Decomposing social groups differential in stunting among children under five in India using nationally representative...

Area of Science:

• Public Health
• Socioeconomic Determinants of Health
• Child Nutrition

Background:

• Child stunting, a marker of chronic malnutrition, disproportionately affects socially and economically deprived populations.
• Significant disparities in stunting prevalence exist across different social strata, particularly between Scheduled Caste-Scheduled Tribe (SC-ST) and non-SC-ST groups.

Purpose of the Study:

• To investigate and quantify the inequality in childhood stunting prevalence between SC-ST and non-SC-ST social groups.
• To identify the key socioeconomic and demographic determinants contributing to this inequality.

Main Methods:

• Utilized data from 1,93,886 children aged 0-59 months from the National Family Health Survey.
• Employed descriptive statistics, multivariable logistic regression, and the Fairlie decomposition model to analyze prevalence, determinants, and inequality.

Main Results:

• Stunting prevalence was higher among SC-ST children (39.60%) compared to non-SC-ST children (33.27%).
• Factors like child's age (15-30 months), male sex, lower maternal BMI, no maternal education, poorest wealth index, and unhygienic sanitation practices were associated with increased stunting risk.
• The Fairlie decomposition model indicated that 68.9% of stunting inequality between groups was explained by the included variables, with household wealth (41.3%), maternal education (12.86%), and maternal BMI (11.02%) being the most significant contributors.

Conclusions:

• Significant socioeconomic inequalities contribute to higher stunting rates in SC-ST children.
• Targeted interventions focusing on economic empowerment, maternal education, and improved sanitation are crucial for reducing stunting disparities.
• Policies addressing household economic status and maternal health are vital for improving child health outcomes and achieving equity.