{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:24:36Z","timestamp":1793831076780,"version":"4.6.1"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T00:00:00Z","timestamp":1527033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>India accounts for approximately one third of the world's total population of stunted preschoolers. Addressing global undernutrition, therefore, requires an understanding of the determinants of stunting across India's diverse states and districts. We created a district\u2010level aggregate data set from the recently released 2015\u20132016 National and Family Health Survey, which covered 601,509 households in 640 districts. We used mapping and descriptive analyses to understand spatial differences in distribution of stunting. We then used population\u2010weighted regressions to identify stunting determinants and regression\u2010based decompositions to explain differences between high\u2010 and low\u2010stunting districts across India. Stunting prevalence is high (38.4%) and varies considerably across districts (range: 12.4% to 65.1%), with 239 of the 640 districts have stunting levels above 40% and 202 have prevalence of 30\u201340%. High\u2010stunting districts are heavily clustered in the north and centre of the country. Differences in stunting prevalence between low and high burden districts were explained by differences in women's low body mass index (19% of the difference), education (12%), children's adequate diet (9%), assets (7%), open defecation (7%), age at marriage (7%), antenatal care (6%), and household size (5%). The decomposition models explained 71% of the observed difference in stunting prevalence. Our findings emphasize the variability in stunting across India, reinforce the multifactorial determinants of stunting, and highlight that interdistrict differences in stunting are strongly explained by a multitude of economic, health, hygiene, and demographic factors. A nationwide focus for stunting prevention is required, while addressing critical determinants district\u2010by\u2010district to reduce inequalities and prevalence of childhood stunting.<\/jats:p>","DOI":"10.1111\/mcn.12620","type":"journal-article","created":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T06:40:17Z","timestamp":1527144017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":106,"title":["Understanding the geographical burden of stunting in India: A regression\u2010decomposition analysis of district\u2010level data from 2015\u201316"],"prefix":"10.1111","volume":"14","author":[{"given":"Purnima","family":"Menon","sequence":"first","affiliation":[{"name":"Poverty, Health and Nutrition Division International Food Policy Research Institute (IFPRI)  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Headey","sequence":"additional","affiliation":[{"name":"Poverty, Health and Nutrition Division International Food Policy Research Institute (IFPRI)  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasmi","family":"Avula","sequence":"additional","affiliation":[{"name":"Poverty, Health and Nutrition Division International Food Policy Research Institute (IFPRI)  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3418-1674","authenticated-orcid":false,"given":"Phuong Hong","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Poverty, Health and Nutrition Division International Food Policy Research Institute (IFPRI)  Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-361"},{"key":"e_1_2_9_3_1","article-title":"How important is parental education for child nutrition?","author":"Alderman H.","year":"2016","journal-title":"World Development"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-016-0480-z"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60996-4"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60937-X"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h4173"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.worlddev.2015.07.006"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1416964112"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980011001315"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12231"},{"key":"e_1_2_9_12_1","first-page":"42","volume-title":"Food and nutrition in India: Facts and interpretations","author":"Deaton A.","year":"2008"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2011.00349.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)70001-X"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1079\/PHN2004632"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078692"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980015003377"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60032-4"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-016-0587-9"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12571-011-0161-0"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.worlddev.2014.09.022"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12274"},{"key":"e_1_2_9_23_1","unstructured":"International Institute for Population Sciences(2017).India Fact Sheet. 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