Page 71 - IJPS-10-3

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

maternal anemia, home birth, child gender, low birth (NIN, 2017). Higher wasting prevalence among children
weight, high birth order, minimum acceptable diet, and belonging to backward classes, STs, and SCs points to the
vaccination status. persistent inequalities and disparate access to nutritional
The adjusted analysis revealed a higher burden of services among marginalized communities (Karlsson et al.,
wasting in rural areas compared to urban areas. Children 2021; Nakkeeran et al., 2020; Ulahannan et al., 2022).
from the poorest households had a 60% higher likelihood Lack of access to sanitation was the most significant
of wasting (adjusted odds ratio [AOR] = 1.60, 95% predictor of wasting, and its effect was mediated through
CI = 1.43 – 1.79), and those from other backward class episodes of communicable diseases. Open defecation was
families had a 10% higher chance of being wasted (AOR a leading contributor to diarrhea and other water and
= 1.10, 95% CI = 1.01 – 1.20). Lack of access to improved foodborne diseases, exacerbating nutritional status of
sanitation increased the odds by 18% (AOR = 1.18, 95% CI children (Nuzhat et al., 2020). The findings emphasize the
= 1.12 – 1.25). Maternal factors such as low BMI increased need for prioritizing access to clean water and sanitation
the odds of wasting by 30% (AOR = 1.30, 95% CI = 1.23 – particularly among underserved communities (Budge
1.37), while higher maternal BMI (BMI >25) reduced the et al., 2019; Chambers & Von Medeazza, 2013; Curtis
odds by 20%. Girls had an 11% lower likelihood of wasting et al., 2000; Dangour et al., 2013; Gera et al., 2018; Spears,
(AOR = 0.89, 95% CI = 0.85 – 0.93), while low birth weight 2020). It is widely acknowledged that the utilization of
increased odds by 27% (AOR = 1.27; 95% CI = 1.20 – 1.36). maternal health-care services contributed to improved
Having diarrhea in the previous 2 weeks raised the odds care practices. Studies conducted in Nigeria demonstrated
of wasting by 13% (AOR = 1.13, 95% CI = 1.05 – 1.21), the association of child malnutrition with the utilization
and receiving an adequate diet decreased odds by 18% of maternal health-care services (Hamel et al., 2015).
(AOR = 0.82; 95% CI = 0.76 – 0.89). However, the association between antenatal care check-up
and wasting was not significant in our study. The findings
4. Discussion showed that maternal BMI <18.5 and low birth weight
Utilizing data from NFHS -5 (2019-2021), we mapped were strong predictors of child wasting. Maternal low BMI
the spatial distribution of wasting (weight for height <-2 contributed to preterm and low birth weight, emphasizing
SD) among children aged 0 – 23 months across districts. the urgent need to address maternal malnutrition (Porwal
Individual-level variables were analyzed to identify et al., 2021; Subramanian et al., 2009; Wali et al., 2021).
significant predictors of wasting among young children Children receiving an adequate diet (e.g., timely
(0 – 23 months) in India. Our findings reveal substantial introduction, frequency, quantity, and diversity of
variation in wasting prevalence across districts, with no complementary feeding) had significantly lower odds
state completely free from child wasting. The prevalence of wasting. Evidence from India and other countries
of wasting has indeed risen in many districts over the past consistently demonstrated the positive effects of appropriate
5 years, consistent with findings of a parallel study on complementary feeding, underscoring the importance
severe wasting (WHZ-3SD) conducted utilizing the same of promoting and supporting optimal feeding practices
dataset (Ulahannan et al., 2022). (Aguayo et al., 2016; Ahmad et al., 2018; Petrikova, 2022).
Our findings suggest that the age-specific prevalence While policies and programs to address undernutrition
of wasting in India among children aged 0 – 23 months among young children exist nationwide, the low coverage
surpassed the national average for children under 5 years. of essential nutrition interventions hinders the impact
The adjusted analysis reveals that infants up to six months (Nguyen et al., 2022). The study calls for the prioritized
faced the highest risk of wasting and that this elevated program actions in high-burden districts. First, prioritized
risk persisted until the age of 23 months. These findings care and follow-up of low birth and preterm babies in
emphasize the critical importance of focusing on the the communities through promotion of optimal feeding
period of 1000 days (conception to 2 years) as a pivotal practices, strong referral, and coordination at various levels
window of opportunity to achieve a child’s potential for of health system are needed. Second, the findings emphasize
growth (Wrottesley et al., 2016). the need to prioritize maternal nutrition within program

Household wealth emerged as a major contributor to settings such as conducting nutritional assessments of both
acute malnutrition, with a significantly higher likelihood mothers and children in the community during Village
observed among children of the poorest households. Health, Sanitation and Nutrition Days, providing nutritional
Proximate factors mediated through poverty such as caste- counselling, and promptly identifying children with wasting.
based social deprivation and lack of access to amenities play Third, accurate measurement of height and weight at
a crucial role in determining children’s nutritional status Anganwadi centers is pivotal to identify and track children

Volume 10 Issue 3 (2024) 65 https://doi.org/10.36922/ijps.453