- Record: found
- Abstract: found
- Article: found
Associations between the household environment and stunted child growth in rural India: a cross-sectional analysis
Charlotte Lee 1 , Monica Lakhanpaul 1 , Bernardo Maza Stern 1 , Kaushik Sarkar 2 , priti parikh , 1
28 June 2020
UCL Open: Environment Preprint
environment, water, sanitation, agriculture, fuel, malnutrition, stunting, growth, India, rural, Sanitation, health, and the environment, People and their environment
Read this article at
Abstract
Stunting is a major unresolved and growing health issue for India. There is a need for a broader interdisciplinary cross sectoral approach in which disciplines such as environment and health have to work together to co-develop integrated socio-culturally tailored interventions. However, there remains scant evidence for the development and application of such integrated, multifactorial child health interventions across Indias most rural communities. In this paper we explore and demonstrate the linkages between environmental factors and stunting thereby highlighting the scope for interdisciplinary research. We examine the associations between household environmental characteristics and stunting in children under five years across rural Rajasthan, India. We used DHS-3 India (2005-06) data from 1194 children living across 109,041 interviewed households. Multiple logistic regression analyses independently examined the association between (i) primary source of drinking water, (ii) primary type of sanitation facilities, (iii) primary cooking fuel type, and (iv) agricultural land ownership and stunting adjusting for child age. Results suggest, after adjusting for child age, household access to (i) improved drinking water source was associated with a 23% reduced odds (OR=077, 95% CI 05 to 100), (ii) improved sanitation facility was associated with 41% reduced odds (OR=051, 95% CI 03 to 082), and (iii) agricultural land ownership was associated with a 30% reduced odds of childhood stunting (OR 070, 95% CI 051 to 094). The cooking fuel source was not associated with stunting. Our findings indicate that a shift is needed from nutrition-specific to contextually appropriate interdisciplinary solutions, which incorporate environmental improvements. This will not only improve living conditions in deprived communities but also help to tackle the challenge of childhood malnutrition across Indias most vulnerable communities.
Related collections
Author and article information
Journal
Affiliations
Article
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.
Funding
Comments
Thank you for encouraging response and please find below our response to your minor editorial changes:
he following small textual adjustments are required during the production process. Editor’s comments in bold. Author’s words in plain text.
P7
A typographical error on p7: Is it NHRM or NRHM?
RESPONSE: Agree it should be NRHM
P9
3.2.3. Other (confounding) Variables
The confounding variable age was selected on the basis of three conditions (LaMorte, 2016)–
1. Age was associated with both stunting and different explanatory factors, including
feeding practices (e.g. Infants and children have predominantly different feeding
practices); risk of infection (children who start to grow, crawl, walk, explore and put
objects in their mouths risk ingesting bacteria from human and animal sources via open
defecation increases).
- verb in wrong place in this parantheses suggest deleting “increases” or placing “increased” before “risk of infection”
RESPONSE: Agree, suggest place 'increased' before 'risk of infection'
P11 middle
Use of similar estimates would allow better synthesis of evidence and would provide evidence comparability.
There is something missing from this sentence or it could be deleted?
RESPONSE: This is what we were trying to say: ' Use of similar methodologies would allow for better analysis of DHS data sets and facilitate comparisons across various DHS data sets.'
If you feel the above is not adding value, then remove our suggested edit for the sentence.
P17
3. DISCUSSION
In this study we found that drinking water source, sanitation facility, and agricultural land
ownership were associated with reduced stunting odds in children across rural Rajasthan, India.
Specifically, reported household use of (i) improved drinking water source was associated with
a 23% reduced odds, (ii) improved sanitation facility was associated with 41% reduced odds,
and (iii) agricultural land ownership was associated with a 30% reduced odds of child stunted
growth. Indoor cooking fuel source was not associated with risk of stunting although did
approach trend level.
Do the authors mean the statistical significance here rather than “trend”. If it is trend that is fine.
RESPONSE: Yes it is trend.
Secondly, the source data did not include information regarding any intervention and any
intervention, which would have introduced either locally or nationally within 5 years period
prior to the onset of study would have disproportional effect on nutritional status of the children.
I would prefer this short paragraph to read (or something similar):
Secondly, the source data did not include information regarding any intervention introduced either nationally or locally within 5 years of the start of the study that might have had an effect on the nutritional status of the children.
RESPONSE: Yes agree with your suggested amendment.