Maternal literacy and regional disparities as independent determinants of child malnutrition in India: an empirical analysis using NFHS-5

Abstract

Background: Child malnutrition remains a critical public health challenge in India. Despite modest improvements between NFHS-4 and NFHS-5, 35.5% of children under five are stunted, 19.3% wasted, and 32.1% underweight. This study aimed to analyze interstate differences in child malnutrition and examine the relationship between maternal education and nutritional outcomes using NFHS-5 data.

Methods: A cross-sectional, quantitative design was employed. State-level prevalence data from 28 Indian states and union territories were analyzed using one‑way ANOVA to test for regional variation in stunting, wasting, and underweight. Pearson’s correlation was used to assess the association between maternal years of schooling and mean Z‑scores for height‑for‑age, weight‑for‑height, and weight‑for‑age.

Results: ANOVA revealed significant regional variation for wasting (F=6.393, p=0.001) and underweight (F=8.525, p<0.001), while stunting variation was marginal (p=0.061). Maternal education showed a very strong positive correlation with height‑for‑age (r=0.95, p=0.003) and weight‑for‑age (r=0.93, p=0.006), and a strong correlation with weight‑for‑height (r=0.84, p=0.034). All correlations were statistically significant.

Conclusions: Both geographical region and maternal education are independent determinants of child malnutrition in India. Regional disparities, especially in wasting and underweight, call for location‑specific interventions. The strong, graded association between maternal education and improved nutritional outcomes underscores the need for continued investment in female education as a long‑term malnutrition reduction strategy.