Clustering of India’s Childhood Undernutrition and Its Determinants Based on National Family Health Survey

Background The prevalence of childhood undernutrition in India is considered a major obstacle to the progress of the country in the near future. Undernutrition is more common in some States than others; it is not uniform throughout the nation. Therefore, to control child undernutrition, area-specific planning is required. The present study attempted to classify Indian States and Union Territories based on the prevalence of undernutrition among under-five children, including stunting, wasting, underweight, and thinness, and to determine the factors influencing child undernutrition. Methods The unit-level data came from the National Family Health Survey from 2019 to 2021, which included 221365 children under the age of five. Based on the WHO-recommended Z-score, stunting, wasting, underweight, and thinness were defined as indicators of child undernutrition. Through the hierarchical clustering on the basis of the prevalence of undernutrition, States and Union Territories were clustered. The determinants of undernutrition were identified using binary logistic regression. Results The highest rates of undernutrition were found in Cluster III including Bihar, Jharkhand, Gujarat, and Maharashtra, where stunting and underweight rates were respectively 39.76% and 39.24%, compared to 35.46% and 32.11% in India. Child undernutrition was frequently caused by anaemia in children, low maternal education, and poor wealth indices in the family. Undernutrition was more prevalent in children from scheduled tribes and castes than in general castes. Conclusion Reducing childhood anaemia should be a priority, as should the overall economic growth of the nation, and mothers' education needs to be improved. The study would help to improve health policy based on States and Union territories for a specific kind of undernutrition will be put in place and child undernutrition can be quickly brought under control.