Open Access Open Access  Restricted Access Subscription Access

Risk factors in childhood stunting in Karnataka, India, vary by geography


Affiliations
1 Tata Cornell Institute, Cornell University, Ithaca, NY 14853, USA; Centre for Human Genetics, Electronic City, Bengaluru 560 100, India
2 Department of Biology and Society, Cornell University, Ithaca, NY 14853, United States
3 Tata Cornell Institute, Cornell University, Ithaca, NY 14853, United States
4 Centre for Human Genetics, Electronic City, Bengaluru 560 100, India
5 Centre for Human Genetics, Electronic City, Bengaluru 560 100, India
6 Tata Cornell Institute, Cornell University, Ithaca, NY 14853, India
 

Childhood stunting remains a public health concern in India. In Karnataka, the districts vary substantially in stunting prevalence. Using the NFHS-4 and AidData GEO datasets, we tested the hypothesis that ‘wet’ and ‘dry’ districts in Karnataka show different contributions to stunting. We found that for 30 environmental and health factors, Bengaluru appears to be distinct from the other districts. Using a mixed linear model approach, we found that for the entire state, and in both wet and dry districts, preceding birth interval, altitude-adjusted haemoglobin level and child age showed significant correlations with height for age (HFA). The wet districts showed an additional association between maternal age and child HFA. However, interaction effects also differed among the three conditions. Our results suggest that subtle variations should not be ignored when considering factors impacting child health outcomes.

Keywords

Childhood stunting in Karnataka, environment, genetics, nutrition, public health.
User
Notifications
Font Size

  • Bhutta, Z. A. et al., Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet, 2013, 382, 452–477.
  • Malnutrition in Children – UNICEF Data, 2021; https://data.unicef.org/topic/nutrition/malnutrition/ (accessed on 10 July 2021).
  • Menon, P., Headey, D., Avula, R. and Nguyen, P. H., Understanding the geographical burden of stunting in India: a regressiondecomposition analysis of district-level data from 2015–16. Matern. Child Nutr., 2018, e12620.
  • Pingali, P., Aiyar, A., Abraham, M. and Rahman, A., Transforming Food Systems for a Rising India, Palgrave Macmillan, 2019, 1st edn.
  • Li, Z., Kim, R., Vollmer, S. and Subramanian, S. V., Factors associated with child stunting, wasting and underweight in 35 low- and middle-income countries. JAMA Netw. Open, 2020, 3, e203386.
  • India state-level disease burden initiative CGF collaborators, mapping of variations in child stunting, wasting and underweight within the states of India: the global burden of disease study 2000– 2017. EClinicalMedicine, 2020, 22, 100317.
  • Mohanty, S. K., Mishra, N. R., Khan, J., Vasishtha, G. and Mishra, U. S., State of health in the districts of India. In The Demographic and Development Divide in India: A District-Level Analyses (eds Mohanty, S. K. et al.), Springer, Singapore, 2019, pp. 329–373.
  • Goodman, S., Ben Yishay, A., Runfola, D, Overview of the geo framework. AidData, 2017.
  • IIPS and ICF, National Family Health Survey (NFHS-4), 2015– 16: India. International Institute for Population Sciences, Mumbai, 2017.
  • Annual Seasonal Rainfall and Area Coverage during 2017 in Karnataka, Directorate of Economics and Statistics, Government of Karnataka, 2018.
  • Cooper, M. W. et al., Mapping the effects of drought on child stunting. Proc. Natl. Acad. Sci. USA, 2019, 116, 17219–17224.
  • Jayachandran, S. and Pande, R., Why are Indian children so short? Am. Econ. Rev., 2017, 107(9), 2600–2629.
  • Abera, L., Dejene, T. and Laelago, T., Magnitude of stunting and its determinants in children aged 6–59 months among rural residents of Damot Gale district; southern Ethiopia. BMC Res. Notes, 2018, 11, 557.
  • Mengistu, K., Alemu, K. and Destaw, B., Prevalence of malnutrition and associated factors among children aged 6–59 months at Hidabu Abote district, North Shewa, Oromia regional state. J. Nutr, Disord. Therapy, 2013, 6, 1–8.
  • Moges, B., Feleke, A., Meseret, S. and Doyore, F., Magnitude of stunting and associated factors among 6–59 months old children in Hossana town, southern Ethiopia. J. Clin. Res. Bioeth., 2015, 6, 1.
  • Asres, G. and Eidelman, A. I., Nutritional assessment of Ethiopian Beta-Israel children: a cross-sectional survey. Breastfeed. Med., 2011, 6, 171–176.
  • Adhikari, R. P., Shrestha, M. L., Acharya, A. and Upadhaya, N., Determinants of stunting among children aged 0–59 months in Nepal: findings from Nepal Demographic and health Survey, 2006, 2011 and 2016. BMC Nutr., 2019, 5, 37.
  • Khan, N. C., Tuyen, L. D., Ngoc, T. X., Duong, P. H. and Khoi, H. H., Reduction in childhood malnutrition in Vietnam from 1990 to 2004. Asia Pac. J. Clin. Nutr., 2007, 16, 274–278.
  • Hien, N. N. and Kam, S., Nutritional status and the characteristics related to malnutrition in children under five years of age in Nghean, Vietnam. J. Prev. Med. Public Health, 2008, 41, 232– 240.
  • Ulak, M., Chandyo, R. K., Mellander, L., Shrestha, P. S. and Strand, T. A., Infant feeding practices in Bhaktapur, Nepal: a cross-sectional, health facility based survey. Int. Breastfeed. J., 2012, 7, 1.
  • Munro, A., Kebede, B., Tarazona-Gomez, M. and Verschoor, A., Autonomy and efficiency. An experiment on household decisions in two regions of India. J. Jpn. Int. Econ., 2014, 33, 114–133.
  • Desai, S. and Andrist, L., Gender scripts and age at marriage in India. Demography, 2010, 47, 667–687.
  • Nahar, S. and Pillai, V. K., Girl child discrimination and child stunting in India: what can be done? Int. J. Commun. Soc. Develop., 2019, 1, 75–86.
  • Mertens, A. et al., Associations between high temperature, heavy rainfall, and diarrhea among young children in rural Tamil Nadu, India: a prospective cohort study. Environ. Health Perspect., 2019, 127, 47004.
  • Guerrant, R. L., DeBoer, M. D., Moore, S. R., Scharf, R. J. and Lima, A. A. M., The impoverished gut – a triple burden of diarrhoea, stunting and chronic disease. Nat. Rev. Gastroenterol. Hepatol., 2013, 10, 220–229.

