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Age-appropriate feeding practices and their association with undernutrition among children aged 6–23 months in aspirational districts of India: a multinomial analysis

Published online by Cambridge University Press:  09 November 2021

Itishree Pradhan Open the ORCID record for Itishree Pradhan [Opens in a new window] ,
Binayak Kandapan Open the ORCID record for Binayak Kandapan [Opens in a new window]  and
Jalandhar Pradhan Open the ORCID record for Jalandhar Pradhan [Opens in a new window]
Itishree Pradhan
Affiliation:
Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, India
Binayak Kandapan
Affiliation:
Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, India
Jalandhar Pradhan*
Affiliation:
Department of Humanities and Social Sciences, National Institute of Technology, Rourkela, India
*
*Corresponding author. Email: jpp_pradhan@yahoo.co.uk
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Abstract

‘Health and nutrition’ is one among the five areas covered by the Aspirational District Programme in India, which aims to achieve the Sustainable Development Goals (SDGs). The reduction of undernutrition in under-five children has remained a major focus of the SDGs, especially at the ages of 6–23 months as this affects child development. This study used National Family Health Survey 2015–16 data to examine appropriate feeding practices and their associations with undernutrition among children aged 6–23 months in the 124 aspirational districts of India. Multinomial logistic regression analysis was used to analyse the association between feeding practices and undernutrition, adjusting for covariates. A total of 13,851 children aged 6–23 months were included in the analysis. Child nutritional outcomes, and children receiving the recommended minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD), were poorer in the aspirational compared with non-aspirational districts. However, the proportions of children who continued to breastfed, i.e. currently breastfeeding and the proportion of children who were receiving appropriate breastfeeding, i.e. receiving complementary feeding, in addition to breast milk, were higher in the aspirational districts. Appropriate breastfeeding and MDD were found to be associated negatively with undernutrition. While the continuation of breastfeeding increased the odds of children being undernourished, appropriate breastfeeding lowered the odds. The significant predictors of undernourishment among the study children were the child being male, of higher birth order, older and of smaller than average birth size; mother’s lower educational level, mother’s lower BMI of mothers and being a teenage mother; and poor household drinking water, sanitation facilities and lower economic status. This study suggests that educating mothers, especially illiterate and poor mothers, about appropriate breastfeeding and dietary diversity could help prevent and reduce child undernutrition in the aspirational districts of India.

