Yashas Vaidya
Child undernutrition remains one of most of the most challenging aspects of the nutrition transition in the lower and middle-income countries of the developing world. Among U.N. and MDG regions, South Asia (classified as South Central Asia or Southern Asia) is one those severally affected by child undernutrition, and in the case of several indicators even more than Sub-Saharan Africa (United Nations Children’s Fund, World Health Organization, and The World Bank 2012). In the last couple of decades other regions, including Africa, have made progress in reducing undernutrition—measured by indicators such as stunting, underweight and wasting. However, Nepal, like other parts of South Asia, still demonstrates high rates of undernutrition. While several explanations have been proposed, there is no consensus on the specific reasons for the persistence of child undernutrition. This project investigates how social determinants of child undernutrition can add to our understanding of such persistent rates. Specifically, it will examine anemic status in children under five in Nepal using Demographic and Health Survey (DHS) data from 2006 and 2011.
Health disparities among different social groups can result from stratification and, in turn, lead to the reproduction of social inequality. This project investigates the presence of ethnic disparities in child health, examining child anemia in Nepal in the early 21st century. It uses childhood anemia as the outcome of interest, due to its well-recognized links to protein energy malnutrition. Child anemia is a good indicator of health status, as it can reflect nutritional deficiencies in important micro-nutrients like iron and vitamin A (Ramakrishnan and Semba 2008; Semba and Bloem 2002) as well as exposure to malaria or parasitic infections (Calis et al. 2008; Dreyfuss and Stoltzfus 2000). Nutritional assessments are particularly important in developing-country contexts due to the synergistic relation between undernutrition and infection on mortality (Schroeder 2008). An infection is much more dangerous to children affected by undernutrition and the combination leads to dangerous increases in risks of mortality. Crucially, mortality risks increase not just with severe undernutrition but also in its mild and moderate forms. Using Demographic and Health Survey data, this study identifies disparities in child anemia among broadly divided ethnic sub-groups in Nepal. Based on hemoglobin levels, the surveys detected anemia (moderate or worse, <9.9 g/dl) in 22 (in 2006) and 18 (in 2011) percent of children aged between 6 months and 5 years (below 59 months). This study attempts to show that considering the social context of child undernutrition will explain the persistence of such high rates.