Do Ethnicity/Caste-Based Disparities Influence Childhood Anemia in India?

Using unit-level data from the two latest rounds of the cross-sectional National Family Health Survey (NFHS) 2015-2016 and 2019-2021, this study explores the role of etiological factors, such as social and environmental factors, maternal condition, and infectious diseases, on the occurrence of anemia in children from 6 to 59 months in India. Anonymized information on 106,466 singleton children aged 6-59 months and alive at the time of the survey was used from the NFHS 2015-2016 and 110,627 children from NFHS 2019-2021. The study uses logistic regression analysis to understand the association of various socioeconomic indicators with childhood anemia. Further, an exogenous switching treatment effect regression (ESTER) model was used to evaluate the causal impact of caste-based ethnicity. Contrary to other nutritional indicators that improved between the survey periods, the prevalence of anemia among children increased from 64% in 2015-2016 to 68% in 2019-2021. Results show maternal anemia as the most critical determinant, followed by maternal body mass index (BMI). The analysis also reveals that the risk of anemia decreases as the socioeconomic indicators improve. Irrespective of socioeconomic characteristics, there is a 1.5 times higher risk of childhood anemia in marginalized groups, particularly in Scheduled Tribes. Therefore, a deeper understanding of the underlying causes of anemia is crucial for designing policies to reduce the prevalence of anemia in India.