feeding practices and growth pattern are better in south
TRANSCRIPT
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Feeding Practices and Growth Pattern are better in South than North India
Mukesh Ravi Raushan1 and Ranjan Kumar Prusty
2
Abstract
The stunted children in India is amongst the highest in world, and nearly doubles of Sub-Saharan Africa
with dire consequences for mobility, mortality, productivity and economic growth. With prime objective of
this paper explain about: a) to assess the age-specific feeding index using the information available in
National Family Health Survey (NFHS-3) data sets for 6-36 month old children in Indian context; b) to
estimate and understand the association between child feeding practices and child nutritional status; c) to
estimate and study whether better feeding practices can sort the nutritional status of children of 6-36 month
of age, depending on economic factor, socio-demographic factors. The National Family Health Survey
(NFHS-3), 2005 has been utilized for the present study to investigate North - South differential in the
feeding practices and nutritional status among 6-36 month old children in India. The composite child
feeding index was created for Indian context with some modification on the basis of current feeding
recommendations for 6-36 month old children given by WHO (WHO, 2008). This index was originally
created by Ruel and Menon in 2002. The findings reports that 97.5 per cent severely stunted 6-9 month old
children are receiving low score of the index in the South region which is slightly higher than their
counterpart from North India. The highly nutritious feeding practices such as giving porridge, milk-dairy
product and flesh and poultry products are not more than ~10 per cent, however, the feeding practices
increases to ~90 per cent among 13-36 month old children in both south as well as north region in India.
As income status is negatively associated with child feeding practices, the children belonging to richest
household were having very less chance to be severely stunted (5 per cent, p<0.01, CI: 95%) as compared
to children from poorest household (19 per cent, p<0.01, CI: 95%) among six to nine month old in south.
The statistically significant more proportion of 6-9 month old Hindu children (~12 per cent, p<0.05) are
severely stunted as compared to Muslim (~9 per cent, p<0.05) in South India. Therefore, the better child
feeding practices are associated with better health status of children.
Authors details: 1Mukesh Ravi Raushan, Research Scholar, International Institute for Population Sciences, Mumbai, India; email: [email protected] 2Ranjan Kumar Prusty, Research Scholar, International Institute for Population Sciences, India; email: [email protected]
Introduction
Malnutrition is one of the significant factors contributing to Infant and child mortality in developing
countries of the world (Black et al, 2008; Victoria et al, 2008). Nutrition during the first five years has
an impact not only on growth and morbidity during childhood, but also acts as a determinant of
nutritional status in adolescent and adult life. The sixth report on global nutrition showed that the
extent of malnutrition is still incongruously high and progress to reduce
it in most regions of the world
is slow (United Nations, 2010). According to WHO 2007 estimates, there are around 19.3 and 31.6
percent of underweight and stunted children in the developing countries as compared to 1.5 and 6.0
per cent of underweight and stunted children respectively in developed world (United Nation, 2010).
Therefore, malnutrition is considered as wide spread public health problem especially in developing
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countries. The prevalence of underweight and stunted children in India is amongst the highest in
world, and nearly doubles that of Sub-Saharan Africa with dire consequences for mobility, mortality,
productivity and economic growth (Gragnolati et al, 2005). Almost half of the preschool children are
stunted, two-fifths of them are underweight and one-fifths of them are wasted and nearly 60 million
children are underweight in India (IIPS & ORG Macro, 2006).
Several studies revealed that major outcome of malnutrition during childhood leads to a higher
incidence of diarrhoea. The malnourished children tend to have more severe diarrhoea episodes and
associated growth faltering (Lutter, Mora, & Habicht, 1989; Tomkins & Watson, 1989; WHO, 1997).
Women’s socio-economic determinant for increased access to nutrition for children in Indian
Context
Income, Education and Nutrition
The income poverty and lower educational attainment of mother are recognised as being the strongest
factors that mark child mortality (Glewwe, 1999). However, there is also evidence that intra-
household relations, particularly those which rely on gendered social and cultural norms, mediate
aspects of child health and nutrition and impact on infant and child mortality (Chen, Huq, & D'Souza,
1981; Dyson & Moore, 1983). The evidences demonstrate the strong link between women’s education
and child survival although it is thought to be linked to women’s increased status and decision-making
power within the household (Heaton, Huntsman, & Flake, 2005). With education as a resource base,
women are better able to gain independence from the constraints of patriarchal traditions (Malhotra,
Vanneman, & Kishor, 1995). Literate women have greater access to information and do not have to
rely heavily on their families for information. This in turn may increase mother’s mobility outside the
community, the accessibility of health care and their ability to negotiate health systems effectively, as
well as increase their knowledge, skills and responsiveness to learned experience to feed and nourish
their child (Glewwe, 1999).
