Intra-Household Clustering of Childhood Stunting: The Impact of Sibling Sex Composition in India, NFHS, 2019-21

Kaviyarasan M, International Institute for Population Sciences, India
Anjali Bansal, International Institute for Population Sciences (IIPS)

India's persistent gender disparity has been widely studied, with evidence showing significant differences in immunization and healthcare access for boys and girls. However, there is limited research on gender differences in childhood health outcomes such as nutritional status, particularly stunting which is the chronic form of malnutrition among children. This study investigates the association between the sex composition of older siblings and the risk of childhood stunting among children aged 0-59 months, using data from the National Family Health Survey-5 (2019-21). A retrospective cross-sectional design was employed, utilizing sex-stratified multivariable logistic regression models to analyse the data. Results indicate that younger male children with two older male siblings are 1.56 odd times more likely to be stunted compared to those with one female sibling, and 1.45 odd times more likely if they have one male and one female sibling, after adjusting for maternal socio-economic factors. Additionally, female children with older male siblings are 1.12 times more likely to be stunted compared to those with older male siblings. These findings suggest that the sex composition of older siblings plays a significant role in childhood stunting, highlighting the need for nutrition and health interventions that account for potential intra-household gender biases.

Keywords: Children, Adolescents, and Youth, Families, Unions and Households, Gender Dynamics, Data visualisation

See extended abstract.