Determinants of Stunting, Wasting and Underweight among Under-Five Children in Tea Plantation Communities of Upper Assam, India: A Community-Based Cross-Sectional Study

Abstract Background: Malnutrition is a major public health issue in India. One of the worst-affected states for childhood malnutrition is Assam. This cross-sectional study investigated risk factors associated with stunting, underweight, and wasting in under-five children among the marginalized Adivasi community working in tea plantations of Assam. Materials and Methods: The outcome variables were stunting, underweight, and wasting. Explanatory variables were divided into maternal, child, and household factors. Multivariate logistic regression was used to assess the relationship between outcome and explanatory variables. A total of 778 mothers in their reproductive years with a child aged 0-59 months were included. Results: The percentage of underweight (41.65%) and stunted children (40.61%) were higher than wasting (31.23%). The Composite Index of Anthropometric Failure (CIAF) identified undernutrition in 71.72% of children and 47.04% with multiple failures. 52.06% of children did not receive exclusive breastfeeding and only 25% received a minimum diversified diet. Female children were more predisposed to stunting, underweight and wasting than their male counterparts. Children in households with non-shared sanitation facilities with potable water showed lowered odds of undernutrition and infections. The odds of being stunted and wasted was higher in those children living with 3–5 siblings, whose mothers were illiterate, underweight, still in adolescent stage at their childbirth, with small birth intervals and insufficient knowledge of child feeding practices. Conclusion: We suggest designing context-specific interventions by the government for these socio-economically marginalized children focusing on maternal and household factors so that the prevalence of malnutrition can be reduced and overall well-being can be ensured.