Co-Occurrences of Forms of Child Undernutrition in India: Insights from the National Family Health Survey
2025
Pooja Arora | Mrigesh Bhatia | Laxmi Kant Dwivedi
Background: The composite index of anthropometric failure (CIAF) studies co-occurrences of three forms of child undernutrition: stunting (S), wasting (W), and underweight (U). This study attempts to modify it through the inclusion of a fourth form of undernutrition, that is, anaemia (A), serving as a proxy for micronutrient deficiencies among under-five children in India. Methods: Spatial and multivariate analyses were employed to analyse the co-occurrences of child undernutrition with reference to the child&rsquo:s and mother&rsquo:s characteristics using National Family Health Survey (NFHS) data. Results: The modified index of &ldquo:CIAF + Anaemia&rdquo: identified thirteen manifestations of child undernutrition in India, the most prevalent co-occurrence being &ldquo:only anaemia&rdquo: (30%), followed by a triple burden or co-occurrence of stunting, underweight, and anaemia (SUA) (12%). The prevalence of the quadruple burden of child undernutrition (SWUA) was found to be highest in the states of Jharkhand and Gujarat (7%). A higher likelihood of the co-occurrence of &ldquo:SUA&rdquo: was observed among underweight mothers (16%), whereas that of &ldquo:only anaemia&rdquo: was observed more among overweight mothers (35%) compared to their counterparts. The co-occurrences &ldquo:SUA&rdquo: and &ldquo:SWUA&rdquo: were found to be moderately clustered among the districts of India. Conclusions: Overall, the study reinforces the need for early identification and specialised treatment approaches for children burdened with multiple forms of undernutrition to prevent its scarring effect.
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