Flood exposure and childhood malnutrition in India using composite index of anthropometric failure (CIAF)

The flood exposure in India exacerbates childhood malnutrition, particularly in the vulnerable regions of India. Presently, India is facing a dual burden of natural disasters and malnutrition, especially in the vulnerable regions that are exposed to floods. Many studies have been focused on micro-level or regional-level analyses. The present study is uniquely examining the association between flood exposure and malnutrition at a national scale. The study investigated the impacts of flood exposure on childhood malnutrition, using the Composite Index of Anthropometric Failure (CIAF) to assess stunting, wasting, and underweight among children under five years age group. The present study is based on the analyses of data from the National Family Health Survey (NFHS-5, 2019-2021) and Central Water Commission (CWC) reports. The data were analyzed across flood-affected regions in India and categorized by the frequency of flood events (i.e., non-flooded; 1-2 times flooded; and three times flooded events). The analysis reveals a significant increase in malnutrition rates with higher flood exposure in regions experiencing three flood events, 38 percent of children were stunted, 20 percent were wasted, and 35.7 percent were underweight as compared to non-flooded areas. Factors such as low birth weight, maternal education, sanitation facilities, and household infrastructure intensified malnutrition outcomes. The major findings of the study suggested that repeated flooding events aggravate food insecurity and increase vulnerability to child malnutrition. This study not only highlights the compounded effects of flood exposure and socio-economic disparities on CIAF malnutrition but also offers policy-relevant insights. The results of the study highlight the urgent need for targeted interventions, including developing disaster-resilient infrastructure, educational programs for mothers, and enhanced access to sanitation and healthcare in flood-affected regions in India.