Research in South Asia and elsewhere has provided evidence that women’s status is correlated
positively with the health status of women and children (Murthi, Guio, & Dreze, 1995). The health
status of both women and children, particularly female children, suffers in relation to that of males in
areas where patriarchal kinship and economic systems limits women’s autonomy. Dyson and Moore
reported that in north India, where women’s status is generally lower, higher rates of fertility, greater
infant and child mortality, and higher ratios of female to male infant mortality were observed (Dyson
& Moore, 1983). Although the problem of malnutrition, as believed by nutritionist is multifaceted not
just related to food shortage but feeding practices are believe to be the most important for child
nutrition (WHO, 1995; Brown et al., 1998).
Efforts to quantify child feeding practices have been limited by due to methodological issues (Ruel &
Menon, 2002). Most of the research on relationship between child feeding practices and nutrition
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outcome has focused on single behaviour e.g. exclusive breastfeeding, timing of introduction of
complimentary food, duration of breastfeeding etc. (Victoria et al, 1989; Popkins et al, 1990; Cohen et
al, 1994; Marquis et al, 1997). It was Ruel and Menon who first attempted to create composite age-
specific feeding index to see its association with child nutrition for the Latin American countries.
Even after this there have been a few research carried out on child feeding practices and nutrition.
The World Health Organization provided regulated guidelines for child feeding practices in 2008.
Despite of the present effort there have been a very few studies which attempted to build a composite
index of feeding practices. In Indian context, this kind of study is rare due to data limitation.
Therefore, the present study tries to understand the role of child feeding practices on child nutrition
using a composite child feeding index. An attempt has been made to create a composite index using
Ruel and Menon’s method with some modification in Indian context.
The prime objective of this paper are: a) to assess the age-specific feeding index using the information
available in National Family Health Survey (NFHS-3) data sets for 6-36 month old children in Indian
context; b) to estimate and understand the association between child feeding practices and child
nutritional status; c) to estimate and study whether better feeding practices can sort the nutritional
status of children of 6-36 month of age, depending on economic factor, socio-demographic factors.
Data and Methodology
We utilize National Family Health Survey, 2005-06 (NFHS-3) for this study which was designed to
provide estimates of important indicators on family welfare, maternal and child health, and nutrition
in India. This survey is the Indian version of Demographic and Health Survey (DHS), conducted
worldwide and considered as one of the most robust data source in India. Information collected on
breastfeeding, complimentary feeding and meal frequencies in the survey were used to construct child
feeding index.
Child Feeding Index: The index was created on the basis of current feeding recommendations for
children 6-36 months given by WHO (WHO, 2008). Age specific feeding indices were created as
feeding practices differ by age group of children. We created indices by three age groups 6-9 months,
9-12 months and 12-36 months of children. The variables were used in the indices are a) breast-
feeding (whether the mother is currently breast-feeding the child or not); b) use of baby bottles in the
previous 24 h (yes/no); c) dietary diversity (whether or not the child received selected food groups in
the previous 24 hr; and d) feeding frequency (how many times the child was offered solid or
semisolid, or soft foods other than liquids in the previous 24 hr. Food frequency is ignored due to data
limitation. The scoring patterns with variables are shown in the details in Table 1.
