Socio-economic Inequalities of Double Burden of Malnutrition among Reproductive-aged Women in India

Abstract

This study examines the status and predictors of individual and household-level inequalities of under- and over-nutrition among women aged 15-49 years in India. It utilised the data from the fourth round of National Family Health Survey conducted in 2015-16. The adjusted odds ratios with Mantel-Haenszel technique was used to estimate the association between BMI and different socio-demographic and epidemiological variables. The trends of nutritional change over time were analysed by using the measure of annual average rate of change. The multilevel regression model and quantile regression were also employed. Over 42 per cent of reproductive aged women are under malnutrition in India. Inequalities in malnutrition have been observed among these women at both individual and household levels. In comparison with higher-educated women, women with no education had higher AARI values for overweight (0.75% vs. 1.37%) and obesity (1.14% vs. 10.50%). The results also found robust association between women living in higher wealth quantile and overweight and obese, while a negative association was observed for underweight. Other factors such as mass media exposure and decision-making power also determined the nutritional well-being of women. The study confirms that under and over nutrition equally affects reproductive-aged women. Household wealth index and education were found as the paramount factors of DBM among the study population. Variations in the effects of these correlates should be considered to address DBM. Prevention of DBM should be given priority as a major public health intervention.