Keywords

Feeding practicesUndernutritionAspirational districts
Type
Research Article
Information
Journal of Biosocial Science , Volume 55 , Issue 1 , January 2023 , pp. 1 - 21
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Agho, KE, Akombi, BJ, Ferdous, AJ, Mbugua, I and Kamara, JK (2019) Childhood undernutrition in three disadvantaged East African Districts: a multinomial analysis. Bio-Med Central Pediatrics 19(118), 1–11.Google ScholarPubMed
Aguayo, VM, Nair, R, Badgaiyan, N and Krishna, V (2016) Determinants of stunting and poor linear growth in children under 2 years of age in India: an in-depth analysis of Maharashtra’s comprehensive nutrition survey. Maternal & Child Nutrition 12(1), 121–140.CrossRefGoogle ScholarPubMed
Ahsan, KZ, Arifeen, SE, Al-Mamun, MA, Khan, SH and Chakraborty, N (2017) Effects of individual, household and community characteristics on child nutritional status in the slums of urban Bangladesh. Archives of Public Health 75(9), 1–13.CrossRefGoogle ScholarPubMed
Akombi, BJ, Agho, KE, Hall, JJ, Wali, N and Renzaho, AM (2017) Stunting, wasting and underweight in Sub-Saharan Africa: a systematic review. International Journal of Environmental Research and Public Health 14(863), 10–18.CrossRefGoogle ScholarPubMed
Bain, LE, Kum Awah, P, Geraldine, N, Kindong, NP, Sigal, Y, Bernard, N and Tanjeko, AT (2013) Malnutrition in Sub-Saharan Africa: burden, causes and prospects. Pan African Medical Journal 15(120), 1–9.CrossRefGoogle ScholarPubMed
Black, RE, Victora, CG, Walker, SP, Bhutta, ZA, Christian, P, De Onis, M et al. (2013) Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet 382(9890), 427–451.CrossRefGoogle ScholarPubMed
Chandwani, H, Prajapati, A, Rana, B and Sonaliya, K (2015) Assessment of infant and young child feeding practices with special emphasis on IYCF indicators in a field practice area of Rural Health Training Centre at Dabhoda, Gujarat, India. International Journal of Medical Science and Public Health 4(10), 1414–1419.CrossRefGoogle Scholar
Dasgupta, A, Parthasarathi, R, Prabhakar, RV, Biswas, R and Geethanjali, A (2014) Assessment of under nutrition with Composite Index of Anthropometric Failure (CIAF) among under-five children in a rural area of West Bengal. Indian Journal of Community Health 26(2), 132–138.Google Scholar
Davalgi, S and Vidya, GS (2015) A study to know infant & young child feeding practices of mothers attending mother and child health clinic at a tertiary care teaching hospital, Davangere, India. International Journal of Community Medicine and Public Health 2(4), 478–483.CrossRefGoogle Scholar
De Onis, M and Branca, F (2016) Childhood stunting: a global perspective. Maternal & Child Nutrition 12(1), 12–26.CrossRefGoogle ScholarPubMed
Grebmer, KV, Bernstein, J, Wiemers, M, Acheampong, K, Hanano, A, Higgins, B et al. (2020) 2020 Global Hunger Index: One Decade to Zero Hunger: Linking Health and Sustainable Food Systems. Concern Worldwide, Bonn, Welthungerhilfe and Dublin.Google Scholar
Harding, KL, Aguayo, VM and Webb, P (2018) Factors associated with wasting among children under five years old in South Asia: implications for action. PLoS One 13(7), 1–17.CrossRefGoogle ScholarPubMed
Harrell, FE Jr (2015) Regression Modeling Strategies: With Applications to Linear Models, Logistic and Ordinal Regression, and Survival Analysis. Springer International Publishing, Switzerland.CrossRefGoogle Scholar
IIPS and ICF (2017) National Family Health Survey (NFHS-4), 2015–16: International Institute for Population Sciences (IIPS). Mumbai, India.Google Scholar
Kapoor, A and Green, M (2020) Aspirational Districts Programme Shifts the Focus Back on Development. URL: https://economictimes.indiatimes.com/news/economy/policy/aspirational-districts-programme-shifts-the-focus-back-on development/articleshow/78142193.cmsGoogle Scholar
Kavosi, E, Rostami, ZH, Kavosi, Z, Nasihatkon, A, Moghadami, M and Heidari, M (2014) Prevalence and determinants of under-nutrition among children under six: a cross-sectional survey in Fars province, Iran. International Journal of Health Policy and Management 3(2), 71–76.CrossRefGoogle Scholar
Kumar, A, Jeeva, JC, Sarkar, A, Sahoo, B and Srivastava, SK (2019) Nutritional status of children in the Aspirational Districts of Odisha, India. International Journal of Current Microbiology and Applied Sciences 8(12), 1910–1915.CrossRefGoogle Scholar
Marriott, BP, White, A, Hadden, L, Davies, JC and Wallingford, JC (2012) World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries. Maternal & Child Nutrition 8(3), 354–370.CrossRefGoogle Scholar
Mehta, AK, Bhide, S, Kumar, A and Shah, A (2018) Poverty, Chronic Poverty and Poverty Dynamics. Policy Imperatives. Springer Nature Singapore Pte Ltd, Singapore.CrossRefGoogle Scholar
Meshram, Rao K II, Balakrishna, N, Harikumar, R, Arlappa, N and Sreeramakrishna, K (2018) Infant and young child feeding practices, sociodemographic factors and their association with nutritional status of children aged <3 years in India: findings of the National Nutrition Monitoring Bureau survey, 2011–2012. Public Health Nutrition 22(1), 104–114.CrossRefGoogle Scholar
