Economic progress in India over the past three decades has not been accompanied by a commensurate improvement in the nutritional status of children, and a disproportionate burden of undernutrition is still focused on socioeconomically disadvantaged populations in the poorest regions. This study examined the nutritional status of children under 3 years of age using data from the fourth round of Indian National Family Health Survey conducted in 2015–2016. Child undernutrition was assessed in a sample of 126,431 under-3 children using the anthropometric indices of stunting, underweight and wasting (‘anthropometric failure’) across 640 districts, 5489 primary sampling units and 35 states/UTs of India. Descriptive statistics were used to examine the regional pattern of childhood undernutrition. Multilevel logistic regression models were fitted to examine the adjusted effect of social group (tribal vs non-tribal) and economic, demographic and contextual factors on the risks of stunting, underweight and wasting accounting for the hierarchical nature of the data. Interaction effects were estimated to model the joint effects of socioeconomic position (household wealth, maternal education, urban/rural residence and geographical region) and social group (tribal vs non-tribal) with the likelihood of anthropometric failure among children. The burden of childhood undernutrition was found to vary starkly across social, economic, demographic and contextual factors. Interaction effects demonstrated that tribal children from economically poorer households, with less-educated mothers, residing in rural areas and living in the Central region of India had elevated odds of anthropometric deprivation than other tribal children. The one-size-fits-all approach to tackling undernutrition in tribal children may not be efficient and could be counterproductive.

中文翻译：

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在印度，部落儿童营养不良的风险是否会增加？多层次分析

在过去的 30 年里，印度的经济进步并没有伴随儿童营养状况的相应改善，营养不良的不成比例的负担仍然集中在最贫困地区的社会经济弱势群体身上。本研究使用 2015-2016 年进行的第四轮印度全国家庭健康调查的数据检查了 3 岁以下儿童的营养状况。使用印度 640 个地区、5489 个初级抽样单位和 35 个州/UT 的发育迟缓、体重不足和消瘦（“人体测量失败”）的人体测量指数，对 126,431 名 3 岁以下儿童的样本进行了儿童营养不良评估。描述性统计数据用于检查儿童营养不良的区域模式。拟合多级逻辑回归模型以检查社会群体（部落与非部落）和经济、人口和背景因素对发育迟缓、体重不足和消瘦风险的调整影响，以解释数据的等级性质。估计交互作用以模拟社会经济地位（家庭财富、母亲教育、城市/农村居住地和地理区域）和社会群体（部落与非部落）与儿童人体测量失败可能性的联合影响。发现儿童营养不良的负担在社会、经济、人口和环境因素方面存在显着差异。交互效应表明，来自经济较贫困家庭、母亲受教育程度较低的部落儿童，与其他部落儿童相比，居住在农村地区和生活在印度中部地区的人被剥夺人体测量学的几率更高。解决部落儿童营养不良的一刀切方法可能效率不高，而且可能适得其反。