Page 67 - IJPS-10-3

International Journal of
Population Studies Associated factors of child wasting in India

enhancing economic growth, and building social capital during the period of 12 – 18 months after birth, with
(United Nations, 2015). India, marked by significant maternal nutrition and health playing a significant
economic growth and increased agricultural productivity, role (De Wagt et al., 2019). NFHS data indicate that the
stands among the world’s fastest growing economies (World highest proportion of wasting occurs among children
Economic Forum, 2023). Despite noticeable improvements aged 0-23 months (WHZ-2SD-22.3%), emphasizing the
in poverty, health services coverage, education, and critical period spanning from conception to the age of
agricultural production, persistent malnutrition and 2 years (Aguayo et al., 2016; De Onis et al., 2018; Harriet
suboptimal child growth poses a greatest societal challenge & Minh, 2020; Wali et al., 2021). Efforts to combat child
in the country (Singh, 2020). wasting in India have experienced sluggish progress, with

Child wasting, defined as “weight for height < -2 SD the proportion of wasting remaining nearly stagnant from
z-scores of the median World Health Organization (WHO) 2005 – 2006 to 2019 – 2021. With significant variations
growth standards,” serves as a vital indicator of measuring child across districts and states, the latest National Family Health
growth failure linked with acute events (the WHO Multicentre Survey (NFHS-5) data indicate an increase in wasting
Growth Reference Study Group, 2006). This condition proportions in 15 out of 36 states during the period of 2019
carries both long- and short-term implications, including – 2021 (IIPS & ICF, 2021).
an elevated risk of mortality, increased susceptibility to This study aims to identify hotspots of child wasting
diseases, impaired cognitive and motor development, limited in Indian districts and understand the socioeconomic,
educational accomplishments, and diminished productivity maternal, and child-level factors associated with wasting
that perpetuates poverty (Aguayo et al., 2016; Black et al., 2008; among children aged 0 – 23 months. The rationale
Black et al., 2013; Dewey & Vitta, 2013). Emerging evidence behind this research is the sluggish progress of wasting
underscores wasting as a precursor of stunting, with episodes indicators over the years, impacting under-five mortality
of wasting heightening the risk of linear growth retardation and World Health Assembly nutrition targets in India.
(Khara & Dolan, 2014; Richard et al., 2012). Analyzing immediate and underlying factors will provide
According to the framework proposed by the a comprehensive understanding of wasting during the first
United Nations Children’s Fund (UNICEF) (2020), 1,000 days and address existing evidence gaps. Furthermore,
child malnutrition results from the interplay of enabling this study utilizes the latest NFHS (NFHS-5 2019-21) data
environments, underlying, and immediate factors. collected in two phases (phase one from June 17, 2019, to
Immediate factors linked to wasting include dietary January 30, 2020, and phase two from January 2, 2020, to
intake, nutrition, and health-care support during illness, April 30, 2021), offering valuable insights into the predictors
while underlying factors involve maternal and child of wasting before the COVID-19 pandemic and aiding in
characteristics such as prematurity, antenatal care, understanding the prevailing drivers of wasting irrespective
education, occupation, height, and body mass index (BMI). of emergencies (IIPS & ICF, 2021).
In addition, basic facilities such as water and sanitation,
access to welfare services, food security, household wealth, 2. Data and methods
and socio-cultural practices are also correlated with child 2.1. Data sources
wasting (De Wagt et al., 2019; Stobaugh et al., 2018;
UNICEF, 2020; Wali et al., 2021). The most recent NFHS (NFHS-5 in 2019 – 2021) was
utilized for the study (IIPS & ICF, 2021). NFHS-5 is the
Globally, approximately 45.4 million children under largest nationally representative survey, providing a
the age of five are affected by wasting, with 13.6 million comprehensive understanding of the health and nutrition
experiencing severely wasting. South Asia, particularly status of children, parents, and households. The survey
India, bears substantial proportion of this burden (Kinyoki employed a two-stage stratified sampling approach to
et al., 2020; UNICEF & WB, 2021). In India, malnutrition collect information. In the first stage, districts were divided
accounts for 68.2% of under five deaths (Swaminathan into rural and urban strata. Within each rural stratum,
et al., 2019), with prevalence of wasting reaching at 19.3% a sample of villages was selected as primary sampling
in 2019 – 2021, surpassing the threshold set by the WHO units (PSUs) while in urban areas, a sample of census
(De Onis et al., 2018; IIPS & ICF, 2021; WHO, 1995). enumeration blocks were selected as PSUs. Subsequently,
Child wasting leads to substantial economic losses, with in the second stage, 22 households per cluster were selected
estimated at US$48 billion in disability-adjusted life years for interview. NFHS-5 covered 636,699 respondents from
due to the loss of lifetime productivity (Global Panel, 2016). 707 districts, 28 states, and 8 union territories. For the
Wasting in India exhibits unique characteristics present study, the individual and household-level datasets
including high prevalence at birth and a peak occurred were downloaded from the demographic and health survey

Volume 10 Issue 3 (2024) 61 https://doi.org/10.36922/ijps.453