Premananda Bharati

Role of individual and household level factors on stunting: A comparative study in three Indian states

Background: Status of growth especially in early childhood is not only the most important determinant of health of a child but also a reflection of the well-being of the entire society. The extent of malnutrition in India is very high, but the exact magnitude varies considerably depending on which indicator is used. Child health in this paper is measured through chronic malnutrition (termed as stunting). Three states were selected, namely Bihar, West Bengal and Kerala. These three states represent the three stages of development. Bihar is one of the least and Kerala is one of the most developed states in India. Aim: The present paper aims to investigate the degree of chronic malnutrition in the context of socio-economic, demographic and other characteristics of the children and their households in the three selected states in India. Subjects and methods: The data for this study were taken from the National Family Health Survey (NFHS-2) conducted by the International Institute for Population Sciences (IIPS), Mumbai, in 1998–1999. The NFHS-2 sample covers ever-married women in the age group 15–49 years from 26 states in India. Besides collecting information on health, the survey collects data on socio-economic and demographic characteristics at individual and household level. Results: The percentage of stunting of children in Bihar, West Bengal and Kerala was found to be 54, 39 and 23%, respectively. Regression analysis showed that the major factors that significantly influenced the status of health in the children in all three states were womens education and the household condition index. Months of breastfeeding and birth interval also had some association with health status. The effect of the above-mentioned variables was most prominent in Bihar and least in Kerala in terms of statistical significance. Conclusion: There is a close positive link between the nutritional status of pre-school children and the stages of development of the states. Mothers’ education and household condition are important influences on childrens health status irrespective of the stage of development.

Sex Bias in Intrahousehold Food Distribution: Roles of Ethnicity and Socioeconomic Characteristics

A review of literature dealing with intrahousehold food distribution in India indicates that inequality of distribution has probably existed since prehistoric times and is present now as a cultural characteristic of diverse social and ethnic groups. Generally females especially young females are the group most discriminated against. A study was undertaken to determine whether variations exist with respect to sex bias: 1) between a traditional rural Hindu group and several groups of different ethnic ancestries; and 2) among economic occupational religious and rural/urban subgroups of these groups. 1-day semiquantitative data on dietary intakes were collected from the woman running each household using as reference 8 containers decreasing in size from 3000 ml to 100 ml for each of the the following categories of household members: male household head; other male adult; male adolescent (13-18 years); male child; household heads wife other female adult; female adolescent; and female child. Sex and age-specific calorie intakes recommended by the Indian Council of Medical Research were used as standards. Null hypotheses tested were that each member of a household received what he or she needs and where the total quantity available was > or < that required by the household members food was shared equitably. Among Lepchas except for urban Christian Lepchas a bias in favor of females is suggested. Among sherpas the relationship is less clear although food intake of the household head and his wife appears lower. Among Oraons no sex bias seems to exist. Mahishyas of high economic status display a bias in favor of males but among those of medium and low income groups intake appears proportional to individual needs. For other groups nutritional intake of most people appears low but small sample sizes may mean differences are insignificant.

Prevalence of Anemia and Its Determinants Among Nonpregnant and Pregnant Women in India

This study investigates the severity and distribution of anemia among nonpregnant and pregnant women aged 15 to 49 years in urban and rural sectors of 26 states in India and its association with certain economic and biosocial factors. A national survey was conducted to collect data on hemoglobin, height, weight, and certain economic and biosocial factors of 72 660 nonpregnant and 5619 pregnant women. Nonpregnant women aged less than 25 years are most affected by anemia. Womens education and standard of living in the households have a vital role in reducing anemia. Urban and well-nourished women also suffer less from anemia. The severity of anemia is higher among pregnant than nonpregnant women. Efforts must be made to educate women and enhance their level of economic status so that the prevalence of anemia can be reduced substantially.

