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Living on the edge? Sensitivity of child undernutrition prevalence to bodyweight shocks in the context of the 2020 national lockdown strategy in India
Authors: Sunil Rajpal, William Joe, and S V Subramanian
Source: Journal of Global Health Science (JGHS) , 2: e19; DOI: 10.35500/jghs.2020.2.e19
Topic(s): Child health
Country: Asia
Published: JUL 2020
Abstract: Background The National Family Health Survey (NFHS) 2015–16, finds that every second child in India suffers from at least one form of nutrition failure. Dichotomised indicators of underweight and wasting based on z-score cut-off does not provide any information regarding those children who are clustered around the threshold and are at an elevated risk of undernutrition through any minor weight-loss. This paper aims to estimate the effect of bodyweight shocks on net increments in the prevalence of child underweight and wasting among the poorest households in India. Methods We used cross-sectional information from NFHS 2015–16 to estimate possible increase in the prevalence of child underweight and wasting as a result of reduction in their bodyweight. The shocks are presumed to range from a minimum of 0.5% to a maximum 5% reduction in the bodyweight for every child from the poorest 20% households. Various raw weight measures scenarios were developed and transformed into age- specific z-scores using World Health Organization child growth standards. Results Nutritional status of children is sensitive to smallest of the shocks to bodyweight. In fact, a reduction of 0.5 and 1 percent in weight can lead to substantial increase in underweight and wasting prevalence. Under a scenario of bodyweight shock of 0.5 percent, the prevalence of underweight and wasting will increase by 1.42 and 1.36 percentage points, respectively. These estimates get translated into 410,413 and 392,886 additional cases of underweight and wasting, respectively. Conclusion With such high concentration of children around the undernutrition threshold, any minor shock to nutritional health of the children can have major implications. In the current scenario of national lockdown and restrictions due to coronavirus disease 2019 pandemic, it is critical to ensure an uninterrupted supply of nutritious meals and food supplements to the poor children while arresting the infection spread. Keywords: Underweight; Wasting; Undernutrition; India; Lockdown; COVID-19