Child Nutrition in India

Malnutrition plagues a disproportionately large number of children in India compared with most other countries. National-level data on child malnutrition in India have, however, been scarce. Recognizing this gap, India’s 1992–93 National Family Health Survey (NFHS) collected anthropometric data on the height and weight of children below four years of age. The NFHS is based on a large, nationally representative sample and therefore offers a unique opportunity to study the levels and determinants of child malnutrition in the country. This report estimates levels of child malnutrition and effects of selected demographic and socioeconomic factors on child malnutrition. The analysis focuses primarily on the country as a whole, with some findings for individual states. The results of the study indicate high levels of both chronic and acute malnutrition among Indian children. Fifty-two percent of all children below age four are stunted (as measured by height-for-age), 54 percent are underweight (as measured by weightfor-age), and 17 percent are wasted (as measured by weight-for-height). The extent of severe malnutrition is also substantial. Twenty-nine percent of the children are severely stunted, 22 percent are severely underweight, and 3 percent are severely wasted, according to internationally accepted definitions. The lower prevalence of wasting than stunting or underweight indicates that chronic malnutrition is more prevalent in India than acute malnutrition. Although less severe in percentage terms, the prevalence of wasting in India is about 8 times and the prevalence of severe wasting is about 25 times the prevalence in the international reference population that provides the basis for comparison. There is considerable variation in the prevalence of malnutrition by state. Among the states, Bihar and Kerala have the highest and lowest prevalence of malnutrition, respectively. Even in Kerala, which has the lowest prevalence, 27 percent of children below age four are stunted, 28 percent are underweight, and 12 percent are wasted. A multivariate analysis of the effects of selected demographic and socioeconomic factors on child malnutrition indicates that the strongest predictors of child nutrition in India are child’s age, child’s birth order, mother’s education, and household standard of living. Older children and children of higher birth order are more likely to be malnourished. Children whose mothers are more educated and children who live in households with a relatively high standard of living tend to be better nourished than