Determinants of nutritional status of pre-school children in india

The aim of this paper is to assess the spatial distribution of nutritional status of children of less than three years through Z-scores of weight-for-age, height-for-age and weight-for-height using data collected by the National Family Health Survey (NFHS-2, 1998-99), India. The nutritional status of pre-school children was regressed on different socio-demographic factors after eliminating the effect of age. The data show that there are gender differences and spatial variations in the nutritional status of children in India. Gender difference is not very pronounced and almost disappears when the effects of age and socio-demographic variables are removed. The spatial difference, especially the rural-urban difference, was found to be very large and decreased substantially when the effects of age and socioeconomic variables were removed. However, the differences were not close to zero. All the variables were found to affect significantly the nutritional status of children. However, the literacy of mothers did not affect height-for-age significantly. The weight-for-age and height-for-age scores showed a dismal picture of the health condition of children in almost all states in India. The worst affected states are Bihar, Madhya Pradesh, Orissa and Uttar Pradesh. Assam and Rajasthans are also lagging behind. Weight-for-height scores do not give a clear picture of state-wise variation. Goa, Kerala and Punjab are the three most developed states in India and also have the lowest percentages of underweight children according to the Z-scores. Along with these three states come the north-eastern states where women are well educated. Thus overall development, enhancement of level of education and low gender inequality are the key factors for improvement in the health status of Indian children.

SOCIOECONOMIC DIFFERENTIALS IN NUTRITIONAL STATUS OF CHILDREN IN THE STATES OF WEST BENGAL AND ASSAM, INDIA

Malnutrition among children is prevalent in almost all the states in India. This study assesses the extent and causes of malnutrition in two eastern Indian states with similar climates, namely West Bengal and Assam, using data from the National Family Health Survey 1998-99 (NFHS-2). The three indices of malnutrition taken for analysis are weight-for-height (WHZ), height-for-age (HAZ) and weight-for-age (WAZ). These are assumed to depend on birth order, preceding birth interval, parents educational status, working status of the mother, mothers age at delivery of the children, source of drinking water, toilet facilities and standard of living of the household. Logistic regression was carried out separately for each of the three indices on the explanatory variables for both the states. It was found that not all variables are equally important in determining whether a baby is underweight, or suffering from acute or chronic malnutrition. Also, the importance of variables is not the same in the two states. It was observed that the coefficients associated with the variables in determining weight-for-height are not significant compared with those for weight-for-age and height-for-age.

Prevalence and causes of chronic energy deficiency and obesity in Indian women.

ABSTRACT We investigate the nutritional status of women in India and its relation to the prevalence of chronic energy deficiency (CED) and obesity. To do this, we have used the data from the Indian National Family Health Survey, 1998–1999, on body mass index (BMI) of ever-married women, ages 15–49 years, along with several socioeconomic factors, such as level of education, religion or caste, occupational status, and standard of living index. The study was based on 81,712 women from 26 states and 6 zones, which were grouped according to geographic proximity of the states of India. A multiple linear regression analysis was done to see the relation between nutritional status of women and different socioeconomic factors. The data reveal that the prevalences of CED, overweight, and obesity in India are 31.2%, 9.4%, and 2.6%, respectively. The incidences of CED and obesity are negatively related. The prevalence of CED is the lowest in Arunachal Pradesh and highest in Orissa. Punjab has the highest prevalence of obesity, and Bihar has the lowest. For the zonewise distribution the Northeast zone has the lowest degree of prevalence of CED and the East zone is at the bottom of the list with the highest degree of malnutrition. We also found that the nutritional status of women goes together with the enhancement of their educational status, standard of living, and so on. There are also significant differences between rural and urban sectors and among castes, religions, and occupations. Furthermore, regression analysis shows that all the socioeconomic variables considered here significantly affect BMI in Indian women.

Variation in adult body dimensions in relation to economic condition among the Mahishyas of Howrah district, West Bengal, India

The body dimensions of adults in three economic subgroups of the Mahishya caste population of Chakpota village, Howrah district, West Bengal, India, were studied. In both sexes, with the decline in economic condition values of body size measurements, skinfold thickness, body fat and anthropometric indices decrease, with the exception of the ponderal index, the value of which increases. The sex difference in height increases with increasing economic status. The correlation between weight and height is highest in the low economic subgroups.