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Table 1 : Variables and scores given to create the child feeding index for children 6-36 months
old by age group
Variables 6-9 months 9-12 months 12-36 months
Breastfeeding No = 0; Yes = +2 No = 0; Yes = +2 No = 0; Yes = +1
Uses bottle No = 1; Yes = 0 No = 1; Yes = 0 No = 1; Yes = 0
Dietary
diversity (past
24 h)
Sum of: (grains + legume +
dairy product +
egg/flesh/poultry + meat +
other)
Sum of: (grains + legume +
dairy product +
egg/flesh/poultry + meat +
other)
Sum of: (grains + legume +
dairy product +
egg/flesh/poultry + meat +
other)
0 = 0 0 = 0 0 = 0
1-3 = 1 1-3 = 1 1-3 = 1
4+ = 2 4+ = 2 4+ = 2
Meal frequency
(past 24 h) 0 meals/d = 0 0 meals/d = 0 0-1 meals/d = 0
1 meals/d = 1 1-2 meals/d = 1 2-3 meals/d = 1
2 meals/d = 2 3+ meals/d = 2 4+ meals/d = 2
Total score 7 points 7 points 7 points
Outcome Variable: The outcome variable used in the study is acute child malnutrition is height-for-
age/stunting status of children. The nutritional status indicators are expressed in standard deviation
units (Z-scores) from the median of the reference population. Children (below three years of age)
whose height-for-age was below minus two standard deviations from the median reference population
were classified as moderately stunted and those whose height-for-age was below minus three standard
deviations have been referred as severely stunted.
To assess the nutritional status of children with respect to reference population, Z-scores (standard
deviation scores) are employed. Z score is defined as:
Z-score = (observed individual value – median value of the reference population)/
(Standard deviation of value in the reference population)
The region was categorized into two as South and North. The states Andhra Pradesh, Karnataka,
Kerala, and Tamil Nadu are as south; and Delhi, Haryana, Himachal Pradesh, Jammu & Kashmir,
Punjab, Rajasthan and Uttaranchal as North region.
The outcome variable is nutritional health status (i.e. stunting) and divided into three categories as
normal, moderate, and severely stunted. Multinomial logistic regression coefficients were converted
into predicted probabilities calculated for the three categories of the stunting for different
demographic and socio-economic factors according to score of the age-specific child feeding index.
These probabilities were changed into percentage and are termed as adjusted percentages. The
analysis focus on the low score of child feeding index in 6-9 month and average for 12-36 month of
children to minimize the appropriate sample distribution for statistical analysis.
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ANOVA was used to test the association between child feeding index terciles and child nutritional
status (HAZ). The objective of testing for two-way interaction terms was to determine whether the
association between child feeding practices and child nutritional status differed according to specific
characteristics of the child, mother or household. For instance, it was hypothesized on the basis of
literatures that the situation of children from lower economy and lower educated women may benefit
from better feeding practices than children whose mother were richer and higher educated. Several
literatures report that the education and women autonomy (or statuses) are higher in south than their
counterpart from North India (Dyson & Moore, 1983; Dreze & Murthi, 2001).
Explanatory variables: The most important independent variable used is composite child feeding
indices to see its age specific association with child nutrition. The child feeding indices has been
categorized into three- low, average, high-based on score. Other explanatory variable used in the
study are different socio-economic characteristics like wealth index, birth order, sex of child, religion,
mother’s educational status, infrastructure development like improved sanitation, ethnicity and
residence.
We used descriptive statistics, and multivariate methods for the purpose of analysis. Multinomial
logistic regression was used to find association of child feeding practices and other socio-economic
variable on child nutritional status.
Findings and discussion
The North-South differential in nutritional health status for 6-36 month of children in
India
The 97.5 per cent severely stunted 6-9 month old children are receiving low score of the index in the
North region which is slightly higher than their counterpart from South India. In both, North and
South region, the 6-9 month old children are greatly concentrated in low score of the index.
Surprisingly, high score of the index has not been reported for 6-9 month old children in both of the
regions. This may be because the overall poor feeding practices. This study found that about 90 per
cent and more than 80 per cent are scored as average in the index for 9-12 and 13-36 month old
children respectively. This may be because the increase in reporting of continuous breastfeeding and
accelerated complementary feeding increases as the child grows. However, the trend of baby bottle
use and the breastfeeding practices are not consistent.
