The Coexistence of Dual Malnutrition At Household Level in India: Evidence From The Comprehensive National Nutrition Study 2016–18

Objective: To examine the prevalence of DBM at national, state, regional level and its proximate determinants in households with a mother and child under 5 years of age. Methods The present study includes data on 38,060 children under 5 years of age and their biological mothers, drawn from the nationally representative Comprehensive National Nutrition Survey (CNNS) of children and adolescents aged 0–19 years in India. The outcome variable for this study was the double burden of malnutrition at the household level. A child was classified as stunted if the height was at least -2SD below the mean for their age. A mother with a body mass index (BMI) of more than or equal to 25kg/m2 (BMI ≥ 25 kg/m2) was considered as overweight. A binary variable with coexistence of both conditions was created and categorized as 1 (existence of stunted child and overweight mother), and 0 otherwise. Multivariate regression analysis was used to examine the association between DBM and covariates at maternal, child and household level. Results 3.4% of households were found to be with DBM, with higher prevalence in urban areas (6.2%) as compared to rural areas (2.5%). Inter-state and regional variations were present in the prevalence of DBM. The proportion of DBM was higher in households with mothers aged 30 years or more, mothers not working and those who had cesarean births. Prevalence of DBM was found to be higher in urban area and rich households. Conclusion This study shows the prevalence of DBM and its proximate determinants. These findings highlight the need for a comprehensive nutrition programme that targets both undernutrition and overnutrition. While formulating standalone policies for both forms of malnutrition is relatively easier, customized policies and programmes are needed to combat the conflicting situation of dietary excess and deprivation at the household level.