Influence of Social Inequalities on Dietary Diversity and Household Food Insecurity: An In-Depth Nutrition Baseline Survey Conducted in Madhya Pradesh, India.

Home to a significant proportion of the world's population, India is one of the hardest hit countries when it comes to malnutrition. While the magnitude of malnutrition in India is vast, it is also unevenly spread due to inequalities of the social, political, and economic situation. As part of the special initiative of the German Ministry for Economic Cooperation and Development (BMZ), "One World - No Hunger," GIZ is implementing a Global Program on "Food and Nutrition Security, Enhanced Resilience" (FaNS) in 12 countries, including India. The GIZ FaNS program, in agreement with the Department of Food and Public Distribution, Ministry of Consumer Affairs, Food and Public Distribution on a central level, and the Department of Women and Child Development in Madhya Pradesh, aims to improve food security and nutrition diversity for women in the reproductive age group (15-49 years) and young children (6-23 months) in the districts of Sheopur and Chhatarpur in Madhya Pradesh. The present study, conducted in the state of Madhya Pradesh in India, describes the nutrition situation of women and children belonging to disadvantaged socioeconomic backgrounds and aims to assess how underlying factors are influencing the nutrition diversity and food security situation. The findings highlight low dietary diversity with more than 80% of women and 77% of children consuming less than the daily recommended food groups. A high level of food insecurity (49.9%) was also reported in the study area (https://www.snrd-africa.net/wp-content/uploads/2017/07/GIZ_Nutrition-Baseline-Survey-Summary-Report.pdf). Furthermore, the study affirms that caste status negatively influences dietary diversity, especially among women and those with household food insecurity. A better educational status and income stability resulted in a better nutrition status for mothers and children. Access to food and nutrition services (OR 1.5; p = 0.04), exposure to nutrition counselling (OR 1.323; p = 0.001), and hygiene practices (OR 1.8; p = 0.002) can be instrumental in improving the dietary diversity and food security status of families, irrespective of prevailing inequalities.