Socioeconomic and regional patterns of child nutritional inequality between tribal and non-tribal communities in India: An analysis based on National Family Health Survey 5 (2019–21)

Abstract

Background: Despite India’s impressive economic growth and the implementation of a large-scale antimalnutrition program, the country continues to face the highest levels of child malnutrition globally. Among the affected children, half of those under the age of 3 years, in both tribal and nontribal populations, are underweight, while a third of the wealthiest children experience overnutrition. Economic inequality plays a significant role in contributing to malnutrition in both tribal and nontribal communities. Therefore, utilizing data from the fifth round of the National Family Health Survey (2019–21), the present study aims to examine the socioeconomic disparities in childhood malnutrition across all 640 districts of India, with a specific focus on tribal and nontribal populations. Methods: The analysis includes a sample of children aged 0 to 59 months from tribal and nontribal communities. Sociodemographic, personal, clinical, and environmental factors are considered as independent variables. The outcomes of interest include stunting, wasting, and underweight, which are assessed using binary variables. Linear modeling are used to determine the associations between the independent variables and child undernutrition. Results: The study reported a negative Z value (−4.763), indicating greater overall inequality in the tribal population compared to the nontribal population. In terms of odds ratios, females had lower odds of being underweight in both tribal and nontribal populations. Children aged 1 to 2 years had higher odds of being underweight compared to those aged 1 year. The duration of breastfeeding showed varying associations, with breastfeeding for 7 to 12 months increased the risk of underweight in nontribal areas, while longer durations (13–24 and >24 months) were associated with higher chances of wasting in nontribal areas. Higher maternal age at first birth, higher education levels, and sufficient antenatal care visits were protective factors against underweight in both populations. A higher wealth index consistently correlated with reduced odds of underweight in both tribal and nontribal populations. Institutional delivery was associated with higher odds of underweight in tribal areas but lower odds in nontribal areas. Conclusion: The study concludes that in order to address the socioeconomic disparities contributing to stunting, wasting, and undernutrition among tribal populations, targeted interventions are required. These interventions should focus on improving access to education, healthcare, and economic opportunities, particularly among tribal communities. Additionally, policies should aim to reduce income inequality and promote inclusive economic development, ensuring that the benefits of progress are equitably distributed across all population groups. By addressing these socioeconomic factors, it is possible to improve the nutritional status and overall well-being of tribal populations.