The 2020 Global Nutrition Report by UNICEF highlights the high rate of deaths among children under five years of
age, with India being one of the top five countries. Studies suggest that more than half of these early child deaths were attributable to health issues associated with malnutrition, particularly in the case of countries with extreme poverty, scarcity of essential resources, lack of access to appropriate healthcare, and wide disparities of wealth. We situated our analysis on the lines of Bronfenbrenner’s ecological systems theory and interpreted the results through the lens of this theory.Observations from 70618 children between ages of 2-5 years old, from poverty ridden communities in India, were used. The poverty ridden households contain poorer and poorest populations classified by DHS based on wealth index. Three measures, namely, stunted, wasted, underweight and overweight were calculated according to WHO child growth standards, and used as dependent variables. The independent variables include child’s biological characteristics, health status, dietary adequacy. We also analyzed the role of maternal factors such as mother’s anthropometry, health status, education, access to healthcare facilities. In addition, the variables include home environmental conditions, social welfare systems and geographical location. Binary Logistic Regression model two sets of Multinomial Logistic regression models were developed for the analyses. We found that a child’s health, particularly anaemia levels, vaccination and multivitamin access play a vital role in influencing a child’s anthropometric measurements. Moreover, dietary diversity has a crucial role to play in forming a child’s height and weight. Finally, we conclude that maternal factors including health status (anaemia levels and anthropometric measurements) and access to healthcare facilities significantly influence a child’s likelihood to experience malnutrition. Three levels, namely, microsystem, mesosystem and exosystem of the Bronfenbrenner’s ecological systems theory emerge as most significant contributors to the likelihood of malnutrition. Implications for policymakers include importance of access to healthcare as basic determinant of child well-being can help mothers to maintain and improve their health status and prevent the health issues which has direct impact on likelihood of children malnutrition.

Keywords
Access to healthcare; Awareness of ICDS program; Bronfenbrenner ecological systems theory; Poverty ridden
children; Nutritional factors

Anjula Gurtoo

Affiliation

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Ecosystem Determinants of Height and Weight Among Poverty Ridden Children in India