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Undernutrition among children and its determinants across the parliamentary constituencies of India: a geospatial analysis
- Apoorva Nambiar, Satish B. Agnihotri, Dharmalingam Arunachalam, Ashish Singh
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- Journal:
- Journal of Biosocial Science / Volume 56 / Issue 2 / March 2024
- Published online by Cambridge University Press:
- 21 November 2023, pp. 338-356
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In India, undernutrition among children has been extremely critical for the last few decades. Most analyses of undernutrition among Indian children have used the administrative boundaries of a state or a district level as a unit of analysis. This paper departs from such a practice and focuses instead on the political boundaries of a parliamentary constituency (PC) as the unit of analysis. The PC is a critical geopolitical unit where political parties and party candidates make election promises and implement programmes to improve the socio-economic condition of their electorate. A focus on child undernutrition at this level has the potential for greater policy and political traction and could lead to a paradigm shift in the strategy to tackle the problem by creating a demand for political accountability. Different dimensions and new approaches are also required to evaluate the socio-economic status and generate concrete evidence to find solutions to the problem. Given the significance of advanced analytical methods and models embedded into geographic information system (GIS), the current study, for the first time, uses GIS tools and techniques at the PC level, conducting in-depth analysis of undernutrition and its predictors. Hence, this paper examines the spatial heterogeneity in undernutrition across PCs by using geospatial techniques such as univariate and bivariate local indicator of spatial association and spatial regression models. The analysis highlights the high–low burden areas in terms of local hotspots and identifies the potential spatial risk factors of undernutrition across the constituencies. Striking variations in the prevalence of undernutrition across the constituencies were observed. Most of these constituencies that performed poorly both in terms of child nutrition and socio-economic indicators were located in the northern, western, and eastern parts of India. A statistically significant association of biological, socio-economic, and environmental factors such as women’s body mass index, anaemia in children, poverty, household sanitation facilities, and institutional births was established. The results highlight the need to bring in a mechanism of political accountability that directly connects elected representatives to maternal and child health outcomes. The spatial variability and pattern of undernutrition indicators and their correlates indicate that priority setting in research may also be greatly influenced by the neighbourhood association.
Framework for enhancing maternal nutrition: addressing under nutrition in tribal children inhabiting Central India
- Suveena Doddalingannavar, Ayushi Jain, Satish B. Agnihotri
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E474
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Our world is transitioning into a new generation of governance with much greater emphasis on targeted actions and mission mode programmes to achieve global sustainable goals (SDG). India with its Twenty-point programme which directly maps national and state programmes to global SDGs has been pacing up for 2030 targets. One of the major programmes that has been the prime focus is Integrated Child Development Services Scheme. India ranked 103rd among 119 countries on global hunger index, 2018. Significant reduction in malnutrition was seen among children below 6 years but the pace of reduction has been slow over the past decade. The path of malnutrition reduction of central belt states (tribal population dominant) deviates from rest of the country.
Our analysis of National Family Health Survey-4 (NFHS) found that 42% of tribal children are underweight (i.e. 1.5 times higher than non-tribal children), over 50% of prevalence of malnutrition is in tribal population. 100% Mother & Child Protection registration do not reciprocate to 100% all Anti-Natal Care visits showing faults in monitoring system indicating that the investment by government in all fronts, economic development has not translated into desired reduction in malnutrition. Their 8.6% population accounts to 30% cases of malaria translating to 50% malarial deaths indicative of higher disease burden. Malnutrition crisis among tribals begins way early manifesting in higher rates of Low Birth Weight deliveries (LBW) which is 3–4% higher compared to non-tribal population. This is due to low nutrient diet, laborious work during gestational period and high disease burden.
The focus of Maternal nutrition enhancement projects by Tribal Welfare Depts in these states should include nutrition sensitive along with nutrition specific interventions targeting the population under risk as well as entering risk. Now with district level data (NFHS) available every 4 years can aid in district level planning, shifting focus from population based to prevalence and exclusive planning for tribals. Our study involves developing a robust framework to enhance maternal nutrition through strong community mobilization and partnership. It also addresses the convergence issue being faced in the current system and paves a way forward for convergence among inter departmental schemes for larger participation by people and greater coverage of the scheme and its benefits.