India’s Child Malnutrition Paradox

Abstract

India has the world’s highest burden of child undernutrition. Lack of income has been attributed as the primary cause of child undernutrition. However, evidence suggests that despite steady economic growth and investments in social services directed towards child welfare, undernutrition rates in India are persistent. Thus factors impacting child undernutrition are entrenched within the social fabric of a community. Previous studies indicate that countries that have higher gender inequality have poorer health outcomes for women and children. India with its dominant patriarchal structure and deep-rooted gender biases has disproportionately worse outcomes for women and children. This dissertation study was designed to do the following: 1) emphasize the importance of maternal autonomy and health related awareness as factors significantly impacting maternal health and child nutritional status and 2) use a strengths-based approach to make recommendations for child welfare policy. By applying an asset-based approach, the social capital within a community is recognized interventions can be developed using community and individual level strengths. This study fills the gap in literature on the role of maternal autonomy and health related awareness on child nutritional status, particularly in communities with high levels of gender inequality. The current study utilized data from the India National Family Health Survey Round-3 (NFHS-3) to conduct a cross sectional analysis. The study sample consisted of urban married women between ages of 15-49 years who had at least one living child between the ages of 0-5 years (N= 9,092). It utilized the UNICEF ‘model of care’ and three distinct theories (i) Ecological Systems Theory, (ii) Capability Approach, and (iii) Positive Deviance Inquiry to develop the conceptual framework. Scales measuring maternal autonomy and health related awareness were developed and validated. Ordered Logistic Regression and Kohler mediation model were utilized to examine the relationship between maternal autonomy and health related awareness and child nutritional status and the mediation effect of maternal health. Implications are provided for child welfare policy and practice, social work policy and research.