Undernutrition continues to be a major public health problem throughout the world. The present study aimed to understand the prevalence and determinants of undernutrition in India and determine what extent it differs by birth order, other child level, maternal and socioeconomic factors.
This study used information from a total weighted sample of 128859 mothers from India National Family Health Survey 4. Univariate and Multivariate logistic regression were used to investigate the association between undernutrition with birth order, other child level, maternal and socio-economic factors. Three models were constructed for the study, model 1 as univariate, model 2 adjusting with birth order and socioeconomic predictors and model 3 adjusting with all the predictors included in the study.
The prevalence of stunting, underweight and wasting were 37.9, 34.0 and 20.7 respectively. The mean age of children was 2.4 years (standard deviation 1.3) of which majority were second order birth (33.6%), males (54.5%), anemic (58.9%) and normal birth weight (87.2%). All three models showed that higher birth order was a strong predictor of a child being stunted and underweight after adjusting for potential confounders. Children with lower wealth quintiles, anemia, male, low birth weight and vaginal delivery had higher odds of being stunted, wasted and underweight in model-3 adjusted analysis.
The findings from this study provide an important interaction between birth order and child undernutrition status in India. However, further longitudinal studies are required to establish such cause-effect relationship between birth order and undernutrition.