Miah, RW, Apanga, PA and Abdul-Haq, Z (2016) Risk factors for undernutrition in children under five years old: evidence from the 2011 Ghana Multiple Indicator Cluster Survey. Journal of AIDS & Clinical Research 7(7), 1–10.Google Scholar
Mosites, E, Dawson-Hahn, E, Walson, J, Rowhani-Rahbar, A and Neuhouser, ML (2017) Piecing together the stunting puzzle: a framework for attributable factors of child stunting. Paediatrics and International Child Health 37(3), 158–165.CrossRefGoogle ScholarPubMed
Mya, KS, Kyaw, AT and Tun, T (2018) Feeding Practices and Nutritional Status of Children Age 6–23 Months in Myanmar: Further Analysis of the 2015–16 Demographic and Health Survey. ICF, Rockville, MD, USA.CrossRefGoogle Scholar
Mya, KS, Kyaw, AT and Tun, T (2019) Feeding feeding practices and nutritional status of children age 6–23 months in Myanmar: a secondary analysis of the 2015–16 Demographic and Health Survey. PLoS One 14(1), 1–13.CrossRefGoogle ScholarPubMed
Aayog, NITI (2018) Strategy for New India@75. National Institution for Transforming India, Aayog, New Delhi.Google Scholar
Perkins, JM, Jayatissa, R and Subramanian, S (2018) Dietary diversity and anthropometric status and failure among infants and young children in Sri Lanka. Nutrition 55(56), 76–83.CrossRefGoogle ScholarPubMed
Rajesh, D and Bavana, D (2016) A study on infant feeding practices in the urban slums: a cross sectional study: a cross sectional study. International Journal of Contemporary Pediatrics 3(2), 350–354.Google Scholar
Ramli, Agho KE, Inder, KJ, Bowe, SJ, Jacobs, J and Dibley, MJ (2009) Prevalence and risk factors for stunting and severe stunting among under-fives in North Maluku province of Indonesia. BMC Pediatrics 9(64), 1–10.CrossRefGoogle ScholarPubMed
Reinbott, A, Kuchenbecker, J, Herrmann, J, Jordan, I, Muehlhoff, E, Kevanna, O and Krawinkel, M (2015) A child feeding index is superior to WHO IYCF indicators in explaining length-for-age Z-scores of young children in rural Cambodia. Paediatrics and International Child Health 35(2), 124–134.CrossRefGoogle ScholarPubMed
Rohner, F, Woodruff, BA, Aaron, GJ, Yakes, EA, Lebanan, MO, Rayco-Solon, P and Saniel, OP (2013) Infant and young child feeding practices in urban Philippines and their associations with stunting, anemia, and deficiencies of iron and vitamin A. Food and Nutrition Bulletin 34(2), S17–S34.CrossRefGoogle Scholar
Sanin, KI, Islam, MM, Mahfuz, M, Ahmed, AS, Mondal, D, Haque, R and Ahmed, T (2018) Micronutrient adequacy is poor, but not associated with stunting between 12–24 months of age: a cohort study findings from a slum area of Bangladesh. PoLS One 13(3), 1–17.Google Scholar
Shetty, P (2006) Malnutrition and Undernutrition. Medicine 34(12), 524–529.CrossRefGoogle Scholar
Singh, H, Chaudhary, V, Joshi, HS, Upadhyay, D, Singh, A and Katyal, R (2016) Sociodemographic correlates of nutritional status of under-five children. Journal of Medical Sciences and Research 7, 44–49.Google Scholar
Srivastava, N and Sandhu, A (2006) Infant and child feeding index. Indian Journal of Pediatrics 73, 767–769.CrossRefGoogle ScholarPubMed
Tariq, J, Sajjad, A, Zakar, R, Zakar, MZ and Fischer, F (2018) Factors associated with undernutrition in children under the age of two years: secondary data analysis based on the Pakistan Demographic and Health Survey 2012–2013. Nutrients 10(676), 1–20.CrossRefGoogle ScholarPubMed
Tzioumis, E and Adair, LS (2014) Childhood dual burden of under and overnutrition in low- and middle-income countries: a critical review. Food and Nutrition Bulletin 35(2), 230–243.CrossRefGoogle ScholarPubMed
UNDP (2020) Human Development Report 2020: The Next Frontier – Human Development and the Anthropocene. United Nations Development Programme, New York.Google Scholar
UNICEF (2018) Levels and Trends in Child Malnutrition. eSocialSciences.Google Scholar
UNICEF (2019) The State of the World’s Children 2019. Children, Food and Nutrition: Growing Well in a Changing World. United Nations Children’s Fund, New York.Google Scholar
UNICEF, WHO and World Bank (2020) Levels and Trends in Child Malnutrition: Key Findings of the 2020 Edition. World Health Organization, Geneva. URL: https://data.unicef.org/resources/jme-report-2020/ Google Scholar
Victora, CG, De Onis, M, Hallal, PC, Blossner, M and Shrimpton, R (2010) Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics 25(3), e473–e480.CrossRefGoogle Scholar
WHO (2009) Infant and Young Child Feeding: Model Chapter for Textbooks for Medical Students and Allied Health Professionals. World Health Organization, Geneva.Google Scholar
WHO (2019) Nutrition Landscape Information System (NLIS) Country Profile Indicators: Interpretation Guide. World Health Organization, Geneva.Google Scholar
Yadav, P and Dubey, BN (2017) Nutritional problems among children in urban slum area. Man in India 97(2), 349–362.Google Scholar
Yeshalem, DM, Tafere, TE and Abitew, DB (2017) Infant and young child feeding practice among mothers with 0–24 months old children in Slum areas of Bahir Dar City, Ethiopia. International Breastfeeding Journal 12(26), 2–9.Google Scholar
Zongrone, A, Winskell, K and Menon, P (2012) Infant and young child feeding practices and child undernutrition in Bangladesh: insights from nationally representative data. Public Health Nutrition 15(9), 1697–1704.CrossRefGoogle Scholar