Understanding the Multifaceted Determinants of Child Malnutrition in a Remote Arid Region of Western India: A Household-Level Study of the Banni Region, Kachchh, Gujarat

Background: Child malnutrition remains the leading underlying cause of mortality among children under five in low- and middle-income countries, yet its determinants in geographically isolated, resource-poor settings remain under-documented. The Banni region of Kachchh, Gujarat, India a remote arid grassland marked by harsh climate, limited infrastructure, and low socioeconomic status exemplifies such a setting.Objective: This study aimed to (i) identify the socioeconomic factors contributing to child malnutrition and (ii) assess the availability and adequacy of healthcare infrastructure for addressing malnutrition in the interior Banni region.Methods: We conducted a cross-sectional household survey of 60 households with children under five across three Banni villages. Data were collected through a pre-tested, expert-validated structured questionnaire, administered in face-to-face interviews with primary caregivers on the Kobo Toolbox platform. Descriptive and inferential statistics were computed in JASP, with significance set at p < 0.05.Results: Caregivers were predominantly illiterate mothers (66.7%); mean household size was 7.7 (SD = 2.42) and mean monthly income ₹12,203. Nearly all households (93.3%) received no social welfare benefits, and the same proportion reported no local employment opportunities. Although 91.7% reported regular access to a balanced diet and 83.3% to clean drinking water, 55% rated healthcare availability as "very poor," and no specialised child-health or nutrition-education services existed in the area.Conclusions: In this remote community, apparent food access coexists with severe deficits in healthcare infrastructure, nutrition literacy, and economic opportunity. These findings challenge supply-side, food-centric framings of malnutrition and underscore the need for integrated, place-based interventions. Targeted recommendations are provided for policy and practice.