The breast-feeding practices are lower in both the region, and it ranges from 10 per cent among 9-12
month old children in north region, however, about 73 per cent of the mother reported that they still
breastfed their child at this age in north as compared to 68 per cent in South India. The feeding
practices such as giving porridge, milk-dairy product and non-vegetables product are not more than
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~10 per cent, however, the feeding practices increases to ~90 per cent among 13-36 month old
children in both South as well as North region in India. This study reports that the feeding practices
among 13-36 month old children are higher in north region than south except for flesh food and eggs
because of region and culture-specific about different kind of food particularly animal products (NIN,
2010). The breast-feeding and baby bottle feeding among 6-12 month old south Indian children are
higher as compared to north, however, both of these practices are reversed with three to five points in
north region among 13-36 month old children in India (Table 2).
Meal frequency varied markedly among different age group children in two regions of India. The
meal frequency one to three are more prevalent among 6-12 month old children with slightly higher
points in south as compared to north region as reported by mother in last 24 hour. The meal frequency
are markedly higher (~90 per cent) among 13-36 month old children in north than south India because
frequency of food increases among children of one and more year old child.
Results of multinomial regression analyses depicts that as the chances of low score for child feeding
index decreases the severely stunted children of all age in the study decreases except for birth order
(Table 5 & 6).
The household characteristics such as wealth index are negatively correlated to that of stunting status
of children. The children belonging to richest household were having very less chance to be severely
stunted (5 per cent, p<0.01, CI: 95%) as compared to children from poorest household (19 per cent,
p<0.01, CI: 95%) among six to nine month old in South. The similar trend had also reported from
north region. As child grows chances of being severely stunted due to deficit in feeding practices
intensify. This intensification increased from 20 per cent among poorest and 1 per cent in richest in
north, and 38 per cent in poorest and below 1 per cent in south to 44 per cent in poorest and 11 per
cent among richest in north and 34 per cent among poorest and 7 per cent among richest in 10-36
month old children in India (p<0.001, CI: 95%). The regression analysis utilizes the average score of
child feeding index for 10-36 month old children for both South and North region in India. India as a
multi-religion country, the children belonging to Hindu religion (~12 per cent, p<0.05) a significantly
more proportion of 6-9 month old children are severely stunted as compared to Muslim because of
poor feeding practices in South. However, there is no statistically insignificant difference of risk of
severely stunted among 13-36 month old children in all three categories of religion in South. This
indicates that the child feeding practices are needs to be focused among children. The demographic
factors such as birth order and parity had statistically significant effect on stunting status on low score
for child feeding index. The birth order and status of severely stunting were positively correlated
across age and region except among 6-12 month old children in North region. The birth order of two
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are having the highest risk of severely stunted due to low score of feeding index among 6-9 month
and 10-12 month old children in North.
The educational attainment of mother and child’s severely stunting status due to poor feeding
practices are negatively associated. Those mother having primary education are significantly (~22 per
cent, p<0.05, CI: 95%) higher as compared to higher educated mother in both the regions of India. It
is important to note that the degree of association between mother’s educational attainment and
severely stunting status are more pronounced in South than North India. There is important scope of
research to dig other factor(s) which is regulating the association between child feeding practices and
stunting status of children when mother’s education is constant. The other demographic factor in the
study such as parity is positively associated with severely stunted 6-36 month old children in North
and South region except 6-9 month old children in North. Those women with parity of five or more
were having 35 per cent and 38 per cent of 13-36 month old children were severely stunted as
compared to 17 per cent and 21 of one to two parity women in South and North respectively. As the
infrastructure is concerned those households which were having improved sanitation facility reported
that ~6 per cent, ~5 per cent and ~11 per cent severely stunted as compared to ~15 per cent, ~16 per
cent and ~25 per cent non-improved sanitation facility households among 6-9 month, 10-12 month
and 13-36 month old children respectively in South region; and similar trend had been reported from
North also.
Conclusion and Policy Implication
Result shows wide diversity in feeding practices in India by different regions and socio-economic
status. Wide differences by region, economic status, sex of the child and maternal education had been
observed. The proportion of child getting better child feeding is high among rich, male children,
southern region and high educated mothers than their counterparts from poor, female child, eastern
region, and illiterate mothers respectively. There is wide diversity in giving animal product in India
and meal frequencies vary widely across age group, religion and region of child. Bivariate results
shows stunting is very high among children with poor feeding practices. However, more child
population are skewed toward low score for child feeding index for 6-9 month and towards average
score for 10-12 month and 13-36 month old children. Thus, it is important to strengthen maternal
education to improve feeding practices which simultaneously improves child nutrition as mother is
closest individual to child. Therefore, this study contributes that despite having better nutrition for
children in hand the emphasis should be given to focus on amount, timing of introduction and
appropriate frequency of food having sensitivity of susceptibility to infection for highly sensitive age-
group of children and culture (region) in mind.
