhesh Yadav
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  2. Laishram Ladusingh
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  3. Ezra Gayawan
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Correspondence to Awdhesh Yadav.

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Yadav, A., Ladusingh, L. & Gayawan, E. Does a geographical context explain regional variation in child malnutrition in India?. J Public Health 23, 277–287 (2015). https://doi.org/10.1007/s10389-015-0677-4

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  • DOI: https://doi.org/10.1007/s10389-015-0677-4

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