Methods for assessing seasonal and annual trends in wasting in Indian surveys (NFHS-3, 4, RSOC & CNNS)

Sane, Renuka and Johnston, Robert and Dhamija, Gaurav and et al, . (2021) Methods for assessing seasonal and annual trends in wasting in Indian surveys (NFHS-3, 4, RSOC & CNNS). PLOS ONE, 16 (11). pp. 1-16. ISSN 1932-6203

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Abstract

Wasting in children under-five is a form of acute malnutrition, a predictor of under-five child mortality and of increased risk of future episodes of stunting and/or wasting. In India, national estimates of wasting are high compared to international standards with one in five children found to be wasted. National surveys are complex logistical operations and most often not planned or implemented in a manner to control for seasonality. Collection of survey data across differing months across states introduces seasonal bias. Cross-sectional surveys are not designed to collect data on seasonality, thus special methods are needed to analyse the effect of data collection by month. We developed regression models to estimate the mean weight for height (WHZ), prevalence of wasting for every month of the year for an average year and an overall weighted survey estimates controlling for the socio-demographic variation of data collection across states and populations over time. National level analyses show the mean WHZ starts at its highest in January, falls to the lowest in June/ August and returns towards peak at year end. The prevalence of wasting is lowest in January and doubles by June/August. After accounting for seasonal patterns in data collection across surveys, the trends are significantly different and indicate a stagnant period followed by a decline in wasting. To avoid biased estimates, direct comparisons of acute malnutrition across surveys should not be made unless seasonality bias is appropriately addressed in planning, implementation or analysis. Eliminating the seasonal variation in wasting would reduce the prevalence by half and provide guidance towards further reduction in acute malnutrition. Copyright: © 2021 Johnston et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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IITH Creators:

IITH Creators	ORCiD
Dhamija, Gaurav	UNSPECIFIED

Item Type:

Article

Uncontrolled Keywords:

Cachexia; Child Mortality; Child, Preschool; Cross-Sectional Studies; Female; Growth Disorders; Humans; India; Infant; Male; Malnutrition; Prevalence; Seasons; Surveys and Questionnaires; Wasting Syndrome

Subjects:

Arts > Liberal arts

Divisions:

Department of Liberal Arts

Depositing User:

. LibTrainee 2021

Date Deposited:

06 Sep 2022 06:12

Last Modified:

06 Sep 2022 06:12

URI:

http://raiithold.iith.ac.in/id/eprint/10441