Role of seasonality variation in prevalence and trend of childhood wasting in India: An empirical analysis using National Family Health Surveys, 2005–2021

BACKGROUND: Wasting develops over a short period and can be reversed with short‐term interventions. The prevalence of wasting typically varies from season to season—becoming higher during the monsoon (June to September) season as compared to the winter (October to January) and summer (February to May) seasons every year in a cyclical fashion. However, to the best of our knowledge, using nationally representative demographic surveys to extensively study the impact of the timing of the survey on the results and trends around wasting has not been done so far. OBJECTIVES: The goal of this study is to ascertain whether seasonality has an impact on the trend and levels of wasting between NFHS‐3 (2005–2006) and NFHS‐5 (2019–2021). METHODS: The analysis was based on data on 51,555, 259,627, and 232,920 children under 5 years included in NFHS‐3, NFHS‐4, and NFHS‐5 respectively. Multivariable logistic regression analysis and the predicted probabilities approach were employed to examine the effect of the months of interview on the prevalence of wasting. The analysis was conducted for 9 states of India which had data for comparable months to compute wasting levels. RESULTS: We found that at the national level, wasting increased in India by one per cent from NFHS‐3 to NFHS‐4 but declined by 2% from NFHS‐4 to NFHS‐5. The results show that seasonality significantly influenced the prevalence of wasting. It was observed that compared to January, the odds of wasting were particularly higher in summer and monsoon seasons, especially in the month of August across all three rounds, indicating the influence of seasonality in the prevalence of wasting in the country. DISCUSSION: The prevalence of wasting in India needs to be interpreted across seasonal changes as seasonality affects many of the variables intrinsically related to child health and nutritional status.