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Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18
BACKGROUND: Conventional indicators used to access the nutritional status of children tend to underestimate the overall undernutrition in the presence of multiple anthropometric failures. Further, factors contributing to the rich-poor gap in the composite index of anthropometric failure (CIAF) have...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325297/ https://www.ncbi.nlm.nih.gov/pubmed/34330292 http://dx.doi.org/10.1186/s12939-021-01512-4 |
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author | Porwal, Akash Acharya, Rajib Ashraf, Sana Agarwal, Praween Ramesh, Sowmya Khan, Nizamuddin Sarna, Avina Johnston, Robert |
author_facet | Porwal, Akash Acharya, Rajib Ashraf, Sana Agarwal, Praween Ramesh, Sowmya Khan, Nizamuddin Sarna, Avina Johnston, Robert |
author_sort | Porwal, Akash |
collection | PubMed |
description | BACKGROUND: Conventional indicators used to access the nutritional status of children tend to underestimate the overall undernutrition in the presence of multiple anthropometric failures. Further, factors contributing to the rich-poor gap in the composite index of anthropometric failure (CIAF) have not been explored. This study aims to estimate the prevalence of CIAF and quantify the contribution of factors that explain the rich-poor gap in CIAF. METHODS: The present study used data of 38,060 children under the age of five years and their biological mothers, drawn from the nationally representative Comprehensive National Nutrition Survey of children and adolescents aged 0–19 years in India. The CIAF outcome variable in this study provide an overall prevalence of undernutrition, with six mutually exclusive anthropometric measurements of height-for-age, height-for-weight, and weight-for-age, calculated using the World Health Organization (WHO) Multicenter Growth Reference Study. Multivariate regression and decomposition analysis were used to examine the association between covariates with CIAF and to estimate the contribution of different covariates in the existing rich-poor gap. RESULTS: An overall CIAF prevalence of 48.2% among children aged aged under 5 years of age was found in this study. 6.0% children had all three forms of anthropometric failures. The odds of CIAF were more likely among children belonging to poorest households (AOR: 2.41, 95% CI: 2.12–2.75) and those residing in urban area (AOR: 1.06, 95% CI 1.00–1.11). Children of underweight mothers and those with high parity were at higher risk of CIAF (AOR: 1.51, 95% CI: 1.42–1.61) and (AOR: 1.15, 95% CI: 1.08–1.22), respectively. Children of mother exposed to mass media were at lower risk of CIAF (AOR: 0.87, 95% CI: 0.81–0.93). CONCLUSION: This study estimated a composite index to assess the overall anthropometric failure, which also provides a broader understanding of the extent and pattern of undernutrition among children. Findings show that maternal covariates contribute the most to the rich-poor gap. As well, the findings suggest that intervention programs with a targeted approach are crucial to reach the most vulnerable groups and to reduce the overall burden of undernutrition. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12939-021-01512-4. |
format | Online Article Text |
id | pubmed-8325297 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83252972021-08-02 Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18 Porwal, Akash Acharya, Rajib Ashraf, Sana Agarwal, Praween Ramesh, Sowmya Khan, Nizamuddin Sarna, Avina Johnston, Robert Int J Equity Health Research BACKGROUND: Conventional indicators used to access the nutritional status of children tend to underestimate the overall undernutrition in the presence of multiple anthropometric failures. Further, factors contributing to the rich-poor gap in the composite index of anthropometric failure (CIAF) have not been explored. This study aims to estimate the prevalence of CIAF and quantify the contribution of factors that explain the rich-poor gap in CIAF. METHODS: The present study used data of 38,060 children under the age of five years and their biological mothers, drawn from the nationally representative Comprehensive National Nutrition Survey of children and adolescents aged 0–19 years in India. The CIAF outcome variable in this study provide an overall prevalence of undernutrition, with six mutually exclusive anthropometric measurements of height-for-age, height-for-weight, and weight-for-age, calculated using the World Health Organization (WHO) Multicenter Growth Reference Study. Multivariate regression and decomposition analysis were used to examine the association between covariates with CIAF and to estimate the contribution of different covariates in the existing rich-poor gap. RESULTS: An overall CIAF prevalence of 48.2% among children aged aged under 5 years of age was found in this study. 6.0% children had all three forms of anthropometric failures. The odds of CIAF were more likely among children belonging to poorest households (AOR: 2.41, 95% CI: 2.12–2.75) and those residing in urban area (AOR: 1.06, 95% CI 1.00–1.11). Children of underweight mothers and those with high parity were at higher risk of CIAF (AOR: 1.51, 95% CI: 1.42–1.61) and (AOR: 1.15, 95% CI: 1.08–1.22), respectively. Children of mother exposed to mass media were at lower risk of CIAF (AOR: 0.87, 95% CI: 0.81–0.93). CONCLUSION: This study estimated a composite index to assess the overall anthropometric failure, which also provides a broader understanding of the extent and pattern of undernutrition among children. Findings show that maternal covariates contribute the most to the rich-poor gap. As well, the findings suggest that intervention programs with a targeted approach are crucial to reach the most vulnerable groups and to reduce the overall burden of undernutrition. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12939-021-01512-4. BioMed Central 2021-07-30 /pmc/articles/PMC8325297/ /pubmed/34330292 http://dx.doi.org/10.1186/s12939-021-01512-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Porwal, Akash Acharya, Rajib Ashraf, Sana Agarwal, Praween Ramesh, Sowmya Khan, Nizamuddin Sarna, Avina Johnston, Robert Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18 |
title | Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18 |
title_full | Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18 |
title_fullStr | Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18 |
title_full_unstemmed | Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18 |
title_short | Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016–18 |
title_sort | socio-economic inequality in anthropometric failure among children aged under 5 years in india: evidence from the comprehensive national nutrition survey 2016–18 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325297/ https://www.ncbi.nlm.nih.gov/pubmed/34330292 http://dx.doi.org/10.1186/s12939-021-01512-4 |
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