Role of individual and household level factors on stunting: a comparative study in three Indian states

BACKGROUND: Status of growth especially in early childhood is not only the most important determinant of health of a child but also a reflection of the well-being of the entire society. The extent of malnutrition in India is very high, but the exact magnitude varies considerably depending on which indicator is used. Child health in this paper is measured through chronic malnutrition (termed as stunting). Three states were selected, namely Bihar, West Bengal and Kerala. These three states represent the three stages of development. Bihar is one of the least and Kerala is one of the most developed states in India. AIM: The present paper aims to investigate the degree of chronic malnutrition in the context of socio-economic, demographic and other characteristics of the children and their households in the three selected states in India. SUBJECTS AND METHODS: The data for this study were taken from the National Family Health Survey (NFHS-2) conducted by the International Institute for Population Sciences (IIPS), Mumbai, in 1998-1999. The NFHS-2 sample covers ever-married women in the age group 15-49 years from 26 states in India. Besides collecting information on health, the survey collects data on socio-economic and demographic characteristics at individual and household level. RESULTS: The percentage of stunting of children in Bihar, West Bengal and Kerala was found to be 54, 39 and 23%, respectively. Regression analysis showed that the major factors that significantly influenced the status of health in the children in all three states were women's education and the household condition index. Months of breastfeeding and birth interval also had some association with health status. The effect of the above-mentioned variables was most prominent in Bihar and least in Kerala in terms of statistical significance. CONCLUSION: There is a close positive link between the nutritional status of pre-school children and the stages of development of the states. Mothers' education and household condition are important influences on children's health status irrespective of the stage of development.