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The double burden of 'malnutrition': Under-Nutrition & Obesity

Longitudinal trends in the health outcomes among children of the North Eastern States of India: a comparative analysis using national DHS data from 2006 to 2020

European Journal of Clinical Nutrition volume 76, pages 1528–1535 (2022)Cite this article

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Abstract

Background/Objectives

Northeastern Indian region has a high density of marginalised populations with a concerning quality of health services. We observed the trends in prevalence of infectious diseases and nutritional disorders among children under-five years from 2006 to 2020 in the Northeastern states. We also assessed the distribution of their burden by place of residence.

Methods

A secondary data analysis of select indicators on infectious diseases and nutritional disorders in seven Northeastern states across three rounds of the National Family Health Survey (2005–06, 2015–16, 2019–20) was undertaken. We calculated outcome indicator mean prevalence, relative change and average annual rates of reduction of the indicators.

Results

A significant relative reduction between 2006–2020 in the prevalence of diarrhoea (0.4 [95CI:0.7,0.1]) at p < 0.05; acute respiratory illness (ARI) (0.7 [95CI:0.1,0.4]), stunting (0.3 [95CI: 0.3,0.12]) and underweight (0.3 [95CI:0.5,0.2]) at p < 0.001 were noted. However, overweight prevalence increased (10.1[95CI:4.3,16.0, p < 0.001]) due to a low annual reduction rate. The highest annual reduction rates were observed in Sikkim and Tripura for diarrhoea and ARI respectively (>10.0%), and in Meghalaya for wasting and severely wasting (6.3%). Rural areas had a higher burden of stunting, wasting (including severe), underweight, anaemia and diarrhoea; overweight was seen in both rural and urban settings.

Conclusion

Significant reductions were observed in ARI, diarrhoea, stunting and underweight prevalence between 2006–2020, with sub-regional variations and a greater burden in rural areas. During this period, overweight prevalence worsened; and anaemia showed a large increase from 2016. To reduce the equity-gap, programmes should be adapted to meet the differential needs of the Northeastern states.

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Fig. 1: Relative change of child health outcomes by states.
Fig. 2: Distribution of the burden of health outcomes by place of residence.

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Data availability

The data supporting the findings of this study are publicly available from NFHS at http://rchiips.org/nfhs/index.shtml; NFHS-3 and NFHS-4 data were obtained from the state reports and NFHS-5 was obtained from the state factsheets.

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Acknowledgements

The authors thank NFHS for their data. The authors also appreciate the support of Solomon Salve from Oxford Policy Management for reviewing the manuscript. No funding was sought for this study.

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Authors and Affiliations

  1. Oxford Policy Management, New Delhi, India

    Ankita Mukherjee

  2. Independent Consultant, Delhi, India

    Rizu

  3. Evidence Action, Delhi, India

    Rakesh Parashar

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  1. Ankita Mukherjee
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  2. Rizu
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Contributions

A.M. was responsible for conceiving and designing the study. She drafted the manuscript, extracted the data, conducted the analyses, and wrote the Results and Discussion sections. She coordinated with co-authors and integrated the feedback, and revised the manuscript. R.R. was responsible for rechecking the data analyses and writing the initial Introduction. She also reviewed the complete manuscript. R.P. was responsible for conceiving and designing the study. He reviewed the draft, provided feedback and revised the manuscript.

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Correspondence to Ankita Mukherjee.

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Mukherjee, A., Rizu & Parashar, R. Longitudinal trends in the health outcomes among children of the North Eastern States of India: a comparative analysis using national DHS data from 2006 to 2020. Eur J Clin Nutr 76, 1528–1535 (2022). https://doi.org/10.1038/s41430-022-01147-w

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