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Table 2: Percentage of mothers reporting breast-feeding and selected feeding practices in
last 24 hour in India, 2005
Age of children 6-9 month 9-12 month 13-36 month
Region North South North South North South
Feeding Practices
Breast-feeding 16.78 19.83 10.7 12.41 72.51 67.75
Baby bottle use 15.6 17.21 12.77 12.82 71.62 69.98
In past 24 hour gave
Porridge 7.71 12.91 8.41 10.61 83.88 76.49
Milk & Dairy Product 6.35 9.02 6.51 8.06 87.15 82.91
Flesh Foods 3.74 3.16 6.98 6.33 89.28 90.51
Egg 4.91 2.06 7.69 5.48 87.41 92.47
In past 24 hour gave
1-3 11.08 15.91 11.16 11.87 77.76 72.22
3+ 4.32 9.38 5.31 7.78 90.38 82.84
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Table 3: Percentage distribution of children (age 6-36 month) according to score of child feeding index with their background characteristics in
South India, 2005
Factors 6-9 month 9-12 month 12-36 month
Health Status: Stunting Low Average High Total (Uw) Low Average High Total (Uw) Low Average High Total (Uw)
Severely 97.5 2.5 0.0 330 8.8 90.3 1.0 221 5.4 86.5 8.1 1408
Moderate 95.5 4.5 0.0 40 2.2 92.1 5.7 53 4.0 89.5 6.5 551
Normal 43.2 0.0 0.0 38 0.0 100.0 0.0 31 3.5 89.0 7.6 394
Total (Uw) 400 8 0 408 18 282 5 305 132 2033 188 2353
Economic Factor
Poorest 97.8 0.0 2.2 39 0.0 94.1 5.9 30 1.6 80.2 18.2 257
Poorer 95.4 4.7 0.0 72 3.9 92.3 3.9 44 3.0 83.6 13.3 400
Middle 89.3 5.7 5.0 115 3.3 90.8 5.9 85 5.2 80.7 14.2 665
Richer 97.8 0.8 1.5 156 8.2 84.8 7.1 119 4.7 85.0 10.3 833
Richest 92.8 3.7 3.5 150 11.7 85.1 3.2 85 7.1 83.7 9.2 758
Religion
Hindu 93.5 3.7 2.8 421 6.1 87.5 6.4 284 4.8 82.6 12.6 2181
Muslim 95.8 1.4 2.8 83 7.1 90.7 2.2 60 3.6 83.3 13.1 539
others 100.0 0.0 0.0 28 1.4 98.6 0.0 19 4.6 84.6 10.9 193
Educational Status
Illiterate 91.8 3.6 4.5 115 1.8 89.5 8.7 73 1.9 84.1 14.0 668
Primary 94.1 4.5 1.4 59 7.5 90.4 2.0 45 6.5 80.1 13.5 398
Secondary 95.0 3.0 1.9 290 7.1 88.3 4.7 198 5.0 82.7 12.4 1516
Higher 95.1 1.7 3.2 68 8.4 84.5 7.0 47 8.1 84.5 7.3 331
Ethnicity
Caste 94.7 3.0 2.2 503 6.3 87.9 5.8 342 4.8 82.9 12.3 2753
Tribe 83.3 6.7 10.1 29 0.0 100.0 0.0 21 2.1 82.2 15.7 160
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Table 3: Cont…
Residence
Urban 95.4 3.5 1.1 246 7.8 87.3 4.9 157 6.4 83.4 10.2 1402
Rural 93.3 3.1 3.5 286 5.1 89.1 5.8 206 3.6 82.5 13.9 1511
Birth Order
One 95.7 1.4 2.9 225 6.7 86.0 7.2 157 5.7 78.3 15.9 1142
Two 91.3 5.6 3.1 195 7.6 89.4 3.0 125 3.9 84.9 11.2 1077
Three 94.5 3.1 2.5 65 2.2 90.2 7.6 53 4.1 87.0 9.0 410
Four+ 97.9 2.1 0.0 47 2.8 94.1 3.1 28 4.0 86.7 9.3 284
Sex of Child
Male 93.7 3.2 3.1 290 6.1 86.7 7.2 203 4.9 82.1 13.0 1542
Female 94.6 3.3 2.1 242 6.0 90.8 3.3 160 4.4 83.6 12.0 1371
Parity
1-2 93.8 3.2 3.0 419 7.1 87.5 5.4 282 5.2 83.6 11.3 2072
3-4 95.2 3.1 1.8 92 2.7 92.0 5.3 71 3.7 80.0 16.3 705
5+ 95.1 4.9 0.0 21 0.6 89.1 10.4 10 1.6 86.4 12.0 136
Sanitation Facility
Improved 95.1 3.2 1.8 287 11.0 84.7 4.4 193 6.2 83.8 10.0 1584
