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Determinants of Child Stunting in Madhya Pradesh: The Role of Household Infrastructure and Dietary Practices in Achieving Zero Hunger

Received: 26 October 2025     Accepted: 8 November 2025     Published: 30 December 2025
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Abstract

Child stunting, which is defined as low height for age, is one of the critical public health issues in Madhya Pradesh, India, with alarmingly high prevalence rates. This study examines the impact of household infrastructure and dietary practices on stunting, using district-level data from the National Family Health Survey (NFHS-5). Poor access to sanitation, clean drinking water, and proper dietary diversity emerged as significant determinants of stunting, compounded by socioeconomic disparities and maternal education levels. Logistic regression analysis shows predictors such as the wealth index, maternal BMI, and extended duration's of breastfeeding all have significant effects in protection against stunting. On the contrary, high fruit intake and grain consumption indicated high odds ratios for stunting. Significant predictors of child stunting in Madhya Pradesh are identified by logistic regression analysis. Children from particular castes had lower odds of stunting (adjusted odds ratio of 0.95, p = 0.03), indicating a weak but statistically significant caste effect. Mothers' education significantly lowered the chances of stunting, with an adjusted odds ratio of 0.87 and a p-value of less than 0.001. Higher Maternal BMI has been demonstrated to correlate with reduced odds of stunting, with an adjusted odds ratio of 0.97 (p < 0.001). Male children are considerably more prone to stunting compared to females, with an adjusted odds ratio of 0.85 and a p-value of less than 0.001. Sanitation and access to clean drinking water significantly decrease stunting, with adjusted odds ratios of 1.00 (p < 0.001) for sanitation and 0.99 (p = 0.01) for water. Housing quality, demonstrates a modest yet significant impact on reducing stunting (adjusted odds ratio of 0.99, p = 0.01). These findings indicate that certain pivotal factors, including maternal education, health, wealth, sanitation, and clean water consumption, are essential to child growth and stunting. Regression analysis revealed both significant and subtle findings regarding the relationship between dietary practices and child stunting. An extended breastfeeding period demonstrates a protective effect against stunting, evidenced by an adjusted odds ratio of 0.99 (95% CI: 0.99-0.65, p < 0.001). Collectively, these findings call for targeted policy intervention to improve infrastructure facilities in households; promote dietary diversification (vegetables, legumes, and grain, home gardening, and animal-source food); and enhance education to achieve the goal of sustainable development related to zero hunger and clean water and sanitation.

Published in International Journal of Health Economics and Policy (Volume 10, Issue 4)
DOI 10.11648/j.hep.20251004.15
Page(s) 194-201
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Stunting, WASH, Hunger, Nutrition, SDG

