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Impact of child marriage on nutritional status and anaemia of children under 5 years of age: empirical evidence from India
Authors: Paul P, Chouhan P, and Zaveri A
Source: Public Health, 177: 95-101; DOI: 10.1016/j.puhe.2019.08.008
Topic(s): Anemia
Child health
Child marriage
Children under five
Nutrition
Country: Asia
  India
Published: SEP 2019
Abstract: OBJECTIVE: Despite several international commitments and national policies to eliminate the practice of girl child marriage, it remains pervasive in India. In this study, we aimed to examine the association between child marriage and nutritional status and anaemia in children aged below 5 years. STUDY DESIGN AND METHODS: We have used the data from the latest round of the Indian National Family Health Survey (NFHS), conducted in 2015-2016. For this study, the sample was limited to 80,539 living children aged below 5 years born to 60,003 ever-married women aged 15-24 years. We have considered children's stunting, wasting, underweight and anaemia as outcomes variables and child marriage (married below 18 years) as the exposure of variables of interest. Pearson's Chi-squared test and binary logistic regressions were applied to assess the associations. RESULTS: About 58% of sample women were married before 18 years of age. The prevalence of children's stunting, wasting and underweight were 37%, 23% and 36%, respectively. More than half of the sample children (62%) were anaemic. Regression analysis revealed that child marriage (<18 years) was significantly associated with increased likelihood of stunting (adjusted odds ratio [AOR] = 1.06, 95% confidence interval [CI] = 1.02-1.10) and underweight (AOR = 1.04, 95% CI = 1.00-1.08) even after controlling for relevant confounding variables. Child marriage had no significant association with children being wasted and anaemic in crude analyses. However, it is found that child marriage significantly increases the risk of childhood anaemia in adjusted analyses (AOR = 1.08, 95% CI = 1.03-1.13). CONCLUSIONS: The findings of our study suggest that there is a need for effective policies and programmes to end the practice of child marriage and targeted intervention should be made to improve nutritional outcomes of children born to women married in childhood. Copyright © 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. KEYWORDS: Anaemia; Child marriage; Children; India; Nutrition