Trends in malnutrition among children in India: Growing inequalities across different economic groups

This paper examines the trends and patterns of economic inequalities with respect to child malnutrition by wealth status of population across major regions and states of India. Data from three rounds of National Family and Health Survey (NFHS) conducted during 1992-2006 were analyzed. The proportion of underweight children (measure of both acute and chronic malnutrition) has been used as a dependent variable. The wealth index is used as proxy for economic status of the population, and was estimated through principal component analysis by employing a set of variables representing durable asset ownership, access to utilities and infrastructure, and housing characteristics of respondents for all the three survey rounds. Bivariate analyses, poor-rich ratio and concentration indices were used to understand the trends in economic inequalities with respect to child malnutrition. Pooled logistic regression models were fitted to estimate the adjusted effect of economic status on the likelihood of child malnutrition over time. Results indicate sluggish change coupled with concomitant rise in economic inequalities with respect to child malnutrition in India during 1992-2006. The burden of malnutrition was disproportionately concentrated among poor children. In addition, average decline in malnutrition concealed large economic disparities across space and time. (C) 2011 Elsevier Ltd. All rights reserved.