Targeting the Lagging Behind: Child Undernutrition in Aspirational Districts of India

Abstract

Although India has shown sustained socio-economic development, child malnutrition remains a major public health concern with pronounced regional disparities. The Government of India launched the Aspirational District Programme (ADP) in 2018 to accelerate development in socioeconomically lagging behind districts. The present study assesses the level, trends and determinants in child nutritional status in aspirational and non-aspiration districts in India. Two rounds of National Family Health Survey (NFHS- 4 and 5) were used for the present study. Child malnutrition was assessed using standard anthropometric indicators—stunting, wasting and underweight. Descriptive statistics and multivariate logistic regression techniques were used for the data analysis. Further, Blinder–Oaxaca decomposition analysis was applied to identify factors contributing to nutritional gaps between aspirational (ADs) and non-aspiration districts (Non-ADs). Findings reveal a consistently higher prevalence of stunting, severe stunting, underweight and severe underweight among children in ADs compared with Non-ADs. Children in aspirational districts had significantly higher odds of stunting and underweight even after controlling other background characteristics. Maternal education, maternal nutritional status, household wealth, caste affiliation, birth order and low birth weight emerged as key determinants of undernutrition. Districts with initially high prevalence of undernutrition demonstrated greater improvements over time, whereas districts with lower baseline prevalence showed stagnation or deterioration. Decomposition results indicate that maternal and household characteristics account for a substantial share of nutritional disparities across districts. The study underscores that strengthening maternal nutrition, education and targeted programme implementation is critical to achieving equitable reductions in child undernutrition and meeting national and global nutrition targets.As