Not improved 93.6 2.5 3.9 184 2.4 91.2 6.4 148 3.2 82.8 14.0 1092
Total (Uw) 506 14 12 532 21 326 16 363 159 2404 350 2913
Note: Uw: Unweighted Cases
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Table 4: Percentage distribution of children (age 6-36 month) according to score of child feeding index with their background characteristics in
North India, 2005
Factors 6-9 month 9-12 month 12-36 month
Health Status: Stunting Low Average High Total (Uw) Low Average High Total (Uw) Low Average High Total (Uw)
Severely 97.67 2.33 0 407 5.45 90.69 3.87 254 4.91 84.98 10.11 1595
Moderate 98.98 1.02 0 65 8.41 89.71 1.88 71 5.2 84.89 9.91 716
Normal 98.15 1.85 0 36 7.69 90.04 2.27 49 3.31 89.76 6.92 703
Total 485 23 0 508 30 320 24 374 169 2546 299 3014
Economic Factor
Poorest 96.27 3.73 0 48 0 91.57 8.43 31 0.75 83.63 15.62 308
Poorer 92.84 1.77 5.38 72 3.25 83.88 12.87 61 1.42 80.03 18.56 461
Middle 94.17 2.43 3.4 143 5.14 88.82 6.04 101 2.99 79.15 17.86 824
Richer 89.44 3.18 7.38 160 7.79 85.55 6.66 117 5.42 79.34 15.25 954
Richest 92.54 1.99 5.48 192 9.63 82.53 7.84 136 7.73 81.71 10.57 1092
Religion
Hindu 94.17 1.95 3.87 461 5.54 86.01 8.46 328 3.71 80.72 15.57 2652
Muslim 88.35 6.38 5.27 98 2.41 88.95 8.64 76 3.42 78.98 17.6 644
others 85.92 2.79 11.28 56 14.94 79.96 5.09 42 9.08 82.65 8.27 341
Educational Status
Illiterate 91.37 3.41 5.21 226 3.44 89.55 7.01 182 2.75 80.35 16.9 1582
Primary 94.89 1.74 3.37 76 5.51 84.6 9.89 57 2.19 83.23 14.59 403
Secondary 93.47 2.29 4.24 249 10.17 80.66 9.17 157 5.73 80.07 14.2 1336
Higher 92.66 1.04 6.3 64 6.51 85.98 7.51 50 11.96 81.46 6.58 318
Ethnicity
Caste 92.52 2.65 4.83 568 6.52 85.14 8.34 395 4.36 80.48 15.16 3236
Tribe 94.76 2.1 3.15 47 2.69 90.7 6.61 51 2.76 82.13 15.1 403
Page | 14 /16
Table 4: Cont…
Residence
Urban 91.83 2.03 6.15 196 11.33 80.76 7.91 151 7.65 79.35 13 1281
Rural 93 2.81 4.19 419 4.04 87.73 8.23 295 2.79 81.2 16.01 2358
Birth Order
One 93.91 0.9 5.19 204 10.99 79.44 9.57 141 5.88 76.24 17.89 1214
Two 94 2.09 3.91 196 4.58 86.83 8.59 141 4.77 81.65 13.58 1075
Three 87.72 4.5 7.78 96 2.59 91.19 6.23 75 3.65 83.93 12.41 617
Four+ 92.21 4.57 3.22 119 3.32 89.86 6.82 89 1.73 83.01 15.26 733
Sex of Child
Male 92.92 3.25 3.83 321 5.97 83.87 10.15 227 4.65 81.45 13.9 1976
Female 92.44 1.91 5.65 294 6.2 87.88 5.92 219 3.61 79.72 16.67 1663
Parity
1-2 93.94 1.47 4.59 399 8.03 83.48 8.49 281 5.94 81.02 13.04 2084
3-4 88.5 6.36 5.13 155 2.7 87.98 9.32 115 2.71 81.4 15.89 1082
5+ 94.18 1.34 4.48 61 3.46 92.55 3.99 50 1.3 78.21 20.5 473
Sanitation Facility
Improved 92.52 2.81 4.67 265 9.93 82.86 7.21 183 7.81 80.24 11.95 1599
Not improved 92.46 2.86 4.68 297 4.01 85.86 10.13 222 1.98 81.29 16.73 1777
Total (Uw) 555 29 31 615 34 364 48 446 192 2913 534 3639
Note: Uw: Unweighted Cases
Page | 15 /16
Table 5: Result of Multinomial Regression of severely stunted children for child feeding index in
South India, 2005.
