Hostname: page-component-848d4c4894-2xdlg Total loading time: 0 Render date: 2024-07-08T00:07:30.710Z Has data issue: false hasContentIssue false
  • English
  • Français

Linkage in stunting status of siblings: a new perspective on childhood undernutrition in India

Published online by Cambridge University Press:  11 November 2019

Kajori Banerjee Open the ORCID record for Kajori Banerjee [Opens in a new window]  and
Laxmi Kant Dwivedi
Kajori Banerjee*
Affiliation:
Department of Mathematical Demography and Statistics, International Institute for Population Sciences (IIPS), Mumbai, India
Laxmi Kant Dwivedi
Affiliation:
Department of Mathematical Demography and Statistics, International Institute for Population Sciences (IIPS), Mumbai, India
*
*Corresponding author. Email: kajori.b2012@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Almost 30% of the world’s stunted children reside in India. This study examined sibling linkage in childhood stunting by assessing the extent of clustering of stunted children born to the same mother. Data were taken from 225,002 children under the age of five from the Indian National Family and Health Survey (NFHS)-4 conducted in 2015–16. States with high fertility and lower socioeconomic development displayed higher clustering of childhood stunting among siblings. Simulating removal of this clustered burden showed an almost 10 percentage point reduction in stunting in India. Multinomial regression analysis highlighted that the propensity to have multiple stunted births was higher among less-educated women, scheduled caste/tribes and poor households. The multilevel model results indicated that the odds of stunting for the index child increased by 1.93 if the older sibling was stunted. The odds of the index child being stunted if the previous child was stunted were high, irrespective of the differences in state-level public health performances and political commitments. Although socioeconomic correlates play a crucial role in determining child stunting status, they also act as proxies for poor-quality intra-generational health. Clustering of stunting among siblings is an indicator of both genetic and environmental association with the height-for-age (HAZ) of children. Mothers with repeated stunted births should be prioritized and monitored over a substantial part of their lives. Inclusion of multiple child beneficiaries in nutrition policies and revisiting the ‘one size fits all’ concept at the micro level, owing to the substantial village/ward-level variation, might be an effective policy measure.

