Status of Child Malnutrition in Rural and Urban India: Evidence from National Family Health Surveys

Child health is a crucial indicator of human development, yet India holds two-thirds of the world's malnourished children, with a rising prevalence. This study examines the effects of various malnutrition components in rural and urban India, using data from the National Family Health Survey (NFHS)-4 and 5 for children aged 0–59 months with malnutrition Z-scores below − 2 SD. Principal component factor (PCF) analysis identified three factors: maternal and child factors, institutional factors, and infections. Principal component panel regression was employed to identify determinants of child malnutrition across Indian states. Boxplots reveal a declining trend in all malnutrition indices in both settings. Biplots showed a close relationship between wasting and underweight, with Gujarat having the highest percentage of underweight children, whereas Maharashtra, Jharkhand, Bihar, and Uttar Pradesh had high rates across multiple indicators. Conversely, Kerala, Uttarakhand, and Tamil Nadu presented better health metrics. Principal component panel regression analysis revealed that child and maternal factors significantly impact stunting in rural and urban areas, with a stronger influence in urban settings. Institutional interventions are crucial in rural areas, while infections are associated with malnutrition in both settings. Residence-based analysis is more effective in identifying the absolute burden of malnutrition and aids in targeted interventions.