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Explaining Cross-Region Disparities in Childhood Stunting in India

Santosh Sharma, International Institute for Population Sciences (IIPS)
Saswata Ghosh, Institute of Development Studies Kolkata (IDSK)

The high and persistent prevalence of child undernutrition in India has been a major public health concern. Moreover, large and graded regional disparities still persist in childhood undernutrition. This study explores what drives large disparities in childhood among different regions of India. Was it due to the variations in observed nutrition-related endowments or differential strengths of relationships between endowments and height-for-age across regions? We explored this question by comparing the regions with relatively poor nutrition outcomes with the benchmark of southern region, the best performer. Applying unconditional quintile regression and counterfactual decomposition methods to the NFHS-4 data, we find that covariate effects (endowments) and coefficient effects (returns to endowments) vary across regions and quintiles when compared to the benchmark region of southern states. For example, observed HAZ disparities are primarily attributable to the differences in returns to endowments, while endowments try to reduce such disparities when southern region is compared with the northern region. On the contrary, if we compared southern region with the central region, covariate and coefficient effects both have significantly increased the observed disparities in HAZ outcomes. We discuss our results in light of the superior track record of food and nutrition policies in the southern states.

Keywords: Children and youth, Econometrics, Decomposition analysis/methods

See paper.

  Presented in Session 3. Undernutrition Among Children and Adolescents in India: From Micro- to Macro-Level Variations