This study used a series of individual-level datasets from National Family Health Surveys conducted in 1998–99, 2005–06 and 2015–16 to assess the factors behind the reduction in childhood stunting and underweight in India between the years 1998–99 and 2015–16. A multivariable decomposition regression analysis was performed. Results showed that the prevalence of childhood stunting declined from 49.4% in 1998–99 to 34.9% in 2015–16. Over the same period, the prevalence of childhood underweight declined from 41.9% in 1998–99 to 33.1% in 2015–16. The reduction in the prevalence of stunting was found to be contributed largely by a reduction in the combined prevalence of stunting and underweight (60%), followed by stunted only (21%) and the combined prevalence of stunting, underweight and wasting (19%). Likewise, the reduction in the prevalence of underweight was contributed by a reduction in the combined prevalence of stunting and underweight and the combined prevalence of stunting, underweight and wasting. Results of the decomposition analysis showed that over the period 1998–99 to 2015–16, improvement in wealth status and maternal education led to 13% and 12% declines, respectively, in childhood stunting and to 31% and 19% declines, respectively, in childhood underweight. Furthermore, reductions in childhood stunting and underweight were due to an increased average number of antenatal care visits, lower average birth order, decreased share of children with below-average birth size, increased use of clean fuel for cooking and a reduction in the practice of open defecation. These findings suggest that further reduction in the prevalence of childhood stunting and underweight could be attained through more equitable household economic growth, investment in girl’s education, greater access to improved toilet facilities, more widespread use of clean fuel for cooking, reduction in average birth order, increased antenatal care visits and greater consumption of IFA tablets by pregnant women. Policymakers need to prioritize these measures to further reduce malnutrition among Indian children.

中文翻译：

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印度减少儿童发育迟缓和体重不足的成功案例：对三轮印度人口和健康调查（1998-2016）的汇总数据的分析

本研究使用了 1998-99 年、2005-06 年和 2015-16 年进行的全国家庭健康调查的一系列个人水平数据集，以评估 1998-99 年至 2015 年间印度儿童发育迟缓和体重不足减少的背后因素–16。进行了多变量分解回归分析。结果显示，儿童发育迟缓的患病率从 1998-99 年的 49.4% 下降到 2015-16 年的 34.9%。同期，儿童体重不足的患病率从 1998-99 年的 41.9% 下降到 2015-16 年的 33.1%。发现发育迟缓患病率的降低主要是由于发育迟缓和体重不足的综合患病率（60%）降低，其次是仅发育迟缓（21%）和发育迟缓、体重不足和消瘦的综合患病率（19%） ）。同样地，体重不足发生率下降的原因是发育迟缓和体重不足的合并发生率以及发育迟缓、体重不足和消瘦的合并发生率降低。分解分析的结果表明，在 1998-99 年至 2015-16 年期间，财富状况和母亲教育的改善导致儿童发育迟缓率分别下降 13% 和 12%，并分别下降 31% 和 19%，在儿童时期体重不足。此外，儿童发育迟缓和体重不足的减少是由于平均产前检查次数增加、平均出生订单减少、出生体重低于平均水平的儿童比例减少、清洁燃料的使用增加以及减少使用露天排便。这些研究结果表明，可以通过更公平的家庭经济增长、对女童教育的投资、更多地获得改善的厕所设施、更广泛地使用清洁燃料做饭、减少平均出生订单来进一步降低儿童发育迟缓和体重不足的发生率, 增加产前检查次数和孕妇服用更多的 IFA 片剂。政策制定者需要优先考虑这些措施，以进一步减少印度儿童的营养不良。