Stunting in India: What Does Women's Empowerment Have to Do with It?

Background

According to the World Health Organization, nearly 165 million children under age five are stunted globally, a manifestation of chronic malnourishment. In India alone, 62 million children under age five are stunted, leading to reduced physical and mental development. The percentage of Indian children under five who suffer from stunting is almost 20 times the percentage of stunted children in a standard well-nourished population of children. While the Indian economy has seen a remarkable increase, India still remains as the country with the highest number of stunted children in the world. Stunting has often been linked with inadequate food, lack of water, sanitation and hygiene practices. Indicators of malnourishment among children include stunting and low weight, both of which are informed respectively by universal norms of age-specific height and weight specifications.  Stunting has been stated as a neglected indicator. Most studies attempt to isolate factors that differentiate the stunted from the not stunted. However, one weakness of this approach is that it incorporates various levels of stunting such as, extremely stunted under the broad category of the stunted. Consequently, the effect of variables in stunting models is expected to be similar for the stunted as well as the extremely stunted. The purpose of this study was therefore, to assess the effect of socioeconomic variables on varying degrees of stunting.

Methods

The study assessed the effects of women’s age at motherhood on three levels of stunting, mild, moderate and severe. Data from National Family Health Survey (2005-2006) was used to test three separate models of stunting with selected determinants of women’s empowerment and variables, controlling for several environmental factors related to stunting. Generalized ordinal regression method was employed to analyze the data.

Results

Our results suggest that policies that directly help mothers to improve their social status through increases in their wealth and educational levels are more likely to reduce stunting than programs that neglect the family context. Additionally, it was found that effects of selected variables varied across stunting levels suggesting a need to develop stunting level specific interventions.

Conclusion

Policies that directly help mothers to improve their social status through gradual increases in their wealth and educational levels are more likely to reduce stunting than programs that neglect the family context. Our results broadly suggest that the most effective programs are likely to empower family members, especially the mother, in decision making and utilizing available resources necessary for stunting prevention. Mothers with a high level of education are more likely to be aware of sanitary practices at the household level and also to improve children’s nutrition within the limits of available monetary resources. Our study found that mothers’ characteristics such as education, wealth status, and age at first birth have significant effect on reducing the level of stunting. Mother’s capacity to make intra household allocations for safeguarding children’s adequate nutritional intake is crucial for the success of prevention programs against stunting. Mother’s education provides social, cultural, and economic protection against threats to her children’s nutritional intake.