References
[1] Alderman, H., & Headey, D. D. (2017). The timing of the effects of improvements in water and sanitation on child health and nutritional status. International Journal of Epidemiology, 46(1), 50-59.
[2] Caldwell, J. C. (1979). Education as a factor in mortality decline: An examination of Nigerian data. Population Studies, 33(3), 395-413.
[3] Esfarjani, F., Roustaee, R., Mohammadi-Nasrabadi, F., & Esmaillzadeh, A. (2013). Major dietary patterns in relation to stunting among children in Tehran, Iran. Journal of Health, Population and Nutrition, 31(2), 202-210.
[4] Fenn, B., Bulti, A. T., Nduna, T., Du Feld, A., & Watson, F. (2012). An evaluation of an operations research project to reduce childhood stunting in a food-insecure area in Ethiopia. Public Health Nutrition, 15(10), 1746-1754.
[5] Headey, D., & Hoddinott, J. (2016). Understanding the nutritional transition in developing countries: Determinants of child stunting decline. World Development, 88, 1-11.
[6] Jacob, R., & Parkinson, J. (2015). The potential for school-based interventions that target executive function to improve academic achievement: A review. Review of Educational Research, 85(4), 511-522.
[7] Mahmudiono, T., Sumarmi, S., & Rosenkranz, R. R. (2017). Household dietary diversity and child stunting in East Java, Indonesia. Asia Pacific Journal of Clinical Nutrition, 26(2), 317-325.
[8] Makoka, D. (2013). The impact of maternal education on child nutrition: Evidence from Malawi, Tanzania, and Zimbabwe. ICF International.
[9] Ministry of Health and Family Welfare. (2022). Annual report 2021-22. Government of India.
[10] NFHS-5 State Report: Madhya Pradesh. (n.d.). National Family Health Survey (NFHS-5).
[11] Patel, H. H. (2022). Water-borne diseases. News-Medical.
[12] Prüss-Ustün, A., Wolf, J., Bartram, J., Clasen, T., Cumming, O., Freeman, M. C., Gordon, B., Hunter, P. R., Medlicott, K., & Johnston, R. (2019). Burden of disease from inadequate water, sanitation, and hygiene for selected adverse health outcomes: An updated analysis with a focus on low- and middle-income countries. International Journal of Hygiene and Environmental Health, 222(5), 765-777.
[13] Rah, J. H., Akhter, N., Semba, R. D., de Pee, S., Bloem, M. W., Campbell, A. A., et al. (2010). Low dietary diversity is a predictor of child stunting in rural Bangladesh. European Journal of Clinical Nutrition, 64(12), 1393-1398.
[14] Reed, B. A., Habicht, J. P., & Niameogo, C. (1996). The effects of maternal education on child nutritional status depend on socio-environmental conditions. International Journal of Epidemiology, 25(3), 585-592.
[15] Stewart, C. P., Iannotti, L., Dewey, K. G., Michaelsen, K. F., & Onyango, A. W. (2013). Contextualizing complementary feeding in a broader framework for stunting prevention. Maternal & Child Nutrition, 9(S2), 27-45.
[16] Victora, C. G., Adair, L., Fall, C., Hallal, P. C., Martorell, R., Richter, L., & Sachdev, H. S. (2008). Maternal and child undernutrition: Consequences for adult health and human capital. The Lancet, 371(9609), 340-357.
[17] United Nations, Department of Economic and Social Affairs. (2016). Report on the World Social Situation 2016: Leaving no one behind - The imperative of inclusive development (ST/ESA/362). United Nations.
[18] World Health Organization. (2012). Comprehensive implementation plan on maternal, infant and young child nutrition (Resolution WHA65.6). In Sixty-fifth World Health Assembly, Geneva, 21-26 May 2012: Resolutions and decisions, annexes (pp. 12-13). WHO.
[19] World Health Organization. (2023). The state of food security and nutrition in the world 2023: Urbanization, agrifood systems transformation, and healthy diets across the rural-urban continuum. Geneva: World Health Organization.
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  • APA Style

    Singh, A., Sudele, S. (2025). Determinants of Child Stunting in Madhya Pradesh: The Role of Household Infrastructure and Dietary Practices in Achieving Zero Hunger. International Journal of Health Economics and Policy, 10(4), 194-201. https://doi.org/10.11648/j.hep.20251004.15

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    ACS Style

    Singh, A.; Sudele, S. Determinants of Child Stunting in Madhya Pradesh: The Role of Household Infrastructure and Dietary Practices in Achieving Zero Hunger. Int. J. Health Econ. Policy 2025, 10(4), 194-201. doi: 10.11648/j.hep.20251004.15

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    AMA Style

    Singh A, Sudele S. Determinants of Child Stunting in Madhya Pradesh: The Role of Household Infrastructure and Dietary Practices in Achieving Zero Hunger. Int J Health Econ Policy. 2025;10(4):194-201. doi: 10.11648/j.hep.20251004.15

