Narayanan Menaka, Karlsson Omar, Kumar Akhil, Pullum Thomas W, Kim Rockli, Subramanian S V
Columbia University, New York City, New York, USA.
Duke Population Research Institute, Durham, North Carolina, USA.
Matern Child Nutr. 2025 Apr;21(2):e13751. doi: 10.1111/mcn.13751. Epub 2024 Dec 4.
Though child anthropometric failure (CAF) is a persistent problem in India, previous studies have often neglected state-level variance and aggregated moderate and severe CAF categories. This study addresses this gap by examining moderate and severe malnutrition across India's states and union territories (UTs) from 1993 to 2021. Data of children under 2 years old from five waves of National Family Health Surveys, a representative cross-sectional survey of Indian households, were analysed. Outcomes included prevalence of moderate and severe stunting, underweight and wasting, as per the 2006 World Health Organization growth standards. Percentage prevalence and standardized absolute change (SAC) were calculated nationally and by region for each wave. From 1993 to 2021, there was a notable reduction in the nationwide prevalence of moderate stunting, underweight and wasting, with rates dropping from 20% to 16%, 23% to 18%, and 15% to 12%, respectively. Severe stunting and underweight declined considerably from 23% to 16% and 18% to 11%, respectively; severe wasting marginally increased from 8% to 9%. From 2016 to 2021 moderate underweight was noted to have the highest SAC across all regions, although 15 regions saw an increase in the prevalence of moderate underweight. In the 2016-2021 period, severe wasting has increased in 13 of the 36 regions. While there has been a nationwide reduction in most indicators of CAF since 1993, the rate and direction of change vary widely among states and UTs and between moderate and severe categories within each of the states and UTs. Understanding these patterns of change can direct context-specific interventions for improving child nutrition and health. A greater focus on reducing severe wasting, which has increased since 1993, is also crucial.
尽管儿童人体测量失败（CAF）在印度一直是个问题，但以往研究往往忽视了邦一级的差异，并且将中度和重度CAF类别合并统计。本研究通过考察1993年至2021年印度各邦及中央直辖区（UTs）的中度和重度营养不良情况来填补这一空白。分析了来自五次全国家庭健康调查的2岁以下儿童数据，该调查是对印度家庭的代表性横断面调查。根据2006年世界卫生组织生长标准，结果包括中度和重度发育迟缓、体重不足和消瘦的患病率。计算了每一轮调查在全国和各地区的患病率百分比和标准化绝对变化（SAC）。1993年至2021年期间，全国范围内中度发育迟缓、体重不足和消瘦的患病率显著下降，比率分别从20%降至16%、23%降至18%、15%降至12%。重度发育迟缓和体重不足分别从23%大幅降至16%和18%降至11%；重度消瘦略有上升，从8%升至9%。2016年至2021年期间，尽管有15个地区中度体重不足患病率上升，但在所有地区中，中度体重不足的SAC最高。在2..16 - 2021年期间，36个地区中有13个地区的重度消瘦情况有所增加。自1993年以来，虽然全国范围内大多数CAF指标都有所下降，但各邦及中央直辖区之间以及各邦及中央直辖区内中度和重度类别之间的变化速度和方向差异很大。了解这些变化模式可为改善儿童营养和健康的因地制宜干预措施提供指导。更加关注减少自1993年以来有所增加的重度消瘦情况也至关重要。
