Social determinants of inequities in under-nutrition (weight-for-age) among under-5 children: A cross sectional study in Gumla district of Jharkhand, India

Abstract

Background: Jharkhand, a state with substantial tribal population in Eastern India has very high rate of undernutrition. The study tries to understand the social determinants of inequities in under-nutrition (weight-for-age) among children aged less than 5 years, in Gumla District of the State. Methods: Cross sectional study of 1070 children from 32 villages of 4 Blocks of Gumla District. Results: 54.3 % (95 % CI 51.3-57.3) children were found to be underweight (less than -2SD), with insignificant difference between girls and boys. Multivariate analysis showed that poverty was the single most important predictor of undernutrition, where a child from the poorest quintile was 70 % more likely to be underweight (aOR 1.70, CI 1.13-2.57), compared to one from the least poor group (Quintile 5). While the difference in weight-for-age status between Scheduled Tribes and "OBC and other communities" was non-significant (95 % OR 1.12, CI 0.88-1.42) in the study context; community disaggregated data revealed that there were large variations within the tribal community, and numerically smaller communities also ranked lower in wealth, and their children showed poorer nutritional status. Other factors like maternal education beyond matriculation level also had some bearing. Bivariate analysis showed that chances of a child being underweight (