Multivariate Analysis of Indicator-Specific Determinants of Childhood Malnutrition in Rajasthan, India: Evidence from NFHS-5.

BACKGROUND: Childhood malnutrition remains a major public health challenge with significant implications for child survival and development. Understanding the differential determinants of stunting, wasting, and underweight is essential for designing targeted interventions. OBJECTIVE: To identify and analyze factors associated with stunting, wasting, and underweight among children under five years in Rajasthan, India, using data from the National Family Health Survey (NFHS-5, 2019-21). METHODS: A cross-sectional study was conducted using data on 12,549 children aged 0-59 months. Nutritional outcomes were defined using the WHO Child Growth Standards. Multivariate logistic regression analyses were performed separately for stunting, wasting, and underweight to assess their associations with socio-demographic and maternal factors. RESULTS: The prevalence of stunting, wasting, and underweight was 32.14%, 16.78%, and 25.71%, respectively. Female children had significantly lower odds of all three malnutrition indicators compared to males. Socioeconomic status was a consistent determinant, with children from poorer households exhibiting higher odds across all outcomes. Urban residence was associated with reduced odds of wasting, but not of stunting. Higher birth order was significantly associated with increased odds of stunting and underweight, but not wasting. Low birth weight was significantly associated with wasting and underweight, but not with stunting. Maternal education showed a protective effect only against underweight. Caste was associated with wasting and underweight but not stunting. No significant associations were observed for maternal anemia or maternal age at childbirth. CONCLUSIONS: Determinants of childhood malnutrition vary across stunting, wasting, and underweight, highlighting the need for indicator-specific interventions. Policies should focus on reducing socioeconomic inequalities, improving maternal education, and addressing risks associated with low birth weight to combat child malnutrition effectively.