Intimate Partner Violence and Childhood Nutritional Outcomes in Madhya Pradesh: Secondary Analysis of National Family Health Survey-5 (NFHS-5) Data

Background: Intimate partner violence (IPV) and childhood undernutrition represent co-occurring public health challenges in Madhya Pradesh (MP), India. This study examined the association between maternal IPV exposure and child health outcomes, including stunting, wasting, and underweight, using data from the National Family Health Survey-5 (NFHS-5), 2019-21. Method: A cross-sectional secondary data analysis was conducted using NFHS-5 Individual Recode and Children's Recode files for MP. The files were merged at the household level, yielding 1,820 mother-child pairs. IPV was assessed using the validated domestic violence (DV) module (n=4,519 women in the 50% subsample). Child outcomes were defined using WHO anthropometric Z-scores. Multivariable binary logistic regression estimated adjusted odds ratios (aOR) with 95% confidence intervals (CIs), adjusting for exogenous sociodemographic confounders, including place of residence, maternal education, wealth index, and maternal age. Demographic and Health Surveys (DHS) sampling weights were applied throughout. Results: IPV prevalence was 28.3% among the DV subsample. Stunting, wasting, and underweight were observed in 36.4%, 18.7%, and 33.4% of children, respectively. After adjustment, IPV was not independently associated with stunting (aOR=1.071, 95% CI: 0.833-1.376, p=0.592), wasting (aOR=0.825, 95% CI: 0.601-1.132, p=0.234), or underweight (aOR=0.912, 95% CI: 0.708-1.174, p=0.475). The household wealth index emerged as the dominant, strongly protective independent predictor across all child health metrics (stunting and underweight: p<0.001; wasting: p=0.017). Conclusion: IPV and pediatric malnutrition represent concurrent, intersecting vulnerabilities within MP, but structural poverty is the primary independent predictor of anthropometric failure. Effective policy responses must shift beyond isolated vertical programmes, integrating gender-based violence prevention within maternal and child health platforms alongside robust household economic empowerment.