Overlooking undernutrition? Exploring an alternative measure of undernutrition among young children

Undernutrition (UN) remains a major public health challenge in the Global South, requiring measures that capture its multidimensional nature. Conventional indicators – stunting, wasting, underweight, and the Composite Index of Anthropometric Failure (CIAF) – primarily assess protein–energy deficiency (PED) while overlooking micronutrient deficiency (MD). This study proposes Protein Energy Micronutrient Deficiency (PEMD), a composite measure integrating thinness as a proxy for PED and anaemia as a proxy for MD. Using data from three rounds of India’s National Family Health Survey (NFHS-3, NFHS-4, and NFHS-5), the study demonstrates that PEMD may provide a more comprehensive assessment of child undernutrition than conventional measures.