Poster Topical Area: Global Nutrition

Location: Hall D

Poster Board Number: 580

P12-078 - Childhood wasting in India manifests early in life and is mainly explained by maternal and household deprivation: Insights from the 2015-2016 National and Health Family Survey

Monday, Jun 11
8:00 AM – 3:00 PM

Objectives: India has made considerable progress on maternal and child health and nutrition in the last decade, but wasting remains a key challenge. We examined the patterns of wasting by child age, and studied the determinants of wasting during different periods of infancy and early childhood.


Methods:
We used representative national survey data, collected in 2015-16 and recently released for public use in 2018 (N= 232,743 children 0-5y). We performed analyses to examine the age dynamics of weight-for-height z-scores (WHZ) and wasting. We conducted multiple regression analysis to examine the role of child-level factors (birth size, age, birth-order and sex), maternal factors (height, weight, age and education), household factors (socioeconomic status [SES], caste and hygiene) as well as health services (antenatal and postnatal care) and child feeding practices. All analyses included state fixed effects, and adjust standard errors for survey design.


Results:
Wasting changed little between 2006 and 2016 (19.8 to 21%). Wasting was very high in early infancy: 33% for children <6 mo, followed by 25% for 6-23 mo and 19% for 24-59 mo. Among children <6 mo, factors associated with higher WHZ included being born with normal birth size (b= 0.25 to 0.30), the mother having received at least 3 antenatal care activities (b= 0.26), early initiation and exclusive breastfeeding (b= 0.14). Among children 6-23 and 24-59 mo, risk factors for wasting were maternal thinness (b= 0.29 to -0.36), shortness (b= -0.06 to -0.18) and tribal community (b= -0.08); protective factors included higher birth size (b= 14 to 0.29), higher SES (b= 0.06 to 0.21) and toilet ownership (b= 0.07 to 0.09), receiving animal source foods and vitamin A supplementation. Similar findings were observed for wasting and severe wasting. Poor maternal status indirectly influences early wasting through birth size, and is both directly and indirectly associated with wasting in later childhood.


Conclusions:
The high burden of wasting in India calls for an urgent nation-wide attention. Our findings indicate that improving maternal nutritional status, ANC services and early breastfeeding could prevent wasting in early infancy. Addressing wasting in later infancy and early childhood will also require attention to child feeding practices, hygiene and poverty alleviation.




Funding Source: Bill & Melinda Gates Foundation through POSHAN, led by International Food Policy Research Institute

CoAuthors: Phuong Nguyen – IFPRI; Derek Headey – IFPRI; Rasmi Avula – IFPRI; Lan Tran – FHI360; Melissa Young – Emory university; Reynaldo Martorell – Emory university

Purnima Menon

Senior Research Fellow
International Food Policy Research Institute
Washington, District of Columbia