The Impact of Grandparental Presence on Child Nutrition and Care Practices in Joint Families: A Cross-Sectional Study in Karachi, Pakistan

Background: Child malnutrition remains a significant public health concern in Pakistan. This study aimed to examine how the presence of grandparents in joint families affects child nutrition and care practices in Karachi. Methods: A cross-sectional study was conducted among 450 households with children under 5 years old. Data on family structure, child nutritional status, and care practices were collected through structured questionnaires and anthropometric measurements. Logistic regression was used to analyze associations. Results: Children in joint families with grandparents present had lower rates of stunting (18.6% vs 32.9%, p<0.001) and underweight (12.4% vs 22.7%, p=0.003) compared to nuclear families. Grandparental presence was associated with improved dietary diversity (aOR 1.68, 95% CI: 1.24-2.27) and feeding practices (aOR 1.53, 95% CI: 1.12-2.09). However, there was no significant difference in overweight prevalence (13.8% vs 12.9%, p=0.78). Conclusions: The presence of grandparents in joint families is associated with better child nutritional outcomes and care practices. Leveraging intergenerational support may be beneficial for child health interventions in this context.