Deciphering disparities in childhood stunting in an underdeveloped state of India: an investigation applying the uncondi
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RESEARCH ARTICLE
Open Access
Deciphering disparities in childhood stunting in an underdeveloped state of India: an investigation applying the unconditional quantile regression method Saswata Ghosh1,2* , Santosh Kumar Sharma3 and Debarshi Bhattacharya4
Abstract Background: Unacceptably high rate of childhood stunting for decades remained a puzzle in the eastern Indian state of Bihar. Despite various programmatic interventions, nearly half of the under-five children (numerically about 10 million) are still stunted in this resource-constrained state. Data and methods: Using four successive rounds of National Family Health Survey (NFHS) data spread over more than two decades and by employing unconditional quantile regressions and counterfactual decomposition (QRCD), the present study aims to assess effects of various endowments as well as returns to those endowments in disparities in childhood stunting over the period. Results: The results show that although the child’s height-for-age Z-scores (HAZ) disparity largely accounted for differing levels of endowments during the earlier decades, in the later periods, inadequate access to the benefits from various development programmes was also found responsible for HAZ disparities. Moreover, effects of endowments and their returns varied across quantiles. We argue that apart from equalizing endowments, ensuring adequate access to different nutrition-centric programmes is essential to lessen the burden of childhood stunting. Conclusion: The state must focus on intersectoral convergence of different schemes in the form of state nutrition mission, and, strengthen nutrition-centric policy processes and their political underpinnings to harness better dividend. Keywords: Childhood stunting, Unconditional quantile regression, Counterfactual decompositions, Bihar, India
* Correspondence: [email protected] 1 Demography and Population Health Expert, Centre for Health Policy (CHP), Asian Development Research Institute (ADRI), Patna 800013, India 2 Institute of Development Studies Kolkata (IDSK), Kolkata, India Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedic
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