Rajaram Yadav, Kalosona Paul and Shrestha Saha
Nutrition, Stunting, Underweight, wasted, BMI, Oaxaca Decomposition Model
|PUBLISHED DATE||April 2016|
|PUBLISHER||The Author(s) 2016. This article is published with open access at www.chitkara.edu. in/publications|
It is well known that child nutrition is affected by many factors like socio-cultural, economic and demographic, etc. Studies found that maternal education, wealth index, and ethnicity have an influence on child nutrition. In this paper, comparative study of malnutrition among children and mothers between 1992-93 and 2005-06 has been done.
Objective: The main objective of the paper is to study how progress in demographic and other socioeconomic factors influence nutritional status of mother and children.
Data and Methods: First round (1992-93) and third round (2005-06) of National Family Health Survey has been used to reach the objective of the study. To show the progress in nutritional status, percentage change in prevalence of malnutrition in different background characteristics from 1992-93 to 2005-06 has been calculated. To show the progress in different background characteristics and its effect on child malnutrition decomposition analysis has been done.
Result: Almost all variable are significantly associated with child malnutrition thus more contribution of any variable in bringing the change in prevalence of malnutrition shows the more progress in that variable from 1992-93 to 2005- 06. The decomposition analysis clearly shows that the condition of mother’s education and timing to initiate breastfeeding are found to be contributing significantly to the reduction of underweight among children between 1992- 93 and 2005-06.
Conclusion: This study shows that improvement in mother’s education contributed the most in improving the nutritional status of children. Thus by increasing the educational in female under-nutrition can be reduced to a larger extent.
Nutrition is the energy available to the body cells to fulfill the energy requirement of the body and malnutrition is the state when a body doesn’t get required level of energy through food intake. Malnutrition among children is caused by inadequate or improper food intake or repeated attack of parasitic or other childhood diseases like diarrhea [11, 13]. NFHS – 1 has calculated percentage of malnourished children below age four as stunted(52%), underweight(54%) and wasted(17%) . According to NFHS-3, 48% children below five years were stunted, 42.5% underweight and 19.8% wasted. Mean BMI of women in India was found to be 20.5 kg/m2 in 2005-06 and prevalence of anemia among women was 55.3% . The adolescent pregnancy wastage is considerably higher (15–20%) specially in case of teenage pregnancy . The prevalence of overweight and obesity is higher among rural women than their tribal counterparts. Three standard indices of physical growth that describe the nutritional status of children are: height-for-age (stunting), weightfor-height (wasting) and weight-for-age (underweight), each of these three indicators is expressed in standard deviation units (Z-scores) from the median of the reference population . Malnourishment or undernutrition is another common factor found among the children born to adolescent mothers. It has been categorized as acute and chronic considering the duration over which it occurred. The acute form of malnutrition mainly affects the weight of the body than height whereas in chronic malnutrition both weight and height of the body are affected. India has the highest percentage of malnourished children along with Ethiopia, Bangladesh and Nepal. Irrespective of state’s level of development, widespread diversity is found in the level of malnourishment of children in the country. .
Underweight is the indicator of acute malnutrition, stunting is the indicator of chronic malnutrition whereas wasting is the composite measure of acute and chronic malnutrition in children . Malnutrition in developing countries is due to poor diet and exposure to repeated illness . Better child nutrition is an important part of child health since nutrition during childhood makes a major contribution to child development, growth, and survival, ultimately influencing the human and social capital of a society. The breastfeeding plays a very important role in the post-neonatal period. The mother’s milk not only provides the complete nutritional requirements of the child but also provides protection against infections .
Socioeconomic well being of a family determines the nutritional intake of the children which affects the nutritional status of children to a large extent. The main reason for steep rise in child malnutrition during first two years of life is poor infant feeding practices . The government of India promotes exclusive breast feeding up to six months of life and other supplementary foods after that. The modern science and technology has not been able to produce a better food for young infants that can replace mother’s milk. It is well known that child nutrition is affected by many factors like socio-culturaleconomic and demographic etc. studies found that maternal education, wealth index and ethnicity have influence on child nutrition . The prevalence and severity of underweight children varied significantly by age. the prevalence of stunting both moderate and severe form increases up to the age three and decline marginally thereafter, the rate of growth is maximum up to 36 month of life and lowers thereafter henace the prevalence is maximum at this age. The stunting among children is lower among the first born children and higher among children with birth order above three .
Malnutrition is costing poor countries up to 3 percent of their yearly GDP, malnourished in children decreases their life time earnings by about 10 percent. Malnourished children are more likely to join school late and drop out early and also they are less likely to benefit from schooling and eventually they would have lower earning potential than other healthy adults in near future. The popular notion that the amount of food intake determines the level of nutrition turns to be untrue when children of wealthy family suffers the outcome of malnutrition like stunting or underweight therefore, the choice of food with its amount are two important facts to determine the nutrition level of human body. The food intake at the time of pregnancy plays an important role in determining the health of new born. In developing countries sometimes the under weight babies are born due to low calorie intake of mother during pregnancy. Sometimes babies are deprived from having ‘colostrums’ which strengthen the child’s immune system . Ideally a baby should be put to mother’s breast immediately after the birth, but in India about 46% babies have to wait to be put to breastfed for more than a day. In some of the poor states like Uttar Pradesh and Bihar this percentage is very high 76% and 70% respectively (estimated from NFHS-3).
Child malnutrition is highly associated with maternal education. The children whose mother has the only primary education or no education tend to have lower nutritional status in comparison to children whose mothers are more educated . The age of the child, birth order, and household’s economic status all have independent effects on child nutritional status. Considering the strong influence of maternal education on child nutritional status, the women’s education and literacy program could play an important role in improving child nutritional status . The prevalence of malnutrition is high and diversification of dietary intake is low in India. In 1999-2000 for average caloric intakes India was ranked at 67th among 167 countries, it means more than half of the developing countries have a lower prevalence of under-nutrition than those of India. The states which are growing faster can improve literacy rates and reduce infant mortality rates and proportion of children severely malnourished 
|ISSN||Print : 2393-8536, Online : 2393-8544|
As far as nutrition level of children is concerned, Haryana shows the maximum change in percentage of stunted and wasted children, followed by Rajasthan and Jharkhand. Poverty, lack of nutritional food, low breastfeeding of infants due to mother’s employment (mostly daily wage laborers), low mother education are the main causes of under nutrition in children (GOI, 2012). The decomposition analysis clearly shows that the condition of mother’s education and timing to initiate the breastfeeding are the significantly contributing factors to the reduction of underweight among children in the period of 1993 to 2006. Mother’s age at first birth and birth order also have played a crucial role in lowering the prevalence of underweight among children during 1993 and 2006. Finally, the demographic and health dimensions like birth spacing, mother’s BMI, mother’s age at first birth, parity, birth order, time of initiation of breastfeeding have shown evidence that they play an important role in deciding the nutritional status of children as well as mothers. The results of the rank Correlation analysis clearly shows that states with poor nutritional level among women also lag behind in nutritional level among children. The nutritional health policy in India requires an effective and responsive public health system bat the state/region/district level to provide easy access to health care services. There is a greater need basic education for compulsory to the lower age of marriage girls cohort population. Additionally, in India, several schemes and policies should be launched at the gross root level for particular of adolescent mothers and their child, to ensure their proper health system.