Geographic distribution and temporal trends of malnutrition and anaemia among women and children in malaria-endemic districts of India: a comparative analysis of NFHS-4 and NFHS-5

Authors

  • Harshitha J. Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Avinash M. Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Shrinivasa B. M. Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Juhi Tiwary Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Sanjana M. Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Pavan B. L. Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Kajal Bankoti Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Gunjan Negi Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Viprasha Tomer Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India
  • Vani H. Chalageri Department of Community Medicine, ICMR-National Institute of Malaria Research (NIMR), Field unit Bengaluru, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20263208

Keywords:

Anaemia, Children under 5, Malaria, Malaria elimination, Malnutrition, NFHS, Non-pregnant women, Pregnant women

Abstract

Introduction: In India malaria and malnutrition are major public health concerns. However, this interplay between anaemia and malnutrition remain poorly understood at the administrative unit (district) level. This study aims to analyse changes in the geographical distribution and temporal trends of malnutrition, and anaemia among children and women in the malaria endemic districts with Annual Parasite Index > 1.

Methods: This study used district-level data from National Family Health Survey –4 (NFHS-4) (2015–16) and National Family Health Survey-5 (NFHS-5) (2019–21) to assess geographical distribution and temporal patterns of malnutrition and anaemia in 29 malaria-endemic districts of India with API≥1 (2024). District-level trends across survey were compared and mapped using R software.

Results: Between NFHS-4 and NFHS-5, several malaria-endemic districts (API≥1) demonstrated meaningful improvements in child nutrition and anaemia indicators. Stunting declined notably in Uttar Bastar Kanker (36.3% to 24.8%) and Godda (54.0% to 39.4%). Wasting showed reduction in Bastar (33.9% to 20.4%), while underweight decreased in Kabeerdham (38.4% to 27.3%). Encouraging improvements in anaemia were observed among children in South Garo Hills (74.9% to 33.6%) and among pregnant women in Uttar Bastar Kanker (56.7% to 33.4%).

Conclusion: The observed reductions in malnutrition and anaemia across multiple malaria-endemic districts highlight the potential impact of focused nutrition and maternal health interventions. Strengthening and scaling successful district-level strategies can support integrated approaches toward improving nutritional outcomes and advancing malaria elimination goals by 2030.

References

Yadav CP, Hussain SS, Pasi S, Sharma S, Bharti PK, Rahi M, Sharma A. Linkages between malaria and malnutrition in co-endemic regions of India. BMJ Global Health. 2023;8(1):10781.

World Health Organization. Levels and trends in child malnutrition child malnutrition: UNICEF/WHO/World Bank Group Joint Child Malnutrition Estimates: Key findings of the 2023 edition. World Health Organization. 2023.

Golshaniniya P, Khatibi MP, Pourhassan A. Challenges and Strategies in Malaria Control: A Case Series from East Azerbaijan Province, 2023–2024. J Infect Public Health. 2026;2:103241.

Gahwai DK, Kaviprawin M, Panigrahi DK, Das JK, Patel K. Evaluation of Malaria Surveillance System in Government Health Facilities in Six Districts of State Chhattisgarh, India, 2023. Indian J Public Health. 2026 ;70(1):9-14.

Verma AK, Shrivastava S, Saxena N. Malaria and malnutrition in tribal areas of India: implications for paediatric health. Front Gastroenterol. 2025;4:1526806.

Mahapatra A, Mohapatra S, Mitter N, Dash SS, Mishra RP, Satapathy DM. Malaria and malnutrition co-existence among under-five children of tribal dense regions of Odisha: a community based study. Int J Community Med Public Health. 2018;5(7):3024–8.

Pushparajan RR, Sreenivasan P, Sarasam AA. Risk factors of obesity among infants and young children below 2 years of age: A case control study. The Indian J Med Res. 2026;163(4):450.

Black RE, Allen LH, Bhutta ZA, Caulfield LE, Onis M de, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60.

World malaria report. 2022. Available at: https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report. Accessed on 21 March 2026.

Ghosh K, Chakraborty AS, Haloi B, Zakir S. Spatial clustering of malnutrition and anemia among reproductive women and its associated risk Factors in India: Evidence From National Family Health Survey-5. Food Nutr Bulle. 2024;45(1):3-11.

Kumar V, Vyas N, Godinho MA, Raj S, Govindan S. Assessing implementation challenges in integrated vector borne disease control programs in India using the consolidated framework for implementation research through a systematic review. Discover Public Health. 2026;23(1):1057.

Singh Chauhan R, Dwivedi LK, Dixit P, Halli SS. Interviewer effects on underreporting of traditional contraceptive use: evidence from National Family Health Survey-5. Front Big Data. 2026;9:1812391.

Nahar MA, Mondal MN, Haque M, Parvin S, Sultana MS. Prevalence and determinants of undernutrition among under-five children in Bangladesh using nationally representative data. Paediatrica Indonesiana. 2025;65(6):516-28.

Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-22.

Seiler J, Müller B, Günther I, Wetscher M, Stauffer R, Umlauf N. Co-occurrence patterns of malnutrition indicators among children in sub-Saharan Africa. Comm Med. 2026;6(1):195.

Guddattu V. Understanding the Change in the Prevalence and Factors Influencing the Childhood Stunting Using District-Level Data from NFHS-4 and NFHS-5 in India. Inq J Med Care Organ Provis Financ. 2022;59:7122.

Nandi A, Behrman JR, Laxminarayan R. The impact of a national early childhood development program on future schooling attainment: Evidence from integrated child development services in India. Economic Dev Cultural Chan. 2020;69(1):291-316.

Sharif N, Das B, Alam A. Prevalence of anemia among reproductive women in different social group in India: cross-sectional study using nationally representative data. Plos One. 2023;18(2):281015.

Anaemia Mukt Bharat: National Health Mission. Available at: https://nhm.gov.in/index. Accessed on 21 January 2026.

Singhal R, Singh K, Tripathi PK. Community perspective and healthcare assessment in malaria endemic states of India: a cross-sectional study protocol. BMJ Open. 2024;14(7):81856.

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Published

2026-08-31

How to Cite

J., H., M., A., M., S. B., Tiwary, J., M., S., L., P. B., Bankoti, K., Negi, G., Tomer, V., & Chalageri, V. H. (2026). Geographic distribution and temporal trends of malnutrition and anaemia among women and children in malaria-endemic districts of India: a comparative analysis of NFHS-4 and NFHS-5. International Journal Of Community Medicine And Public Health, 13(9), 5218–5226. https://doi.org/10.18203/2394-6040.ijcmph20263208

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Original Research Articles