Stunting and severe stunting among infants in India: the role of delayed introduction of complementary foods and community and household factors

Figures & data

Table 1. Characteristics of the study population (N = 13,548).

Characteristic	n	%
Community level factors
Geographical region
North	1746	12.8
South	2288	16.8
East	3536	26.1
West	1684	12.4
Central	3910	28.8
North East	384	2.8
Residence
Urban	3683	27.1
Rural	9863	72.8
Household characteristics
Household wealth index
Poorest	3366	24.8
Poorer	3012	22.2
Middle	2712	20.0
Richer	2439	18.0
Richest	2017	14.8
Source of drinking water
Improved	11411	84.23
Not improved	2136	15.77
Maternal Characteristics
Mother’s age
15–19 years	923	6.8
20–34 years	11958	88.2
35–49 years	666	4.9
Mother’s education
No education	3808	28.1
Primary	1803	13.3
Secondary and higher	7936	58.5
Employment
Did not work	2116	15.6
Worked	254	1.8
Mother’s religion
Hindu	10726	79.1
Muslim	2148	15.8
Christianity and others	673	4.9
Type of Caste or tribe
Scheduled Caste	3101	22.8
Scheduled tribe	1376	10.1
Other backward class	5921	43.7
Others^$	3148	23.2
Child Characteristics
Sex of baby
Male	7312	53.9
Female	6235	46.0
Perceived Size of baby
Small	1728	12.7
Average	8960	66.1
Large	2695	19.8
Health Service characteristics
Antenatal clinic visits
None	2228	16.4
1–3	4576	33.7
4+	6588	48.6
Mode of delivery
Non-Caesarean	10961	80.9
Caesarean	2586	19.1
Study outcomes
Stunting (<- 2 SD)
Not stunted	9143	67.4
Stunted	2325	17.1
Severe stunting (<- 3 SD)
Not severely stunted	10430	76.9
Severely stunted	1038	7.6

n = weighted counts; ^$ = no caste or tribe/don’t know)

Table 2. Factors associated with stunting among infants aged 6–8 months in India, NFHS-4.

Variables	OR [95% CI]	P-value	aOR^¥ [95% CI]	P-value
Introduction of solid, semi-solid or soft foods
Early introduction of foods	1.00		1.00
Delayed introduction of foods	1.33 (1.18, 1.51)	<0.001	1.24(1.09, 1.41)	0.001
Household Wealth Index
Poorest	1.00		1.00
Poorer	0.76(0.65, 0.89)	0.001	0.83(0.70, 0.98) *	0.029
Middle	0.58(0.49, 0.70)	<0.001	0.66(0.54, 0.80) *	<0.001
Richer	0.47(0.38, 0.58)	<0.001	0.54(0.43, 0.68) *	<0.001
Richest	0.38(0.30, 0.48)	<0.001	0.46(0.36, 0.61) *	<0.001
Mother’s education
No education	1.00		1.00
Primary	0.80(0.66,0.98)	0.031	0.90(0.74, 1.09)	0.295
Secondary and higher	0.58(0.50, 0.66)	<0.001	0.81(0.69, 0.94) *	0.008
Type of Caste or tribe
Scheduled Caste	1.00		1.00
Scheduled tribe	0.88(0.72, 1.07)	0.217	0.79(0.64, 0.96) *	0.024
Other backward class (OBC)	0.85(0.73, 0.99)	0.04	0.90(0.77, 1.05)	0.196
Others^$	0.65(0.53, 0.79)	<0.001	0.79(0.64, 0.97) *	0.031
Sex of baby
Male	1.00		1.00
Female	0.78(0.69, 0.88)	<0.001	0.75(0.66, 0.84) *	<0.001
Birth order
Firstborn	1.00		1.00
2^nd–4^th	1.13(0.992, 1.307)	0.063	1.02(0.89, 1.18)	0.727
5 or more	1.68(1.35, 2.08)	<0.001	1.17(0.92, 1.48)	0.186
Perceived Size of baby
Small	1.00		1.00
Average	0.60(0.50, 0.72)	<0.001	0.62(0.51, 0.74) *	<0.001
Large	0.48(0.38, 0.61)	<0.001	0.50(0.40, 0.64) *	<0.001

*Statistically significant (95% confidence intervals and P < 0.05) study variables from multivariate models are shown. Multivariate models adjusted for child, maternal, household, health service and community factors. OR: odds ratios; aOR: adjusted odds ratios; 95%CI: 95% confidence interval; ^$ = no caste or tribe/don’t know)

Figure 1. Prevalence and 95% Confidence Intervals (CI) of stunting (A) and severe stunting (B) by the introduction of solid, semi-solid or soft foods among infants aged 6–8 months in India.

Table 3. Factors associated with severe stunting among infants aged 6–8 months in India, NFHS-4.

Variables	OR [95% CI]	P-value	aOR [95% CI]	P-value
Introduction of solid, semi-solid or soft foods
Early introduction of foods	1.00		1.00
Delayed introduction of foods	1.29 (1.07, 1.54)	0.007	1.21(1.01, 1.45)	0.039
Household Wealth Index
Poorest	1.00		1.00
Poorer	0.78(0.62, 0.99)	0.047	0.81(0.64, 1.03)	0.093
Middle	0.67(0.52, 0.85)	0.001	0.70(0.55, 0.90) *	0.006
Richer	0.63(0.47, 0.84)	0.002	0.68(0.51, 0.92) *	0.012
Richest	0.46(0.32, 0.67)	<0.001	0.52(0.37,0.74) *	<0.001
Sex of baby
Male	1.00		1.00
Female	0.69(0.57, 0.82)	<0.001	0.67(0.56, 0.80) *	<0.001
Perceived size of baby
Small	1.00		1.00
Average	0.63(0.50, 0.80)	<0.001	0.64(0.51, 0.82) *	<0.001
Large	0.60(0.44, 0.81)	0.001	0.63(0.46, 0.85) *	0.003
Mode of delivery
Non-caesarian	1.00		1.00
Caesarian	0.59(0.43, 0.82)	0.001	0.69(0.50, 0.95) *	0.023

*Statistically significant (95% confidence intervals and P < 0.05) study variables from multivariate models are shown. Multivariate models adjusted for child, maternal, household, health service and community factors. OR: odds ratios; aOR: adjusted odds ratios; 95%CI: 95% confidence interval