Nutritional status of children in India: household socio-economic condition as the contextual determinant

<p>Abstract</p> <p>Background</p> <p>Despite recent achievement in economic progress in India, the fruit of development has failed to secure a better nutritional status among all children of the country. Growing evidence suggest there exists a socio-economic gradient of childhood malnutrition in India. The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children.</p> <p>Methods</p> <p>Using National Family Health Survey-3 data, an attempt is made to estimate socio-economic inequality in childhood stunting at the state level through Concentration Index (CI). Multi-level models; random-coefficient and random-slope are employed to study the impact of SES on long-term nutritional status among children, keeping in view the hierarchical nature of data.</p> <p>Main findings</p> <p>Across the states, a disproportionate burden of stunting is observed among the children from poor SES, more so in urban areas. The state having lower prevalence of chronic childhood malnutrition shows much higher burden among the poor. Though a negative correlation (r = -0.603, p < .001) is established between Net State Domestic Product (NSDP) and CI values for stunting; the development indicator is not always linearly correlated with intra-state inequality in malnutrition prevalence. Results from multi-level models however show children from highest SES quintile posses 50 percent better nutritional status than those from the poorest quintile.</p> <p>Conclusion</p> <p>In spite of the declining trend of chronic childhood malnutrition in India, the concerns remain for its disproportionate burden on the poor. The socio-economic gradient of long-term nutritional status among children needs special focus, more so in the states where chronic malnutrition among children apparently demonstrates a lower prevalence. The paper calls for state specific policies which are designed and implemented on a priority basis, keeping in view the nature of inequality in childhood malnutrition in the country and its differential characteristics across the states.</p

Multiple Shocks, Coping and Welfare Consequences: Natural Disasters and Health Shocks in the Indian Sundarbans

Background: Based on a household survey in Indian Sundarbans hit by tropical cyclone Aila in May 2009, this study tests for evidence and argues that health and climatic shocks are essentially linked forming a continuum and with exposure to a marginal one, coping mechanisms and welfare outcomes triggered in the response is significantly affected. Data & Methods: The data for this study is based on a cross-sectional household survey carried out during June 2010. The survey was aimed to assess the impact of cyclone Aila on households and consequent coping mechanisms in three of the worst-affected blocks (a sub-district administrative unit), viz. Hingalganj, Gosaba and Patharpratima. The survey covered 809 individuals from 179 households, cross cutting age and gender. A separate module on health-seeking behaviour serves as the information source of health shocks defined as illness episodes (ambulatory or hospitalized) experienced by household members. Key findings: Finding reveals that over half of the households (54%) consider that Aila has dealt a high, damaging impact on their household assets. Result further shows deterioration of health status in the period following the incidence of Aila. Finding suggests having suffered multiple shocks increases the number of adverse welfare outcomes by 55%. Whereas, suffering either from the climatic shock (33%) or the health shock (25%) alone increases such risks by a much lesser extent. The multiple-shock households face a significantly higher degree of difficulty to finance expenses arising out of health shocks, as opposed to their counterparts facing only the health shock. Further, these households are more likely to finance the expenses through informal loans and credit from acquaintances or moneylenders. Conclusion: This paper presented empirical evidence on how natural and health shocks mutually reinforce their resultant impact, making coping increasingly difficult and present significant risks of welfare loss, having short as well as long-run development manifestations.DFI

Significance of Multiple Shocks on Individual Items of Welfare, Sundarbans, West Bengal, India.

<p>Significance of Multiple Shocks on Individual Items of Welfare, Sundarbans, West Bengal, India.</p

Effect of climate shock intensity on use of different coping strategies, Sundarbans, West Bengal, India.

<p>Note: ^#Includes both ‘moneylenders’ and ‘mortgage etc.’ as coping strategies.</p><p>Second column values are odds ratios from logit regressions on the predictor variable denoting whether the household had suffered relatively greater impact from Aila. The indicator variable is based on a self-rating question on impact of <i>Aila</i> on eight categories of household assets and means of livelihood with a household reporting ‘devastating’ for more than half the categories classified as of suffering a greater impact – termed as ‘high impact’ households. The logit model additionally controls for <i>pre-shock</i> vulnerabilities (see text) and village-level fixed effects. The t-statistic tests for the hypothesis that the variable is not different from zero. * p<0.1, ** p<0.05.</p><p>Effect of climate shock intensity on use of different coping strategies, Sundarbans, West Bengal, India.</p

Proportion of households incurring sacrifices of different items according to self-assessed intensity of climatic shock, Sundarbans, West Bengal, India.

#<p>building embankments, dwelling repairs etc.</p><p>*p<0.1,</p><p>** p<0.05,</p><p>*** p<0.001.</p><p>Proportion of households incurring sacrifices of different items according to self-assessed intensity of climatic shock, Sundarbans, West Bengal, India.</p

Percentage distribution of coping strategies against shock inflinted by cyclone <i>Aila</i>, according to perceived severity of the shock, Sundarbans, West Bengal, India.

<p>Percentage distribution of coping strategies against shock inflinted by cyclone <i>Aila</i>, according to perceived severity of the shock, Sundarbans, West Bengal, India.</p

Percentage of households with members in different age-sex groups reporting a deterioration of self-assessed health in the one year following <i>Aila</i>, Sundarbans, West Bengal, India.

<p>*p<0.1,</p><p>** p<0.05,</p><p>*** p<0.001.</p><p>Percentage of households with members in different age-sex groups reporting a deterioration of self-assessed health in the one year following <i>Aila</i>, Sundarbans, West Bengal, India.</p

Multiple Shocks and Aggregate Welfare Losses due to cyclone <i>Aila</i>, Sundarbans, West Bengal, India.

<p>*p<0.1,</p><p>** p<0.05,</p><p>*** p<0.001.</p><p>Multiple Shocks and Aggregate Welfare Losses due to cyclone <i>Aila</i>, Sundarbans, West Bengal, India.</p