Deconstructing the sex gap in child undernutrition in India
Published in Healthcare & Nursing, Social Sciences, and Public Health
Backgrounds & Objectives: The privileging of boys in immunization coverage, breastfeeding, and other childcare practices in the Indian patriarchal society raises questions about whether there are sex differences in the prevalence of undernutrition among children. This study evaluates the sex gap in the prevalence of Composite Index of Anthropometric Failure (CIAF) among Indian children from 2015–16 to 2019–21. Additionally, it seeks to identify the sex specific determinants and persistent sex gap at national and subnational levels (social, economic, religious, and geopolitical regions) in anthropometric failure among the children from 2015–16 to 2019–21.
Materials and Methods: The study utilizes the 4th (2015–16) and 5th (2019–21) rounds of the National Family Health Survey data. Logistic regression models and the Fairlie decomposition technique were employed to explore the persistent and significant sex gap in the prevalence of CIAF, as well as the sex-specific determinants of CIAF among children in 2015–16 and 2019–21.
Results: The study reveals a significant sex gap (approximately 4%-points), with boys' disadvantage in the prevalence of CIAF from 2015–16 to 2019–21 at both the national and subnational levels (social, religious, socioeconomic groups, and geopolitical regions). The gap is more pronounced in the first year of life and decreases in later stages. A comparatively faster CIAF decline among girls from 2016 to 2021 has widened the sex gap in the final year than the previous. Child, mother, household, community, and geographic backgrounds explain about 5%–6% of the sex gap in the prevalence of CIAF from 2015–16 to 2019–21. The remaining 94%–95% of the unexplained sex gap may be attributed to biological factors or other factors. Currently, a heightened boy's disadvantage in CIAF risk is observed in the ST community, wealthiest families, and northern India.
Conclusion: The findings suggest special attention for boys under 3 years to offset biological disadvantages like greater disease sensitivity and fragility compared to girls early on.
Dr. Pritam Ghosh is an Assistant Professor in the Department of Geography at Hijli College, specializing in Health Geography and Public Health Research. His work focuses on the social and geospatial dimensions of child and maternal health, as well as WASH (Water, Sanitation, and Hygiene) issues in India. Additionally, he explores the intersection of climate crises and public health, addressing critical challenges in the field.
With over 30 research articles and book chapters published in renowned international journals and edited volumes, Dr. Ghosh has significantly contributed to the academic discourse. He is also an active reviewer for more than 35 international journals, affiliated with leading global publishing houses such as Springer Nature, Nature, Elsevier, Sage, Wiley, Taylor & Francis, and Routledge.
Beyond his research, Dr. Ghosh serves as an Academic Editor for PLOS ONE and is currently leading three edited volumes in Health Geography and Public Health Research.
