Clustering of Child Undernutrition amongst under-Five Siblings: Evidence from India

Pooja Arora, International Institute for Population Sciences (IIPS)
Laxmi Kant Dwivedi, International Institute for Population Sciences (IIPS)

Household is a highly homogenous entity and studying clustering of undernutrition among siblings holds a huge potential for improved policy planning. This study aims to identify prevalence and factors affecting such clustering using data from National Family Health Survey rounds. Undernutrition is said to be clustered amongst siblings when two or more siblings are found to be stunted or wasted or underweight, or anemic. This paper also determines role of individual-level clustering, sibling-level clustering and parent-level clustering of undernutrition on the nutritional status of the youngest child of the household using multilevel-logistic regression. The findings underscore that more children are getting clustered in a smaller number of mothers over time, indicating the increased influence of mothers over the child's nutritional outcomes. The least amount of clustering was observed in wasting. Clustering of undernutrition among siblings varied across child age, preceding birth interval, maternal characteristics (age, BMI, height, education, diet), household attributes (cooking fuel, toilet facility), caste, religion, socioeconomic-status and region. It is found that nutritional deficits of older siblings can potentially influence the nutritional environment for younger siblings, especially in the case of underweight, highlighting that interventions should be targeted on clusters rather than addressing a single individual.

Keywords: Children, Adolescents, and Youth, Multi-level modeling , Families, Unions and Households, Health and Morbidity

See extended abstract.