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  • @article{10.11648/j.hep.20251004.15,
      author = {Ankit Singh and Shweta Sudele},
      title = {Determinants of Child Stunting in Madhya Pradesh: 
    The Role of Household Infrastructure and Dietary Practices in Achieving Zero Hunger},
      journal = {International Journal of Health Economics and Policy},
      volume = {10},
      number = {4},
      pages = {194-201},
      doi = {10.11648/j.hep.20251004.15},
      url = {https://doi.org/10.11648/j.hep.20251004.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20251004.15},
      abstract = {Child stunting, which is defined as low height for age, is one of the critical public health issues in Madhya Pradesh, India, with alarmingly high prevalence rates. This study examines the impact of household infrastructure and dietary practices on stunting, using district-level data from the National Family Health Survey (NFHS-5). Poor access to sanitation, clean drinking water, and proper dietary diversity emerged as significant determinants of stunting, compounded by socioeconomic disparities and maternal education levels. Logistic regression analysis shows predictors such as the wealth index, maternal BMI, and extended duration's of breastfeeding all have significant effects in protection against stunting. On the contrary, high fruit intake and grain consumption indicated high odds ratios for stunting. Significant predictors of child stunting in Madhya Pradesh are identified by logistic regression analysis. Children from particular castes had lower odds of stunting (adjusted odds ratio of 0.95, p = 0.03), indicating a weak but statistically significant caste effect. Mothers' education significantly lowered the chances of stunting, with an adjusted odds ratio of 0.87 and a p-value of less than 0.001. Higher Maternal BMI has been demonstrated to correlate with reduced odds of stunting, with an adjusted odds ratio of 0.97 (p < 0.001). Male children are considerably more prone to stunting compared to females, with an adjusted odds ratio of 0.85 and a p-value of less than 0.001. Sanitation and access to clean drinking water significantly decrease stunting, with adjusted odds ratios of 1.00 (p < 0.001) for sanitation and 0.99 (p = 0.01) for water. Housing quality, demonstrates a modest yet significant impact on reducing stunting (adjusted odds ratio of 0.99, p = 0.01). These findings indicate that certain pivotal factors, including maternal education, health, wealth, sanitation, and clean water consumption, are essential to child growth and stunting. Regression analysis revealed both significant and subtle findings regarding the relationship between dietary practices and child stunting. An extended breastfeeding period demonstrates a protective effect against stunting, evidenced by an adjusted odds ratio of 0.99 (95% CI: 0.99-0.65, p < 0.001). Collectively, these findings call for targeted policy intervention to improve infrastructure facilities in households; promote dietary diversification (vegetables, legumes, and grain, home gardening, and animal-source food); and enhance education to achieve the goal of sustainable development related to zero hunger and clean water and sanitation.},
     year = {2025}
    }
    

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  • TY  - JOUR
    T1  - Determinants of Child Stunting in Madhya Pradesh: 
    The Role of Household Infrastructure and Dietary Practices in Achieving Zero Hunger
    AU  - Ankit Singh
    AU  - Shweta Sudele
    Y1  - 2025/12/30
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    N1  - https://doi.org/10.11648/j.hep.20251004.15
    DO  - 10.11648/j.hep.20251004.15
    T2  - International Journal of Health Economics and Policy
    JF  - International Journal of Health Economics and Policy
    JO  - International Journal of Health Economics and Policy
    SP  - 194
    EP  - 201
    PB  - Science Publishing Group
    SN  - 2578-9309
    UR  - https://doi.org/10.11648/j.hep.20251004.15
    AB  - Child stunting, which is defined as low height for age, is one of the critical public health issues in Madhya Pradesh, India, with alarmingly high prevalence rates. This study examines the impact of household infrastructure and dietary practices on stunting, using district-level data from the National Family Health Survey (NFHS-5). Poor access to sanitation, clean drinking water, and proper dietary diversity emerged as significant determinants of stunting, compounded by socioeconomic disparities and maternal education levels. Logistic regression analysis shows predictors such as the wealth index, maternal BMI, and extended duration's of breastfeeding all have significant effects in protection against stunting. On the contrary, high fruit intake and grain consumption indicated high odds ratios for stunting. Significant predictors of child stunting in Madhya Pradesh are identified by logistic regression analysis. Children from particular castes had lower odds of stunting (adjusted odds ratio of 0.95, p = 0.03), indicating a weak but statistically significant caste effect. Mothers' education significantly lowered the chances of stunting, with an adjusted odds ratio of 0.87 and a p-value of less than 0.001. Higher Maternal BMI has been demonstrated to correlate with reduced odds of stunting, with an adjusted odds ratio of 0.97 (p < 0.001). Male children are considerably more prone to stunting compared to females, with an adjusted odds ratio of 0.85 and a p-value of less than 0.001. Sanitation and access to clean drinking water significantly decrease stunting, with adjusted odds ratios of 1.00 (p < 0.001) for sanitation and 0.99 (p = 0.01) for water. Housing quality, demonstrates a modest yet significant impact on reducing stunting (adjusted odds ratio of 0.99, p = 0.01). These findings indicate that certain pivotal factors, including maternal education, health, wealth, sanitation, and clean water consumption, are essential to child growth and stunting. Regression analysis revealed both significant and subtle findings regarding the relationship between dietary practices and child stunting. An extended breastfeeding period demonstrates a protective effect against stunting, evidenced by an adjusted odds ratio of 0.99 (95% CI: 0.99-0.65, p < 0.001). Collectively, these findings call for targeted policy intervention to improve infrastructure facilities in households; promote dietary diversification (vegetables, legumes, and grain, home gardening, and animal-source food); and enhance education to achieve the goal of sustainable development related to zero hunger and clean water and sanitation.
    VL  - 10
    IS  - 4
    ER  - 

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