Factors associated with double burden of malnutrition among mother-child pairs in India: A study based on National Family Health Survey 2015-16

Sustainable Development goal 2 focusses on preventing all forms of malnutrition by 2030. Therefore, it is important to understand the double burden of malnutrition (DBM) in mother-child pairs in India. This study attempted to explore the coexistence of DBM among mother-child pairs in India. Also, this study tries to explore various factors associated with DBM in India. The study utilized data from national representative cross-sectional fourth round of National Family Health Survey (NFHS-4) conducted in 2015-16. The study used anthropometric indices such as height-for-age, weight-for-height, and weight-for-age to examine the nutritional status of children aged 0-59 months. Further, the study used body mass index (BMI) of women and classified according to WHO cut-off values (normal BMI: 18.5 to < 24.99 kg/m(2) and overweight/obesity: >= 25.0 kg/m(2)). The bivariate and multivariate logistic regression analysis were applied to assess the factors associated with DBM. It was found that 4.1 percent, 3.3 percent, and 2.1 percent of mother-child pairs in the same household were a combination of Overweight/Obese women with stunted children (OM/SC), Overweight/Obese women with underweight children (OM/UC), and Overweight/Obese women with wasted children respectively (OM/WC). Additionally, 6% of mother-child pairs in the same household were suffering from DBM. Mothers with secondary education were more likely to face risk of DBM as compared to uneducated mothers [OR: 1.17, p < 0.01]. DBM was higher among mother-child pairs, which belong to rich wealth quintile than mother-child pairs from poor wealth quintile [OR: 1.98, p < 0.01]. Interventions need to be scaled up to target undernutrition as well as obesity at the same time in a household. Isolated focus on undernourished children may not be sufficient, and it is recommended to address different nutritional problems simultaneously. Another important recommendation is to formulate nutrition interventions keeping in mind the inclusion of wealthier families, as DBM is higher among such families.