Malnutrition was the main cause of death among children below 5 years in every state of India in 2017. Despite several flagship programmes and schemes implemented by the Government of India, the latest edition of the Global Nutrition Report 2018 addressed that India tops in the number of stunted children, which is a matter of concern. Thus, a micro-level study was designed to know the level of nutritional status and to study this by various disaggregate levels, as well as to examine the risk factors of stunting among pre-school children aged 36–59 months in Malda. A primary cross-sectional quantitative survey was conducted using structured questionnaires following a multi-stage, stratified simple random sampling procedure in 2018. A sum of 731 mothers with at least one eligible child aged 36–59 months were the study participants. Anthropometric measures of children were collected following the WHO child growth standard. Children were classified as stunted, wasted, and underweight if their HAZ, WHZ, and WAZ scores, respectively, were less than −2SD. The random intercept multilevel logistic regression model has been employed to estimate the effects of possible risk factors on childhood stunting. The prevalence of stunting in the study area is 40% among children aged 36–59 months, which is a very high prevalence as per the WHO’s cut-off values (≥40%) for public health significance. Results of the multilevel analysis revealed that preceding birth interval, low birth weight, duration of breastfeeding, mother’s age at birth, mother’s education, and occupation are the associated risk factors of stunting. Among them, low birth weight (OR 2.22, 95% CI: 1.44–3.41) and bidi worker as mothers’ occupation (OR 1.92, 95% CI: 1.18–3.12) are the most influencing factors of stunting. Further, about 14 and 86% variation in stunting lie at community and child/household level, respectively. Special attention needs to be placed on the modifiable risk factors of childhood stunting. Policy interventions should direct community health workers to encourage women as well as their male partners to increase birth interval using various family planning practices, provide extra care for low birth weight baby, that can help to reduce childhood stunting.

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印度马尔达学龄前儿童发育迟缓的营养状况和伴随因素：采用多层次方法的微观研究

营养不良是 2017 年印度各邦 5 岁以下儿童死亡的主要原因。 尽管印度政府实施了多项旗舰计划和计划，但最新一期的《2018 年全球营养报告》指出，印度在发育迟缓的儿童，这是一个值得关注的问题。因此，设计了一项微观研究，以了解营养状况的水平，并通过不同的分类水平进行研究，并检查马尔达 36-59 个月的学龄前儿童发育迟缓的风险因素。2018 年，按照多阶段、分层的简单随机抽样程序，使用结构化问卷进行了初步横断面定量调查。 研究参与者共有 731 名至少有一个符合条件的 36-59 个月婴儿的母亲。根据世界卫生组织儿童生长标准收集儿童的人体测量数据。如果儿童的 HAZ、WHZ 和 WAZ 分数分别小于 -2SD，则儿童被归类为发育迟缓、消瘦和体重不足。随机截距多级逻辑回归模型已被用于估计可能的风险因素对儿童发育迟缓的影响。研究区域内 36-59 个月儿童发育迟缓的患病率为 40%，按照世界卫生组织关于公共卫生意义的临界值（≥40%），这是一个非常高的患病率。多层次分析结果显示，早产间隔、低出生体重、母乳喂养时间、母亲出生年龄、母亲受教育程度和职业是发育迟缓的相关危险因素。其中，低出生体重（OR 2.22，95% CI：1.44-3。41) 和比迪烟工人作为母亲的职业 (OR 1.92, 95% CI: 1.18–3.12) 是发育迟缓的最大影响因素。此外，大约 14% 和 86% 的发育迟缓变异分别存在于社区和儿童/家庭级别。需要特别注意儿童发育迟缓的可改变风险因素。政策干预应指导社区卫生工作者鼓励妇女及其男性伴侣使用各种计划生育做法延长生育间隔，为低出生体重婴儿提供额外护理，这有助于减少儿童发育迟缓。需要特别注意儿童发育迟缓的可改变风险因素。政策干预应指导社区卫生工作者鼓励妇女及其男性伴侣使用各种计划生育做法延长生育间隔，为低出生体重婴儿提供额外护理，这有助于减少儿童发育迟缓。需要特别注意儿童发育迟缓的可改变风险因素。政策干预应指导社区卫生工作者鼓励妇女及其男性伴侣使用各种计划生育做法延长生育间隔，为低出生体重婴儿提供额外护理，这有助于减少儿童发育迟缓。