Observational studyJMIR public health and surveillance2024
Association of Child Growth Failure Indicators With Household Sanitation Practices in India (1998-2021): Spatiotemporal Observational Study.
Observational study in JMIR public health and surveillance, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Explaining rural-urban disparities in child stunting in African least developed countries: a multi-country cross-sectional analysis.International journal for equity in health · 2026Article
- Regional vulnerability assessment using poverty, undernutrition, and burden of infectious diseases in India: a spatial syndemic analysis.BMC public health · 2026Article
- Addressing the poverty-nutrition gap for SDG 1 and SDG 2: a Bayesian geo-additive analysis of spatial heterogeneity and nonlinear maternal risks in childhood stunting in India (NFHS-4 and NFHS-5).Frontiers in public health · 2026Article
- Social and Environmental Determinants of Childhood Stunting in Indonesia: National Cross-Sectional Study.JMIR pediatrics and parenting · 2025Article
- Impact of Fortified Malt-Based Food on Immunity Outcomes in School Children in India: Cluster Randomized Controlled Trial.Interactive journal of medical research · 2025Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUndernutrition among children younger than 5 years is a subtle indicator of a country's health and economic status. Despite substantial macroeconomic progress in India, undernutrition remains a significant burden with geographical variations, compounded by poor access to water, sanitation, and hygiene services.
objectiveThis study aimed to explore the spatial trends of child growth failure (CGF) indicators and their association with household sanitation practices in India.
methodsWe used data from the Indian Demographic and Health Surveys spanning 1998-2021. District-level CGF indicators (stunting, wasting, and underweight) were cross-referenced with sanitation and sociodemographic characteristics. Global Moran I and Local Indicator of Spatial Association were used to detect spatial clustering of the indicators. Spatial regression models were used to evaluate the significant determinants of CGF indicators.
resultsOur study showed a decreasing trend in stunting (44.9%-38.4%) and underweight (46.7%-35.7%) but an increasing prevalence of wasting (15.7%-21.0%) over 15 years. The positive values of Moran I between 1998 and 2021 indicate the presence of spatial autocorrelation. Geographic clustering was consistently observed in the states of Madhya Pradesh, Jharkhand, Odisha, Uttar Pradesh, Chhattisgarh, West Bengal, Rajasthan, Bihar, and Gujarat. Improved sanitation facilities, a higher wealth index, and advanced maternal education status showed a significant association in reducing stunting. Relative risk maps identified hotspots of CGF health outcomes, which could be targeted for future interventions.
conclusionsDespite numerous policies and programs, malnutrition remains a concern. Its multifaceted causes demand coordinated and sustained interventions that go above and beyond the usual. Identifying hotspot locations will aid in developing control methods for achieving objectives in target areas.
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