Associated factors of child wasting among children aged 0 – 23 months in India: Analysis of the National Family Health Survey-5

The enduringly high prevalence of child wasting (weight-for-height-2SD) in India is a significant cause for concern. The objective of this study is to identify areas with high incidence of wasting among children aged 0 – 23 months and to uncover the factors influencing wasting among young children in India. The analysis utilized individual and district-level data from the National Family Health Survey-5 in 2019 – 2021. The wasting prevalence exceeding 30% was found in 81 districts, with 501 districts surpassing 15%. Our analysis indicated that children from the poorest households (adjusted odds ratio [AOR] = 1.60, 95% confidence interval [CI] = 1.43 – 1.79), those lacking access to improved sanitation facilities (AOR = 1.18, 95% CI = 1.11 – 1.25), belonging to other backward class families (AOR =1.12, 95% CI = 1.04 – 1.20), and born to mothers with body mass index (BMI) <18.5 (AOR = 1.30, 95% CI = 1.23 – 1.37) faced higher odds of wasting. In addition, low birth weight (<2500 g) increased the odds of wasting by 27% (AOR = 1.27, 95% CI = 1.20 – 1.36). The study further found that a minimum acceptable diet and female gender had protective effects on wasting among children aged 6 – 23 months. These findings underscore the need for a comprehensive programmatic response to addressing wasting in young children. Urgent policies and programmatic actions are warranted, with a specific focus on strengthening the care of low birth weight and premature babies, as well as promoting optimal child feeding practices. There is a call for intensified nutrition services as an integral component of routine health services for mothers. Early identification and management of wasting and counseling during pre-conception and pregnancy should be prioritized.