Trends, Predictors, and Consequences of Child Undernutrition

点击翻译按钮获取中文摘要

RR-7: ABSTRACT One out of every three children under the age of five in India are undernourished (48 million). To address this crisis, Indian government established a National Rural Health Mission (NRHM) program in 2005, which improved healthcare and nutritional services. Unfortunately, this efforts which spanned from 2005 to 2012 have yielded minimal improvement. Persistent child undernutrition limits growth, productivity, quality of life, and life expectancy of Indians. In other words, Indian children are unable to realize their full potential due to undernutrition. Our current understanding of child undernutrition in India is 1) outdated because most of the analyses uses data from 2005, before the implementation of NRHM program, 2) contradictory because investigations of predictors of child undernutrition in India with improper methodologies has produced inconsistent findings despite using the same data source), and 3) lacking because no national level study has assessed the consequences of child undernutrition. Therefore, this study will apply advanced geospatial and multilevel methods on publicly available nationally representative data from NICHD-funded India Human Development Survey (IHDS) series to fill these critical knowledge-gaps. The first of the two IHDS surveys was conducted in 2005 (IHDS-I) before the implementation of NRHM and surveyed 24,314 children aged five or less from 41,554 households. IHDS-II was conducted in 2012 and surveyed 42,152 households, including 34,621 that were surveyed in 2005, and collected information on 20,810 children under the age of five and 26,559 pre-adolescents. We will use this unique data source, the largest panel dataset on child undernutrition in India to investigate: Aim 1) the trends of child undernutrition in India from 2005 to 2012 in relation to NRHM, Aim 2) individual, household, and community level predictors of child undernutrition, and Aim 3) consequences of undernutrition in the first five years of life on development during pre-adolescent (8-11) years within the Indian socio-cultural context. Our investigation will define the heterogeneity in the burden of child undernutrition and its association with a variety of predictors across different regions of India. Moreover, it will elucidate the magnitude of its consequences on child development within the Indian context. Thus, this study will establish a foundation for addressing this humanitarian and economic crisis by identifying effective entry points for existing intervention. This proposal will also position me to take the next step towards my career goal of reducing health disparities among children through clinical practice in underserved regions, community-based research, and evidence-based advocacy. To accomplish the study aims and prepare me for my career, this research proposal is paired with a carefully curated training plan that includes specific graduate-level courses and individualized mentorship experiences with a team of technical and content experts.