Geographic Disparities in Minimum Dietary Diversity among Indian Children Aged 6-23 Months

Background: Dietary diversity is a critical determinant of children's nutritional well-being and micronutrient intake, particularly during the complementary feeding period (6–23 months). This study examines geographic disparities in minimum dietary diversity (MDD) among Indian children aged 6–23 months, emphasizing its role in addressing malnutrition. Despite India's high burden of child undernutrition, less than one-third of children meet the WHO’s MDD standards. The study aligns with Sustainable Development Goal 2 (SDG 2), zero hunger, aiming to identify regional inequalities and inform targeted interventions. Data and Methods: Using data from the National Family Health Survey-5 (NFHS-5, 2019–2021), this study analyzed a final sample of 63,247 children aged 6–23 months. Predictor variables included individual, maternal, and household-level factors, while MDD was defined as the consumption of foods from at least five out of eight food groups. Spatial analysis techniques, including choropleth mapping, Getis-Ord Gi* hotspot analysis, Ordinary Kriging interpolation, and Geographically Weighted Regression (GWR), were employed to explore geographic variations and their determinants. Results: The prevalence of adequate MDD was 22.94%, with significant geographic disparities. Southern and northeastern states exhibited better dietary practices, while central and northern regions, including Bihar and Uttar Pradesh, showed alarmingly high inadequacy rates (80.10–96.00%). GWR analysis revealed spatially varying relationships between predictors and MDD. For example, improved sanitation infrastructure demonstrated stronger associations with dietary adequacy in southern districts but weaker or inverse relationships in northern regions. Similarly, maternal education strongly influenced MDD in southern states but had limited explanatory power in northern areas. Household wealth and media exposure also displayed regional heterogeneity, with wealthier households in southern states showing higher dietary adequacy compared to poorer households in central India. Conclusion: This study highlights critical geographic disparities in MDD among Indian children, emphasizing the need for region-specific interventions. Central and northern regions require urgent attention due to the high clustering of inadequate dietary diversity, while southern and northeastern states demonstrate favourable conditions. Integrated approaches addressing Maternal education, higher birth order, poorer household sanitation, and socio-economic inequities are essential for improving child nutrition outcomes.