PMID- 30119652
OWN - NLM
STAT- MEDLINE
DCOM- 20180913
LR  - 20181202
IS  - 1471-2458 (Electronic)
IS  - 1471-2458 (Linking)
VI  - 18
IP  - 1
DP  - 2018 Aug 17
TI  - Spatial heterogeneity and correlates of child malnutrition in districts of India.
PG  - 1027
LID - 10.1186/s12889-018-5873-z [doi]
LID - 1027
AB  - BACKGROUND: Despite sustained economic growth and reduction in money metric 
      poverty in last two decades, prevalence of malnutrition remained high in India. 
      During 1992-2016, the prevalence of underweight among children had declined from 
      53% to 36%, stunting had declined from 52% to 38% while that of wasting had 
      increased from 17% to 21% in India. The national average in the level of 
      malnutrition conceals large variation across districts of India. Using data 
      from the recent round of National Family Health Survey (NFHS), 2015-16 this paper 
      examined the spatial heterogeneity and meso-scale correlates of child 
      malnutrition across 640 districts of India. METHODS: Moran's I statistics and 
      bivariate LISA maps were used to understand spatial dependence and clustering of 
      child malnutrition. Multiple regression, spatial lag and error models were used 
      to examine the correlates of malnutrition. Poverty, body mass index (BMI) of 
      mother, breastfeeding practices, full immunization, institutional births, 
      improved sanitation and electrification in the household were used as meso scale 
      correlates of malnutrition. RESULTS: The univariate Moran's I statistics was 
      0.65, 0.51 and 0.74 for stunting, wasting and underweight respectively suggesting 
      spatial heterogeneity of malnutrition in India. Bivariate Moran's I statistics of 
      stunting with BMI of mother was 0.52, 0.46 with poverty and - 0.52 with 
      sanitation. The pattern was similar with respect to wasting and underweight 
      suggesting spatial clustering of malnutrition against the meso scale correlates 
      in the geographical hotspots of India. Results of spatial error model suggested 
      that the coefficient of BMI of mother and poverty of household were strong and 
      significant predictors of stunting, wasting and underweight. The coefficient of 
      BMI in spatial error model was largest found for underweight (beta = 0.38, 95% CI: 
      0.29-0.48) followed by stunting (beta = 0.23, 95% CI: 0.14-0.33) and wasting 
      (beta = 0.11, 95% CI: 0.01-0.22). Women's educational attainment and breastfeeding 
      practices were also found significant for stunting and underweight. CONCLUSION: 
      Malnutrition across the districts of India is spatially clustered. Reduction of 
      poverty, improving women's education and health, sanitation and child feeding 
      knowledge can reduce the prevalence of malnutrition across India. Multisectoral 
      and targeted intervention in the geographical hotspots of malnutrition can reduce 
      malnutrition in India.
FAU - Khan, Junaid
AU  - Khan J
AUID- ORCID: 0000-0003-4662-2318
AD  - International Institute for Population Sciences, Govandi Station Road, Deonar, 
      Mumbai, 400088, India. statjun@gmail.com.
FAU - Mohanty, Sanjay K
AU  - Mohanty SK
AD  - Department of Fertility Studies, International Institute for Population Sciences, 
      Govandi Station Road, Deonar, Mumbai, 400088, India.
LA  - eng
PT  - Journal Article
DEP - 20180817
PL  - England
TA  - BMC Public Health
JT  - BMC public health
JID - 100968562
SB  - IM
MH  - Child Nutrition Disorders/*epidemiology
MH  - Child, Preschool
MH  - Growth Disorders/epidemiology
MH  - Health Surveys
MH  - Humans
MH  - India/epidemiology
MH  - Infant
MH  - Prevalence
MH  - Risk Factors
MH  - Socioeconomic Factors
MH  - Spatial Analysis
MH  - Thinness/epidemiology
MH  - Wasting Syndrome/epidemiology
PMC - PMC6098604
OTO - NOTNLM
OT  - India
OT  - Malnutrition
OT  - Spatial heterogeneity
OT  - Stunting
OT  - Underweight
OT  - Wasting
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: This study compiled the data 
      information from the district level fact sheets from National Family Health 
      Survey, 2015-16 for India which is publicly available and with no access to 
      personal identifiers. COMPETING INTERESTS: The authors declare that they have no 
      competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with 
      regard to jurisdictional claims in published maps and institutional affiliations.
EDAT- 2018/08/19 06:00
MHDA- 2018/09/14 06:00
PMCR- 2018/08/17
CRDT- 2018/08/19 06:00
PHST- 2018/01/12 00:00 [received]
PHST- 2018/07/23 00:00 [accepted]
PHST- 2018/08/19 06:00 [entrez]
PHST- 2018/08/19 06:00 [pubmed]
PHST- 2018/09/14 06:00 [medline]
PHST- 2018/08/17 00:00 [pmc-release]
AID - 10.1186/s12889-018-5873-z [pii]
AID - 5873 [pii]
AID - 10.1186/s12889-018-5873-z [doi]
PST - epublish
SO  - BMC Public Health. 2018 Aug 17;18(1):1027. doi: 10.1186/s12889-018-5873-z.