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Mokalla TR and Mendu VVR

Table 3. Child stunting, underweight and wasting prevalence and socio-economic quintile stunting, underweight, and wasting
prevalence, %, per quintile) among children (248,174) aged 0-59 months.
Poorest Poorer Middle Richer Richest Concentration index SE(CI)
Stunting 51.0 43.0 36.0 29.0 23.0 −0.14 0.038
Underweight 48.0 38.0 31.0 26.0 20.0 −0.16 0.038
Wasting 25.0 21.0 19.0 18.0 17.0 −0.08 0.016
SE: Standard error.
in months, mother’s education, size of a child at birth, wealth index, type of caste, and mother’s nutritional status) have a
significant association with child nutritional status. Child’s age in months emerged as one of the strongest determinants of
the nutritional status of children. In the first 6 months of life, stunting and underweight children were least and, it increased
with the increase in age. Similar findings, along with other child health-related indicators, were reported from India
(Singh, Srivastava and Upadhyay, 2019; Mishra, Pandey, Chaubey, et al. 2015; Vir, 2013). In malnourishment, the size of
a newborn baby at birth plays a significant role. This study reveals that children have the least risk of being malnourished
if they were born healthy and large size at birth when compared to children who were born weak (Rahman and Sultana,
2019; Prado and Dewey, 2014). A child with higher birth orders is at a greater risk of being severely undernourished. It
may occur due to lack of food supplementation to the children (Rahman, 2016).
Household’s economic status also affects child malnutrition. In this study, we observed that odds of being stunted,
underweight, and wasted were significantly higher among children with the lowest socio-economic background. Since these
lower-income families are having limited access to food, health services and unable to fulfill the basic needs of children,
which effects in growth and development of children (Agrawal, Farrell, Wethington, et al., 2019; Singh, Srivastava and
Upadhyay, 2019). A child’s nutritional status is likely to be affected by a mother’s educational and nutritional status.
This study shows that children of mothers with no education were more likely to be severely malnourished (stunted,
underweight, and wasted) as compared to children whose mothers are educated. Hence, an association was found between
maternal education and child nutritional status, which is consistent with several previous studies (Mishra, Pandey,
Chaubey, et al., 2015; Khan, Zaheer and Safdar, 2019). Educated mothers are well aware of the nutritional requirements
of infants, also make comparative choices of existing health services over traditional practices for improved health care
of their children. Hence, they are capable of taking proper care as compared to illiterate mothers, who may contribute to
the increase in malnourished children (Banerjee, Alok, Lakhtakia, et al., 2019; Hetherington and McNally, 2020). Hence,
these maternal characteristics should be carefully examined for executing proper interventions to reduce the burden of
child malnutrition status in India.
The present study also established a strong association between the child’s and the mother’s nutritional status. Healthy
mothers (children whose mothers BMI is not below normal) were more likely to produce healthy and well-nourished
children as compared to the unhealthy and weak undernourished mothers. Therefore, the risk of stunting, underweight,
and wasting was higher in those children whose mothers’ BMI was below normal. Social characteristics were also one
of the significant determinants of child malnutrition other than demographic characteristics. Hence, mothers belonging
to the scheduled castes or tribes were more likely to have malnourished children than those who are not from any of the
sub-classes mentioned.
5. Conclusions

According to the findings, the poorest family children were associated with an increased risk of undernutrition when
compared to the wealthiest of children. Child undernutrition causes the poorer family to bear an extra burden, resulting in
more illnesses in additions to infectious and non-communicable diseases. There is an immediate need to establish services
to low-income families to avoid child malnutrition. In the health sector, priority should be given to current programs for
children suffering undernutrition, as well as for the most deprived group of families. The findings of this study illustrate
the need to increase the level of education of parents, to improve the nutritional status of the mother and therefore achieve
better nutritional status among under-five children in India.
Acknowledgments

The authors gratefully acknowledge the financial support and fellowship granted by the National Institute of Nutrition
(NIN), Indian Council of Medical Research, Hyderabad, India, for carrying out the study. The authors wish to thank

International Journal of Population Studies | 2019, Volume 5, Issue 2 21