Economic Factor 6 – 9 month 10 - 12 month 13 – 36 month
Low Score
Sig. Average Score
Sig. Average Score
Sig.
Poorest®
18.92
37.54
34.10
Poorer 13.59 ** 3.43 *** 25.65
Middle 9.74 12.73 * 18.90 ***
Richer 10.57 10.14 ** 15.41 **
Richest 5.18 *** 0.10 *** 7.21 ***
Religion
Hindu®
11.90
10.21
19.50
Muslim 8.34 ** 18.68 ** 12.94
others 0.10 *** 0.10 *** 19.82
Birth Order
One®
8.03
12.44
15.53
Two 6.35 ** 4.89 17.29
Three 20.72 ** 11.18 21.67
Four+ 21.82 25.52 30.33
Sex of child
Male®
11.16 10.29
19.79
Female 10.37 11.32 17.36 **
Literacy Status
Illiterate®
12.81
17.89
28.00
Primary 21.67 ** 14.46 19.50
Secondary 7.51 6.91 14.66 *
Higher 0.99 * 0.15 *** 6.26 **
Sanitation Facility
Improved®
5.59
4.85
11.35
Not improved 15.17 * 15.78 ** 24.81 **
Parity
1-2®
6.71
9.54
17.06
3-4 19.06 * 8.15 * 19.37
5+ 17.30 40.39 34.66
Note: ® Reference category, Sig: Significance Level; *** p<0.01, **p<0.05, *p<0.10; CI: 95%.
Page | 16 /16
Table 6: Result of Multinomial Regression of severely stunted children for child feeding index in
North India.
Economic
Status
6 – 9 month 10 - 12 month 13 – 36 month
Low Score
Sig. Average Score
Sig. Average Score
Sig.
Poorest®
13.47
19.90
43.66
Poorer 15.82 26.86 34.69
Middle 4.24 ** 20.85 29.52 ***
Richer 9.29 ** 10.05 22.03 ***
Richest 2.45 *** 1.37 * 11.25 ***
Religion
Hindu®
7.65
15.89 27.08
Muslim 8.65 10.37 28.82
others 11.86 6.48 15.46 *
Birth Order
One®
9.13
14.46 18.93
Two 12.37 19.28 24.95 *
Three 8.87 6.71 25.81
Four+ 2.50 ** 13.77 35.78
Sex of child
Male®
8.82
11.72 28.17
Female 7.43 17.23 23.88 **
Literacy Status
Illiterate®
8.72
19.90
33.84
Primary 9.82 * 12.83 * 26.12
Secondary 8.36 * 7.29 15.13 **
Higher 0.00 *** 0.00 *** 12.00
Sanitation Facility
Improved®
5.19
6.02 17.95
Not improved 10.09 * 19.43 31.47
Parity
1-2®
7.04
15.55
21.25
3-4 13.99 * 12.16 26.11
5+ 1.35 14.48 38.21
Note: ® Reference category, Sig: Significance Level; *** p<0.01, **p<0.05, *p<0.10; 95% CI.