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      Associations between the household environment and stunted child growth in rural India: a cross-sectional analysis

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            Stunting is a major unresolved and growing health issue for India. Yet there remains scant evidence for the development and application of integrated, multifactorial child health interventions across Indias most rural communities. We examine the associations between household environmental characteristics and stunting in children under 5 years across rural Rajasthan, India. We used DHS-3 India data from 1194 children living across 109,041 interviewed households. Multiple logistic regression analyses independently examined the association between (1) main source of drinking water, (2) main type of sanitation facilities, (3) main cooking fuel type, and (4) agricultural land ownership and stunting adjusting for child age. After adjusting for child age, household access to (1) improved drinking water source was associated with a 23% reduced odds (OR=077, 95% CI 05 to 100), (2) improved sanitation facility was associated with 41% reduced odds (OR=051, 95% CI 03 to 082), and (3) agricultural land ownership was associated with a 30% reduced odds of childhood stunting (OR 070, 95% CI 051 to 094). Cooking fuel source was not associated with stunting. Although further research is needed, intervention programmes should consider shifting from nutrition-specific to nutrition-sensitive solutions to address Indias childhood malnutrition crisis. Results and implications are discussed.


            Author and article information

            UCL Open: Environment Preprint
            UCL Press
            06 March 2019
            [1 ] University College London
            Author information

            This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY) 4.0 https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

            N/A N/A

            Civil engineering,General behavioral science,Environmental engineering
            environment,water,sanitation,agriculture,fuel,malnutrition,stunting,growth,India,rural,Sanitation, health, and the environment,People and their environment


            Date: 11/6/2020

            Handling Editor: Dan Osborn

            The Handling Editor requested revisions; the article has been returned to the authors to make this revision.

            2020-09-17 13:25 UTC

            Date: 8/3/2020

            Handling Editor: Dan Osborn

            This article is a preprint article and has not been peer-reviewed. It is under consideration following submission to UCL Open: Environment Preprint for open peer review.

            2020-09-17 13:25 UTC

            Decision of the handling editor after review:

            This manuscript requires revisions before it can be published. Once the author has revised the manuscript it shall need to undergo further peer-review. We encourage the authors to revise this version 1 and resubmit for open peer review.

            1. Provide fuller context for the study in relation to other studies on child growth stunting in India, pointing out the links between the three main pillars of sustainability and this study.
            2. Match the statistical analysis more closely to the nature of the complex dataset involved.
            3. Provide some more characterisation of the social, economic and environmental circumstances of the non-stunted and stunted samples based on the datasets.
            4. Provide fuller explanatory legends for the Tables in the draft paper.
            5. Clarify the text in certain sections.
            2020-02-14 13:12 UTC

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