Pradhan Itishree, Kandapan Binayak, Pradhan Jalandhar
Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, India.
J Biosoc Sci. 2023 Jan;55(1):1-21. doi: 10.1017/S0021932021000596. Epub 2021 Nov 9.
'Health and nutrition' is one among the five areas covered by the Aspirational District Programme in India, which aims to achieve the Sustainable Development Goals (SDGs). The reduction of undernutrition in under-five children has remained a major focus of the SDGs, especially at the ages of 6-23 months as this affects child development. This study used National Family Health Survey 2015-16 data to examine appropriate feeding practices and their associations with undernutrition among children aged 6-23 months in the 124 aspirational districts of India. Multinomial logistic regression analysis was used to analyse the association between feeding practices and undernutrition, adjusting for covariates. A total of 13,851 children aged 6-23 months were included in the analysis. Child nutritional outcomes, and children receiving the recommended minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD), were poorer in the aspirational compared with non-aspirational districts. However, the proportions of children who continued to breastfed, i.e. currently breastfeeding and the proportion of children who were receiving appropriate breastfeeding, i.e. receiving complementary feeding, in addition to breast milk, were higher in the aspirational districts. Appropriate breastfeeding and MDD were found to be associated negatively with undernutrition. While the continuation of breastfeeding increased the odds of children being undernourished, appropriate breastfeeding lowered the odds. The significant predictors of undernourishment among the study children were the child being male, of higher birth order, older and of smaller than average birth size; mother's lower educational level, mother's lower BMI of mothers and being a teenage mother; and poor household drinking water, sanitation facilities and lower economic status. This study suggests that educating mothers, especially illiterate and poor mothers, about appropriate breastfeeding and dietary diversity could help prevent and reduce child undernutrition in the aspirational districts of India.
“健康与营养”是印度“有抱负地区计划”涵盖的五个领域之一，该计划旨在实现可持续发展目标（SDGs）。减少五岁以下儿童的营养不良一直是可持续发展目标的主要重点，尤其是在6至23个月龄时，因为这会影响儿童发育。本研究使用2015 - 2016年全国家庭健康调查数据，调查印度124个有抱负地区6至23个月龄儿童的适当喂养方式及其与营养不良的关联。采用多项逻辑回归分析来分析喂养方式与营养不良之间的关联，并对协变量进行了调整。分析共纳入了13851名6至23个月龄的儿童。与非有抱负地区相比，有抱负地区儿童的营养状况以及达到推荐的最低饮食多样性（MDD）、最低进餐频率（MMF）和最低可接受饮食（MAD）的儿童情况较差。然而，在有抱负地区，继续母乳喂养的儿童比例，即目前正在母乳喂养的儿童比例，以及接受适当母乳喂养的儿童比例，即在母乳喂养之外还接受辅食喂养的儿童比例更高。发现适当母乳喂养和饮食多样性与营养不良呈负相关。虽然继续母乳喂养会增加儿童营养不良的几率，但适当母乳喂养则会降低这种几率。研究儿童中营养不良的显著预测因素包括：儿童为男性、出生顺序较高、年龄较大且出生时体重低于平均水平；母亲教育水平较低、母亲体重指数较低以及母亲为青少年母亲；以及家庭饮用水质量差、卫生设施差和经济状况较低。本研究表明，对母亲，尤其是文盲和贫困母亲进行适当母乳喂养和饮食多样性方面的教育，有助于预防和减少印度有抱负地区的儿童营养不良情况。
