Identifying Factors Associated with the Level of Child Malnutrition in India: Observations from the Comprehensive National Nutrition Survey

Background: Malnutrition is a complex phenomenon that has become a universal problem inhibiting human development. India is home of disproportionate height and weight of children including anemia are sign of malnutrition. This study aimed to examine child malnutrition by considering three parameters—stunting (short), underweight (thin), and/or anaemia—among children aged 1–9 years. Methods: This study used nationally representative data from the Comprehensive National Nutrition Survey (CNNS). The analytic sample was restricted to 25,885 children aged 1–9 years for whom data on height, weight, and haemoglobin level was available. This analytic sample was not significantly different from the total sample of 69,413. Based on World Health Organisation’s (WHO) cut-off for child growth standards, child malnutrition is defined as ‘severe’ if a child has suffered all 3 parameters—stunting, underweight, and anaemia, ‘mild/moderate’ if a child has suffered 1 or 2 parameters and ‘none’ if a child has not suffered from any of the 3 parameters. Univariate and bivariate analysis were used for descriptive associations and marginal effects probabilities were calculated using the ordinal logit regression model to identify the correlates of severe malnutrition. Results: Nine percent of children aged 1-9 years were severely malnourished in the country. The prevalence of malnutrition declined considerably with increasing age of children—13% in children aged 1–4 years to 6% in children aged 5–9 years. Severe malnutrition was significantly higher among higher birth order children, children born to illiterate mothers, children belonging to Scheduled Tribes and poor families, children living in rural areas and the eastern region of the country. Zinc deficiency was found more (22%, 95% CI:18.2–26.0) among severely malnourished children as compared to normal children (16%, 95% CI:13.9–17.3). Conclusions: Malnutrition is widely prevalent in children belonging to illiterate mothers, Scheduled Tribes, poor families, rural areas, and eastern region of the country. Frontline workers should identify such vulnerable children through regular monitoring of height, weight, and haemoglobin testing in their coverage areas.