Body Mass Index and Chronic Energy Deficiency of Adult Males of Central Indian Populations

ABSTRACT Data on body weight, height, and sitting height from 11,496 adult males, age 18–62 years, belonging to 38 different populations of five major social groups (scheduled tribes, scheduled castes, “other backward castes,” general castes, and Muslims) of Central India were taken for our analysis to assess the nutritional status of these groups. Cormic index and body mass index (BMI) were computed, and an analysis of variance (ANOVA) was carried out among different populations as well as among social groups separately on Cormic index and BMI. Shape, size, and generalized distances among the different social groups were computed and dendro-grams were drawn. The level of malnutrition is the lowest among the general castes. The opposite is the case with the scheduled castes and scheduled tribes. Comparison of the coefficient of variation shows that there is variation in weight and BMI but that there is no marked variation in the other anthropometric variables. The ANOVA on Cormic index and BMI suggests that the people within a population are more homogeneous than the people between populations. There is a positive but statistically insignificant correlation between Cormic index and BMI. The five social groups differ more in size distance than in shape distance. According to the dendrogram of generalized distance values, the Muslims and the general castes can be grouped into one cluster and the scheduled castes, scheduled tribes, and other backward castes can be grouped into another cluster.

BODY MASS INDEX OF MARRIED BANGLADESHI WOMEN: TRENDS AND ASSOCIATION WITH SOCIO-DEMOGRAPHIC FACTORS

Body mass index (BMI) is a good indicator of nutritional status in a population. In underdeveloped countries like Bangladesh, this indicator provides a method that can assist intervention to help eradicate many preventable diseases. This study aimed to report on changes in the BMI of married Bangladeshi women who were born in the past three decades and its association with socio-demographic factors. Data for 10,115 married and currently non-pregnant Bangladeshi women were extracted from the 2007 Bangladesh Demographic and Health Survey (BDHS). The age range of the sample was 15-49 years. The mean BMI was 20.85 ± 3.66 kg/m(2), and a decreasing tendency in BMI was found among birth year cohorts from 1972 to 1992. It was found that the proportion of underweight females has been increasing in those born during the last 20 years of the study period (1972 to 1992). Body mass index increased with increasing age, education level of the woman and her husband, wealth index, age at first marriage and age at first delivery, and decreased with increasing number of ever-born children. Lower BMI was especially pronounced among women who were living in rural areas, non-Muslims, employed women, women not living with their husbands (separated) or those who had delivered at home or non-Caesarean delivery.

Spatial patterns of anthropometric variation in India with reference to geographic, climatic, ethnic and linguistic backgrounds.

Background: Anthropometric variation can be fruitfully utilized to investigate microevolutionary processes. Anthropometric variations in the Indian subcontinent based on stature and three indices (Cephalic Index, Nasal Index, and Total Facial Index) are highly variable and discriminative among populations across geographical regions. Aims: Anthropometric variation in stature, Cephalic Index (CI), Nasal Index (NI) and Total Facial Index (TFI) were investigated with respect to ethnic, linguistic, geographical and climatic affiliation, across the Indian subcontinent. Subjects and methods: Published data on anthropometric variations of 531 populations from the Indian subcontinent were analysed using discriminant analysis and spatial autocorrelation analysis. Results: Discriminant analysis of the four anthropometric variables shows that stature and NI are good discriminators for populations of different languages. Stature, NI and CI discriminate well among populations of diverse ethnic origin and climatic conditions in different regions. TFI is not a good discriminator for populations of diverse ethnic, linguistic and climatic attributes. Spatial autocorrelation analysis showed significant departure from randomness, suggesting geographic structuring. The Morans I estimate is positive and statistically significant for the four variables at low distances but exhibits significant negative association at higher values. Conclusion: The results suggest geographical clines for the four anthropometric variables and indicate the influence of population structure on the studied variables.