Abstract Views: 379

PDF Views: 132




  • Risk factors in childhood stunting in Karnataka, India, vary by geography

Abstract Views: 379  |  PDF Views: 132

Authors

Srilakshmi M. Raj
Tata Cornell Institute, Cornell University, Ithaca, NY 14853, USA; Centre for Human Genetics, Electronic City, Bengaluru 560 100, India
Ruwanthi Ekanayake
Department of Biology and Society, Cornell University, Ithaca, NY 14853, United States
Kiera Crowley
Tata Cornell Institute, Cornell University, Ithaca, NY 14853, United States
Meenakshi Bhat
Centre for Human Genetics, Electronic City, Bengaluru 560 100, India
Jayarama Kadandale
Centre for Human Genetics, Electronic City, Bengaluru 560 100, India
Prabhu L. Pingali
Tata Cornell Institute, Cornell University, Ithaca, NY 14853, India

Abstract


Childhood stunting remains a public health concern in India. In Karnataka, the districts vary substantially in stunting prevalence. Using the NFHS-4 and AidData GEO datasets, we tested the hypothesis that ‘wet’ and ‘dry’ districts in Karnataka show different contributions to stunting. We found that for 30 environmental and health factors, Bengaluru appears to be distinct from the other districts. Using a mixed linear model approach, we found that for the entire state, and in both wet and dry districts, preceding birth interval, altitude-adjusted haemoglobin level and child age showed significant correlations with height for age (HFA). The wet districts showed an additional association between maternal age and child HFA. However, interaction effects also differed among the three conditions. Our results suggest that subtle variations should not be ignored when considering factors impacting child health outcomes.

Keywords


Childhood stunting in Karnataka, environment, genetics, nutrition, public health.

References





DOI: https://doi.org/10.18520/cs%2Fv121%2Fi4%2F502-510