Keywords

Child growthFamily influencesStunting
Type
Research Article
Information
Journal of Biosocial Science , Volume 52 , Issue 5 , September 2020 , pp. 681 - 695
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arnold, F, Choe, MK and Roy, TK (1998) Son preference, the family-building process and child mortality in India. Population Studies 52(3), 301–315.CrossRefGoogle Scholar
Arulampalam, W and Bhalotra, S (2006) Sibling death clustering in India: state dependence versus unobserved heterogeneity. Journal of the Royal Statistical Society: Series A (Statistics in Society) 169(4), 829–848.CrossRefGoogle Scholar
Arulampalam, W and Bhalotra, S (2008) The linked survival prospects of siblings: evidence for the Indian states. Population Studies 62(2), 171–190.CrossRefGoogle ScholarPubMed
Barker, DJP, Godfrey, KM, Gluckman, PD, Harding, JE, Owens, JA and Robinson, JS (1993) Fetal nutrition and cardiovascular disease in adult life. The Lancet 341(8850), 938–941.CrossRefGoogle ScholarPubMed
Barker, DJP and Osmond, C (1986) Infant mortality, childhood nutrition, and ischaemic heart disease in England and Wales. The Lancet 327(8489), 1077–1081.CrossRefGoogle Scholar
Behrman, JR, Schott, W, Mani, S, Crookston, BT, Dearden, K, Duc, LTet al. (2017) Intergenerational Transmission of Poverty and Inequality: Parental Resources and Schooling Attainment and Children’s Human Capital in Ethiopia, India, Peru, and Vietnam. Economic Development and Cultural Change 65(4), 657–697.CrossRefGoogle ScholarPubMed
Bhutta, ZA, Ahmed, T, Black, RE, Cousens, S, Dewey, K, Giugliani, Eet al. (2008) What works? Interventions for maternal and child undernutrition and survival. The Lancet 371(9610), 417–440.CrossRefGoogle ScholarPubMed
Black, RE, Allen, LH, Bhutta, ZA, Caulfield, LE, de Onis, M, Ezzati, Met al. (2008) Maternal and child undernutrition: global and regional exposures and health consequences. The Lancet 371(9608), 243–260.CrossRefGoogle ScholarPubMed
Black, RE, Victora, CG, Walker, SP, Bhutta, ZA, Christian, P, de Onis, Met al. (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet 382(9890), 427–451.CrossRefGoogle ScholarPubMed
Caulfield, LE, Richard, SA, Rivera, JA, Musgrove, P and Black, RE (2006) Stunting, wasting, and micronutrient deficiency disorders. In Jamison, DTet al. (eds) Disease Control Priorities in Developing Countries. Oxford University Press, New York, pp. 551–567.Google ScholarPubMed
Chalasani, S (2012) Understanding wealth-based inequalities in child health in India: a decomposition approach. Social Science & Medicine 75(12), 2160–2169.CrossRefGoogle ScholarPubMed
Gupta, MD (1987) Selective discrimination against female children in rural Punjab, India. Population and Development Review 13(1), 77–100.CrossRefGoogle Scholar
Das Gupta, M (1990) Death clustering, mothers’ education and the determinants of child mortality in rural Punjab, India. Population Studies 44(3), 489–505.CrossRefGoogle Scholar
Fenske, N, Burns, J, Hothorn, T and Rehfuess, EA (2013) Understanding child stunting in India: a comprehensive analysis of socio-economic, nutritional and environmental determinants using additive quantile regression. PloS One 8(11), e78692.CrossRefGoogle ScholarPubMed
Fledderjohann, J, Agrawal, S, Vellakkal, S, Basu, S, Campbell, O, Doyle, Pet al. (2014) Do girls have a nutritional disadvantage compared with boys? Statistical models of breastfeeding and food consumption inequalities among Indian siblings. PloS One 9(9), e107172.CrossRefGoogle ScholarPubMed
Glewwe, P and Miguel, EA (2007) The impact of child health and nutrition on education in less developed countries. Handbook of Development Economics 4, 3561–3606.CrossRefGoogle Scholar
Gragnolati, M, Shekar, M, Das Gupta, M, Bredenkamp, C and Lee, Y-K (2005) India’s undernourished children: a call for reform and action No. Health, Nutrition and Population (HNP) Discussion Paper, World Bank Publications, Washington, DC.Google Scholar
Griffiths, P, Matthews, Z and Hinde, A (2002) Gender, family, and the nutritional status of children in three culturally contrasting states of India. Social Science & Medicine 55(5), 775–790.CrossRefGoogle ScholarPubMed
Guven, C and Lee, W-S (2015) Height, aging and cognitive abilities across Europe. Economics & Human Biology 16, 16–29.CrossRefGoogle ScholarPubMed
Heaver, R (2002) India’s Tamil Nadu Nutrition Program: Lessons and Issues in Management and Capacity Development. HNP Discussion Paper, World Bank, Washington, DC.Google Scholar
Hoddinott, J, Behrman, JR, Maluccio, JA, Melgar, P, Quisumbing, AR, Ramirez-Zea, et al. (2013) Adult consequences of growth failure in early childhood. American Journal of Clinical Nutrition 98(5), 1170–1178.CrossRefGoogle ScholarPubMed
Naandi Foundation (2011) HUNGaMA: Fighting Hunger and Malnutrition. Naandi Foundation, Hyderabad.Google Scholar
IIPS and ICF (2017) National Family Health Survey (NFHS-4), 2015–16: India. Mumbai, India.Google Scholar
Jayachandran, S and Pande, R (2017) Why are Indian children so short? The role of birth order and son preference. American Economic Review 107(9), 2600–2629.CrossRefGoogle ScholarPubMed
Joe, W, Rajaram, R and Subramanian, SV (2016) Understanding the null‐to‐small association between increased macroeconomic growth and reducing child undernutrition in India: role of development expenditures and poverty alleviation. Maternal & Child Nutrition 12(S1), 196–209.CrossRefGoogle ScholarPubMed
