Shah Gulzar, Siddiqa Maryam, Shankar Padmini, Karibayeva Indira, Zubair Amber, Shah Bushra
Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA.
Department of Mathematics and Statistics, International Islamic University, Islamabad 44000, Pakistan.
Children (Basel). 2024 Jul 26;11(8):902. doi: 10.3390/children11080902.
This study examines the levels and predictors of malnutrition in Indian children under 5 years of age.
Composite Index of Anthropometric Failure was applied to data from the India National Family Health Survey 2019-2021. A multivariable logistic regression model was used to assess the predictors.
52.59% of children experienced anthropometric failure. Child predictors of lower malnutrition risk included female gender (adjusted odds ratio (AOR) = 0.881) and average or large size at birth (AOR = 0.729 and 0.715, respectively, compared to small size). Higher birth order increased malnutrition odds (2nd-4th: AOR = 1.211; 5th or higher: AOR = 1.449) compared to firstborn. Maternal predictors of lower malnutrition risk included age 20-34 years (AOR = 0.806), age 35-49 years (AOR = 0.714) compared to 15-19 years, normal BMI (AOR = 0.752), overweight and obese BMI (AOR = 0.504) compared to underweight, and secondary or higher education vs. no education (AOR = 0.865). Maternal predictors of higher malnutrition risk included severe anemia vs. no anemia (AOR = 1.232). Protective socioeconomic factors included middle (AOR = 0.903) and rich wealth index (AOR = 0.717) compared to poor, and toilet access (AOR = 0.803). Children's malnutrition risk also declined with paternal education (primary: AOR = 0.901; secondary or higher: AOR = 0.822) vs. no education. Conversely, malnutrition risk increased with Hindu (AOR = 1.258) or Islam religion (AOR = 1.369) vs. other religions.
Child malnutrition remains a critical issue in India, necessitating concerted efforts from both private and public sectors. A 'Health in All Policies' approach should guide public health leadership in influencing policies that impact children's nutritional status.
本研究调查了印度5岁以下儿童的营养不良水平及其预测因素。
将人体测量失败综合指数应用于2019 - 2021年印度全国家庭健康调查的数据。使用多变量逻辑回归模型评估预测因素。
52.59%的儿童存在人体测量失败情况。营养不良风险较低的儿童预测因素包括女性性别（调整后的优势比[AOR]=0.881）以及出生时为平均或较大体型（与小体型相比，AOR分别为0.729和0.715）。与头胎相比，出生顺序较高会增加营养不良几率（第2 - 4胎：AOR = 1.211；第5胎及以上：AOR = 1.449）。营养不良风险较低的母亲预测因素包括20 - 34岁（AOR = 0.806）、35 - 49岁（与15 - 19岁相比，AOR = 0.714）、正常体重指数（AOR = 0.752）、超重和肥胖体重指数（与体重过轻相比，AOR = 0.504）以及接受过中等或高等教育与未接受教育相比（AOR = 0.865）。营养不良风险较高的母亲预测因素包括重度贫血与无贫血相比（AOR = 1.232）。具有保护作用的社会经济因素包括中等（AOR = 0.903）和富裕财富指数（与贫困相比，AOR = 0.717）以及有厕所可用（AOR = 0.803）。与未接受教育相比，随着父亲受教育程度提高（小学：AOR = 0.901；中等或高等：AOR = 0.822），儿童的营养不良风险也会降低。相反，与其他宗教相比，印度教（AOR = 1.258）或伊斯兰教（AOR = 1.369）会增加营养不良风险。
儿童营养不良在印度仍然是一个关键问题，需要私营和公共部门共同努力。“所有政策中的健康”方法应指导公共卫生领导层影响那些对儿童营养状况有影响的政策。
