Inequalities in the prevalence of double burden of malnutrition among mother–child dyads in India

In the midst of rapid urbanization and economic shifts, the global landscape witnesses a surge in overweight and obese individuals, even as child malnutrition persists as a formidable public health challenge in low- and middle-income countries (LMICs). This study seeks to unravel the prevalence of the double burden of malnutrition (DBM) within the context of India and delve into the associated disparities rooted in wealth. This study leverages data from the fifth wave of the National Family and Health Survey (NFHS-5), a nationally representative survey conducted in the year 2019–21 in India. This study focuses on mother–child dyads with children under the age of 3 years. Descriptive, bivariate and logistic regression analysis is used to decipher the intricate web of DBM’s prevalence and risk factors, as underscored by socio-demographic attributes. Wagstaff decomposition analysis is applied to quantify the contribution of each inequality in the social determinants on the observed income-related inequality in the DBM. Result from bivariate and logistic regression indicated a heightened risk of DBM within households marked by C-section births, affluence, ongoing breastfeeding practices, advanced maternal age, and larger household sizes. Additionally, households harbouring women with abdominal obesity emerge as hotspots for elevated DBM risk. Notably, the interplay of abdominal obesity and geographical disparities looms large as drivers of substantial inequality in DBM prevalence, whereas other factors exert a comparably milder influence. As India grapples with the burgeoning burden of DBM, a conspicuous imbalance in its prevalence pervades, albeit inadequately addressed. This juncture warrants the formulation of dual-purpose strategies, and a slew of innovative actions to deftly navigate the complex challenges poised by the dual burden of malnutrition. Amidst these exigencies, the imperative to forge a holistic approach that encompasses both sides of the malnutrition spectrum remains a beacon guiding the quest for equitable health and nutrition outcomes.