Kanjilal, B, Mazumdar, PG, Mukherjee, M and Rahman, MH (2010) Nutritional status of children in India: household socio-economic condition as the contextual determinant. International Journal for Equity in Health 9(1), 19.CrossRefGoogle ScholarPubMed
Lee, S-H and Mason, A (2005) Mother’s education, learning-by-doing, and child health care in rural India. Comparative Education Review 49(4), 534–551.CrossRefGoogle Scholar
Lokshin, M, Das Gupta, M, Gragnolati, M and Ivaschenko, O (2005) Improving child nutrition? The integrated child development services in India. Development and Change 36(4), 613–640.CrossRefGoogle Scholar
Martorell, R and Zongrone, A (2012) Intergenerational influences on child growth and undernutrition. Paediatric and Perinatal Epidemiology 26(s1), 302–314.CrossRefGoogle ScholarPubMed
Ministry of Women and Child Development (2017) Pradhan Mantri Matru Vandana Yojana (PMMVY) : Scheme Implementation Guidelines. Ministry of Women and Child Development, New Delhi.Google Scholar
Mohmand, SK (2012) Policies Without Politics: Analysing Nutrition Governance in India. UKAid, Institute of Development Studies. URL: http://www.ids.ac.uk/idsproject/analysing-nutrition-governanceGoogle Scholar
Mussa, R (2015) Intrahousehold and interhousehold child nutrition inequality in Malawi. South African Journal of Economics 83(1), 140–153.CrossRefGoogle Scholar
Onis, M (2006) Assessment of differences in linear growth among populations in the WHO Multicentre Growth Reference Study. Acta Paediatrica 95(S450), 56–65.Google Scholar
Onis, M and Branca, F (2016) Childhood stunting: a global perspective. Maternal & Child Nutrition 12(S1), 12–26.CrossRefGoogle ScholarPubMed
Pande, RP and Yazbeck, AS (2003) What’s in a country average? Wealth, gender, and regional inequalities in immunization in India. Social Science & Medicine 57, 2075–2088.CrossRefGoogle Scholar
Sastry, N (1997) Family-level clustering of childhood mortality risk in Northeast Brazil. Population Studies 51(3), 245–261.CrossRefGoogle Scholar
Schott, WB, Crookston, BT, Lundeen, EA, Stein, AD and Behrman, JR (2013) Periods of child growth up to age 8 years in Ethiopia, India, Peru and Vietnam: key distal household and community factors. Social Science & Medicine 97, 278–287.CrossRefGoogle ScholarPubMed
Scrimshaw, NS and SanGiovanni, JP (1997) Synergism of nutrition, infection, and immunity: an overview. American Journal of Clinical Nutrition 66(2), 464S–477S.CrossRefGoogle ScholarPubMed
Singh, A, Arokiasamy, P, Pradhan, J, Jain, K and Patel, SK (2016) Sibling- and family-level clustering of underweight children in Northern India. Journal of Biosocial Science 49(3), 348–363.CrossRefGoogle ScholarPubMed
Smith, LC and Haddad, LJ (2000) Explaining Child Malnutrition in Developing Countries: A Cross-Country Analysis. Research Report 111. International Food Policy Research Institute, Washington, DC.Google Scholar
Solon, G, Corcoran, M, Gordon, R and Laren, D (1991) A longitudinal analysis of sibling correlations in economic status. The Journal of Human Resources 26(3), 509–534.CrossRefGoogle Scholar
Strauss, J and Thomas, D (1998) Health, nutrition, and economic development. Journal of Economic Literature 36(2), 766–817.Google Scholar
Subramanian, SV, Ackerson, LK, Smith, GD and John, NA (2009) Association of maternal height with child mortality, anthropometric failure, and anemia in India. JAMA 301(16), 1691–1701.CrossRefGoogle ScholarPubMed
Subramanian, SV, Joe, W and Venkataramanan, R (2018) India lives in her villages, not districts: an exclusive focus on districts in policymaking can be misleading in the presence of large village-level variation. Live Mint. URL: https://www.livemint.com/Opinion/fPriQPiSkdJb64UWW6mMZI/India-lives-in-her-villages-not-districts.html (accessed 20th April, 2018).Google Scholar
Subramanian, SV, Kawachi, I and Smith, GD (2007) Income inequality and the double burden of under- and overnutrition in India. Journal of Epidemiology & Community Health 61(9), 802–809.CrossRefGoogle ScholarPubMed
Subramanian, SV, Mejía‐Guevara, I and Krishna, A (2016) Rethinking policy perspectives on childhood stunting: time to formulate a structural and multifactorial strategy. Maternal & Child Nutrition 12(S1), 219–236.CrossRefGoogle ScholarPubMed
Subramanyam, MA, Kawachi, I, Berkman, LF and Subramanian, SV (2011) Is economic growth associated with reduction in child undernutrition in India? PLoS Medicine 8(3), e1000424.CrossRefGoogle ScholarPubMed
Tanner, JM, Healy, MJR, Lockhart, RD, Mackenzie, JD and Whitehouse, RH (1956) Aberdeen growth study: I. The prediction of adult body measurements from measurements taken each year from birth to 5 years. Archives of Disease in Childhood 31(159), 372.CrossRefGoogle Scholar
UNICEF (1990) Strategy for Improved Nutrition of Children and Women in Developing Countries. UNICEF, New York.Google Scholar
UNICEF (2007) The State of the World’s Children 2008:Child Survival, Volume 8. UNICEF, New York.Google Scholar
UNICEF (2013) Improving Child Nutrition: The Achievable Imperative for Global Progress. UNICEF, New York.Google Scholar
Vikram, K, Vanneman, R and Desai, S (2012) Linkages between maternal education and childhood immunization in India. Social Science & Medicine 75(2), 331–339.CrossRefGoogle ScholarPubMed
WHO Multicentre Growth Reference Study Group (2006) WHO Child Growth Standards. World Health Organization, Geneva.Google Scholar
World Health Organization (2010) Nutrition Landscape Information System (NLIS) Country Profile Indicators: Interpretation Guide. WHO Document Production Services, World Health Organization, Geneva.Google Scholar