Household context and child wasting in northeast India

Background: Local contextual factors are important for effective intervention for improving nutritional status of children of indigenous people living in remote and inaccessible regions. Objective: This study attempts to shed light on contextual correlates of malnutrition among children in northeast India. Methodology: Household environment which includes provision for safe drinking water, toilet facility, biomass fuel use and housing condition are considered as contextual factors for this study. Each contextual factor was assigned score of 0 or 1 depending on the condition is favourable for the health of children or not; then an index of household environmental health risks incorporating these contextual factors was constructed as the sum of scores of each contextual factor. Descriptive statistics were used for describing nutritional status of children and multilevel multiple regression was used for assessment of significance of contextual, child and mother level factors in explaining variation in nutritional status of children. Results: It was found that 8.9%, 3.7% and 3.6% of children in high, medium and low risk households respectively, were severely wasted. Lower household health risks, literate household heads, and scheduled tribe households had a deterrent effect on child malnutrition. Children who received colostrum feeding at the time of birth and those who were vaccinated against measles were less likely to be wasted compared to other children, and these differences were statistically significant. Conclusion: This study showed the importance of household environmental health risks as important determinant of child malnutrition in northeast India.