Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016

Wealth inequality in anthropometric failure is a persistent concern for policymakers in India. This necessitates a comprehensive analysis and identification of various risk factors that can explain the poor-rich gap in anthropometric failure among children in India. We analyze the fifth and fourth r...

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Main Authors: Gaurav Dhamija, Mudit Kapoor, Rockli Kim, S.V. Subramanian
Format: Article
Language:English
Published: Elsevier 2023-09-01
Series:SSM: Population Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352827323001477
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author Gaurav Dhamija
Mudit Kapoor
Rockli Kim
S.V. Subramanian
author_facet Gaurav Dhamija
Mudit Kapoor
Rockli Kim
S.V. Subramanian
author_sort Gaurav Dhamija
collection DOAJ
description Wealth inequality in anthropometric failure is a persistent concern for policymakers in India. This necessitates a comprehensive analysis and identification of various risk factors that can explain the poor-rich gap in anthropometric failure among children in India. We analyze the fifth and fourth rounds of the Indian National Family Health Survey collected from June 2019 to April 2021 and January 2015 to December 2016, respectively. Two samples of children aged 0–59 and 6–23 months old with singleton birth, alive at the time of the survey with non-pregnant mothers, and with valid data on stunting, severe stunting, underweight, severely underweight, wasting, and severe wasting are included in the analytical samples from both rounds. We estimate the wealth gradients and distribution of wealth among children with anthropometric failure. Wealth gap in anthropometric failure is identified using logistic regression analysis. The contribution of risk factors in explaining the poor-rich gap in AF is estimated by the multivariate decomposition analysis. We observe a negative wealth gradient for each measure of anthropometric failure. Wealth distributions indicate that at least 60% of the population burden of anthropometric failure is among the poor and poorest wealth groups. Even among children with similar modifiable risk factors, children from poor and poorest backgrounds have a higher prevalence of anthropometric failure compared to children from the richest backgrounds. Maternal BMI, exposure to mass media, and access to sanitary facility are the most significant risk factors that explain the poor-rich gap in anthropometric failure. This evidence suggests that the burden of anthropometric failure and its risk factors are unevenly distributed in India. The policy interventions focusing on maternal and child health, implemented with a targeted approach prioritizing the vulnerable groups, can only partially bridge the poor-rich gap in anthropometric failure. The role of anti-poverty programs and growth is essential to narrow this gap in anthropometric failure.
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spelling doaj.art-47282ebe8a90413f81cf4081b13e0edb2023-09-01T05:02:39ZengElsevierSSM: Population Health2352-82732023-09-0123101482Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016Gaurav Dhamija0Mudit Kapoor1Rockli Kim2S.V. Subramanian3Indian Institute of Technology Hyderabad, Telangana, IndiaIndian Statistical Institute, New Delhi, IndiaDivision of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea; Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South KoreaDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Harvard Center for Population and Development Studies, Cambridge, MA, USA; Corresponding author. Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.Wealth inequality in anthropometric failure is a persistent concern for policymakers in India. This necessitates a comprehensive analysis and identification of various risk factors that can explain the poor-rich gap in anthropometric failure among children in India. We analyze the fifth and fourth rounds of the Indian National Family Health Survey collected from June 2019 to April 2021 and January 2015 to December 2016, respectively. Two samples of children aged 0–59 and 6–23 months old with singleton birth, alive at the time of the survey with non-pregnant mothers, and with valid data on stunting, severe stunting, underweight, severely underweight, wasting, and severe wasting are included in the analytical samples from both rounds. We estimate the wealth gradients and distribution of wealth among children with anthropometric failure. Wealth gap in anthropometric failure is identified using logistic regression analysis. The contribution of risk factors in explaining the poor-rich gap in AF is estimated by the multivariate decomposition analysis. We observe a negative wealth gradient for each measure of anthropometric failure. Wealth distributions indicate that at least 60% of the population burden of anthropometric failure is among the poor and poorest wealth groups. Even among children with similar modifiable risk factors, children from poor and poorest backgrounds have a higher prevalence of anthropometric failure compared to children from the richest backgrounds. Maternal BMI, exposure to mass media, and access to sanitary facility are the most significant risk factors that explain the poor-rich gap in anthropometric failure. This evidence suggests that the burden of anthropometric failure and its risk factors are unevenly distributed in India. The policy interventions focusing on maternal and child health, implemented with a targeted approach prioritizing the vulnerable groups, can only partially bridge the poor-rich gap in anthropometric failure. The role of anti-poverty programs and growth is essential to narrow this gap in anthropometric failure.http://www.sciencedirect.com/science/article/pii/S2352827323001477I120I140I150J130O150
spellingShingle Gaurav Dhamija
Mudit Kapoor
Rockli Kim
S.V. Subramanian
Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016
SSM: Population Health
I120
I140
I150
J130
O150
title Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016
title_full Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016
title_fullStr Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016
title_full_unstemmed Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016
title_short Explaining the poor-rich gap in anthropometric failure among children in India: An econometric analysis of the NFHS, 2021 and 2016
title_sort explaining the poor rich gap in anthropometric failure among children in india an econometric analysis of the nfhs 2021 and 2016
topic I120
I140
I150
J130
O150
url http://www.sciencedirect.com/science/article/pii/S2352827323001477
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