Expected and Observed District-Level Changes in Child Growth Indicators Associated With Changes in Human Development Indicators, India, 2015–2016 and 2019–2021 (n=640 Districts)
| Stuntinga | Wastinga | Underweighta | Overweighta | |||||
|---|---|---|---|---|---|---|---|---|
| Observed Change −2.5% | Observed Change −2.2% | Observed Change −3.3% | Observed Change 1.7% | |||||
| Observed Percentage Point Change, Mean | Expected Change, PP (95% CI) | Difference Between Observed and Expected Changeb2016–2021, PP (95% CI) | Expected Change, PP (95% CI) | Difference Between Observed and Expected Changeb2016–2021, PP (95% CI) | Expected Change, PP (95% CI) | Difference Between Observed and Expected Changeb2016–2021, PP (95% CI) | Expected Change, PP (95% CI) | Difference Between Observed and Expected Changeb2016–2021, PP (95% CI) |
| Mean human development, composite score | −5.1 (−5.9, −4.3) | 2.6 (1.8, 3.4) | −1.7 (−2.0, −1.3) | −0.5 (−1.3, 0.3) | −5.5 (−6.3, −4.7) | 2.2 (1.2, 3.3) | 0.6 (0.4, 0.7) | 1.1 (0.8, 1.4) |
| Percentage of women who are literate | −1.7 (−2.4, −1.0) | −0.9 (−1.8, 0) | −0.6 (−0.8, −0.4) | −1.6 (−2.4, −0.7) | −1.9 (−2.5, −1.2) | −1.4 (−2.4, −0.4) | 0.2 (0.1, 0.3) | 1.5 (1.2, 1.8) |
| Percentage of women with 10 or more years of schooling | −2.3 (−3.0, −1.6) | −0.2 (−1.0, 0.5) | −0.8 (−1.0, −0.6) | −1.4 (−2.2, −0.6) | −2.5 (−3.1, −1.9) | −0.8 (−1.7, 0.2) | 0.3 (0.2, 0.3) | 1.4 (1.1, 1.7) |
| Percentage of women aged 20–24 years first cohabiting after age 18 years | −0.1 (−0.2, 0) | −2.5 (−3.5, −1.4) | −1.7 (−2.0, −1.3) | −0.5 (−1.3, 0.3) | −0.2 (−0.4, −0.1) | −3 (−4.3, −1.8) | 0.1 (0, 0.2) | 1.6 (1.3, 1.9) |
| Mean sex ratio at birth for children born in the last five years (females per 1,000 males) | 0 (−0.1, 0) | −2.5 (−3.5, −1.6) | 0 (0, 0) | −2.2 (−3.0, −1.4) | 0 (−0.1, 0.1) | −3.2 (−4.3, −2.2) | 0 (0, 0.1) | 1.7 (1.4, 2) |
| Percentage of population living in households that use an improved sanitation facility | −6.5 (−7.2, −5.7) | 3.9 (2.8, 5.0) | −2.9 (−3.5, −2.3) | 0.8 (−0.2, 1.7) | −8.2 (−9.1, −7.2) | 4.9 (3.8, 6.0) | 0.9 (0.7, 1.1) | 0.8 (0.4, 1.1) |
| Percentage of population living in households with an improved drinking-water source | −0.1 (−0.2, 0.1) | −2.5 (−3.5, −1.5) | −0.2 (−0.3, 0) | −2 (−2.8, −1.2) | −0.1 (−0.3, 0.1) | −3.2 (−4.3, −2.0) | 0.0 (−0.1, 0.0) | 1.7 (1.4, 2.0) |
| Percentage of population living in households with electricity | −5.2 (−6.3, −4.2) | 2.7 (1.6, 3.8) | −1 (−1.6, −0.5) | −1.2 (−2.2, −0.1) | −4.4 (−5.5, −3.4) | 1.2 (−0.2, 2.5) | 0.3 (0.1, 0.5) | 1.4 (1.0, 1.8) |
| Percentage of households using clean fuel for cooking | −3.1 (−3.8, −2.5) | 0.6 (−0.3, 1.5) | −0.9 (−1.2, −0.6) | −1.3 (−2.0, −0.5) | −3.2 (−3.9, −2.6) | −0.1 (−1.1, 1.0) | 0.4 (0.3, 0.5) | 1.3 (1.0, 1.6) |
| Percentage of households with any usual member covered under a health insurance or financing scheme | −1.4 (−1.8, −1.0) | −1.1 (−2.2, −0.1) | 0 (−0.2, 0.2) | −2.2 (−3.0, −1.3) | −0.8 (−1.3, −0.4) | −2.4 (−3.5, −1.4) | 0 (−0.1, 0.1) | 1.7 (1.3, 2.0) |
Abbreviations: CI, confidence interval; NFHS, National Family Health Survey; PP, percentage points, SD, standard deviation.
↵aChild stunting was defined as height-for-age < −2SD. Child wasting was defined as weight-for-height < −2SD. Child underweight was defined as weight-for-age < −SD. Child overweight was defined as weight-for-height > 2SD. All values are coefficient (bootstrapped 95% confidence interval).
↵bDifference between observed and expected change between 2016 (NFHS-4) and 2021 (NFHS-5). Contributions are modelled through 2-way Blinder-Oaxaca decomposition with each indicator entered separately. Equal weights (w=0.5) were applied for both survey rounds. The decomposition model gives each of the 640 districts analyzed equal weight, and district grand mean will not sum to the state population-weighted mean.