Journal Article

Geospatial and environmental determinants of stunting, wasting, and underweight: Empirical evidence from rural South and Southeast Asia

Mishra, Raman, Rahut, Dil Bahadur, Bera, Subhasis

2024

Overview

•It examines undernourishment in India, Bangladesh, Pakistan, Nepal, Cambodia, and Timor-Leste.•Stunting, wasting, and underweight among children aged 0 to 59 months in rural areas is high.•Considerable variation between countries and between primary sampling units is observed.•Maternal illiteracy, unsafe drinking water, and dirty fuel are positively associated with undernourishment.•Children from impoverished households in India, Pakistan, and Cambodia were disproportionately malnourished.•Temperature and rainfall also emerged as influential determinants of undernourishment in India, Bangladesh, and Timor-Leste. Child malnutrition, comprising of undernutrition and obesity, is a global concern with severe implications for survival, leading to acute and chronic diseases that adversely affect the productivity of individuals and society. Asia shoulders the greatest burden, with 7 out of 10 undernourished children residing in the region. Despite the decline in global child stunting, particularly in Asia, its prevalence remains significant. In 2017, an estimated 151 million children under five experienced stunting, and an additional 38 million were overweight, with Africa and Asia accounting for 25% and 46% of the global figures, respectively. Therefore, this paper aims to analyze the geospatial and environmental determinants of undernutrition in rural South and Southeast Asia. To explore the geospatial and environmental determinants of undernutrition (stunting, wasting, and underweight), we use Poisson regression and the data from recent rounds of the Demographic and Health Survey (DHS) from India, Bangladesh, Pakistan, Nepal, Cambodia, and Timor-Leste. This study found a high prevalence of stunting, wasting, and underweight among children aged 0 to 59 months in rural areas of South and Southeast Asia, with considerable variation between countries and clusters/primary sampling units. Results show a positive association between child malnutrition and factors such as maternal illiteracy, unsafe drinking water, and dirty cooking fuel in South and Southeast Asia. Children from impoverished households in India, Pakistan, and Cambodia were disproportionately affected. In addition to socio-economic factors, climatic risks such as temperature increase and rainfall variations also emerged as important determinants of child malnutrition in India, Bangladesh, and Timor-Leste. This paper emphasizes the role of environmental and climatic factors on child nutrition, underscoring their significance regardless of socio-economic conditions. As the impacts of climate change continue to intensify, and agrarian societies bear the brunt, these factors will play a critical role in shaping child nutritional outcomes. Thus, amid growing climate change, nutritional security should be prioritized, considering the spatial domain and targeting climate distress areas along with other socio-economic and demographic aspects.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Africa / Agrarian society / Agricultural production / Asia / Asia, Southeastern - epidemiology / Bangladesh / Birth weight / Body weight / Cachexia / Cambodia / Child / Child development / child nutrition / Child Nutrition Disorders - epidemiology / Children / Children & youth / Chronic illnesses / climate / Climate change / Cognitive ability / Demographics / Demography / Developing countries / distress / domain / Drinking water / Drought / East Timor / Economic conditions / Economic factors / Economics / Empirical analysis / Environmental impact / Families & family life / Food security / fuels / Geospatial / Growth Disorders - epidemiology / Growth Disorders - etiology / Health care access / health surveys / Households / Human nutrition / Humans / India / Infant / Infant nutrition / LDCs / literacy / Low income groups / Malnutrition / Malnutrition - epidemiology / Mortality / Mothers / Nepal / Nutrition / Nutritional status / obesity / Pakistan / Poverty / Prevalence / Rain / Rainfall / Rural areas / Sanitation / Social factors / society / Socioeconomic factors / Socioeconomics / Sustainable development / temperature / Thinness - epidemiology / Thinness - etiology / Undernutrition / Underserved populations / Underweight