| Summary: | <p class="first" id="d205409e156">Stunting is a major unresolved and growing health issue for India. There is a need
for a broader interdisciplinary cross-sectoral approach in which disciplines such
as the environment and health have to work together to co-develop integrated socio-culturally
tailored interventions. However, there remains scant evidence for the development
and application of such integrated, multifactorial child health interventions across
India’s most rural communities. In this paper we explore and demonstrate the linkages
between environmental factors and stunting thereby highlighting the scope for interdisciplinary
research. We examine the associations between household environmental characteristics
and stunting in children under 5 years of age across rural Rajasthan, India. We used
Demographic and Health Survey (DHS)-3 India (2005–2006) data from 1194 children living
across 109,041 interviewed households. Multiple logistic regression analyses independently
examined the association between (i) the primary source of drinking water, (ii) primary
type of sanitation facilities, (iii) primary cooking fuel type, and (iv) agricultural
land ownership and stunting adjusting for child age. The results suggest, after adjusting
for child age, household access to (i) improved drinking water source was associated
with 23% decreased odds [odds ratio (OR) = 0.77, 95% confidence interval (CI) 0.5–1.00],
(ii) improved sanitation facility was associated with 41% decreased odds (OR = 0.51,
95% CI 0.3–0.82), and (iii) agricultural land ownership was associated with 30% decreased
odds of childhood stunting (OR 0.70, 95% CI 0.51–0.94]. The cooking fuel source was
not associated with stunting. Our findings indicate that a shift is needed from nutrition-specific
to contextually appropriate interdisciplinary solutions, which incorporate environmental
improvements. This will not only improve living conditions in deprived communities
but also help to tackle the challenge of childhood malnutrition across India’s most
vulnerable communities.
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