Is Economic Growth Associated with Reduction in Child Undernutrition
in India?
Background:
Economic growth is widely perceived as a major policy instrument in reducing
childhood undernutrition in India. We assessed the association between
changes in state per capita income and the risk of undernutrition among
children in India.
Methods and Findings:
Data for this analysis came from three cross-sectional waves of the National
Family Health Survey (NFHS) conducted in 1992–93,
1998–99, and 2005–06 in India. The sample sizes in the
three waves were 33,816, 30,383, and 28,876 children, respectively. After
excluding observations missing on the child anthropometric measures and the
independent variables included in the study, the analytic sample size was
28,066, 26,121, and 23,139, respectively, with a pooled sample size of
77,326 children. The proportion of missing data was
12%–20%. The outcomes were underweight,
stunting, and wasting, defined as more than two standard deviations below
the World Health Organization–determined median scores by age and
gender. We also examined severe underweight, severe stunting, and severe
wasting. The main exposure of interest was per capita income at the state
level at each survey period measured as per capita net state domestic
product measured in 2008 prices. We estimated fixed and random effects
logistic models that accounted for the clustering of the data. In models
that did not account for survey-period effects, there appeared to be an
inverse association between state economic growth and risk of undernutrition
among children. However, in models accounting for data structure related to
repeated cross-sectional design through survey period effects, state
economic growth was not associated with the risk of underweight (OR 1.01,
95% CI 0.98, 1.04), stunting (OR 1.02, 95% CI 0.99,
1.05), and wasting (OR 0.99, 95% CI 0.96, 1.02). Adjustment for
demographic and socioeconomic covariates did not alter these estimates.
Similar patterns were observed for severe undernutrition outcomes.
Conclusions:
We failed to find consistent evidence that economic growth leads to reduction
in childhood undernutrition in India. Direct investments in appropriate
health interventions may be necessary to reduce childhood undernutrition in
India.
:
Please see later in the article for the Editors' Summary
Vyšlo v časopise:
Is Economic Growth Associated with Reduction in Child Undernutrition
in India?. PLoS Med 8(3): e32767. doi:10.1371/journal.pmed.1000424
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pmed.1000424
Souhrn
Background:
Economic growth is widely perceived as a major policy instrument in reducing
childhood undernutrition in India. We assessed the association between
changes in state per capita income and the risk of undernutrition among
children in India.
Methods and Findings:
Data for this analysis came from three cross-sectional waves of the National
Family Health Survey (NFHS) conducted in 1992–93,
1998–99, and 2005–06 in India. The sample sizes in the
three waves were 33,816, 30,383, and 28,876 children, respectively. After
excluding observations missing on the child anthropometric measures and the
independent variables included in the study, the analytic sample size was
28,066, 26,121, and 23,139, respectively, with a pooled sample size of
77,326 children. The proportion of missing data was
12%–20%. The outcomes were underweight,
stunting, and wasting, defined as more than two standard deviations below
the World Health Organization–determined median scores by age and
gender. We also examined severe underweight, severe stunting, and severe
wasting. The main exposure of interest was per capita income at the state
level at each survey period measured as per capita net state domestic
product measured in 2008 prices. We estimated fixed and random effects
logistic models that accounted for the clustering of the data. In models
that did not account for survey-period effects, there appeared to be an
inverse association between state economic growth and risk of undernutrition
among children. However, in models accounting for data structure related to
repeated cross-sectional design through survey period effects, state
economic growth was not associated with the risk of underweight (OR 1.01,
95% CI 0.98, 1.04), stunting (OR 1.02, 95% CI 0.99,
1.05), and wasting (OR 0.99, 95% CI 0.96, 1.02). Adjustment for
demographic and socioeconomic covariates did not alter these estimates.
Similar patterns were observed for severe undernutrition outcomes.
Conclusions:
We failed to find consistent evidence that economic growth leads to reduction
in childhood undernutrition in India. Direct investments in appropriate
health interventions may be necessary to reduce childhood undernutrition in
India.
:
Please see later in the article for the Editors' Summary
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