Title: Does the community SES modify the household-level effects on child malnutrition in the Empowered Action Group (EAG) states of India?

Despite sustained economic growth, reduction in money metric poverty and introduction of innovative health programmes in last two decades, the reduction in child malnutrition has been sluggish in India. By 2005-06, about half of the children continued to be malnourished with large variation across states. Though empirical research has established the household wealth and maternal characteristics as significant predictors of child malnutrition, little is known about the role of community and parental attributes in explaining child malnutrition in India. The aim of this paper is to examine the role of community and household factors in explaining malnutrition among children under five in the Empowered Action Group (EAG) states of India. The eight EAG states constitute about half of India’s population and lag behind in key demographic and socioeconomic indicators. The unit data from National Family Health Survey (NFHS) 3 is used in the analyses. Bivariate analyses, concentration curves and multilevel models are used to understand the patterning and contextual effects of child malnutrition in the EAG states. The dependent variables, weight-for-age, height-for-age and weight-for-height are analysed with respect to three composite indices; community socioeconomic status (SES), household wealth and household social status. Results indicate that in EAG states half of children in poor communities and households were underweight, stunted and one fourth were wasted. The prevalence of underweight is higher among children belonging to poor households that are located in poor communities rather than those located in rich communities. The multilevel results indicate that controlling for individual characteristics community SES, household wealth and household social status were significant predictors in determining child malnutrition. The cross level interaction between community SES and household social status was significant in EAG states but not in the non EAG states. This implies that the community infrastructure and accessibility to basic health services can play a significant role in reducing child malnutrition in EAG states of India.