Distinct clusters of stunted children in India: An observational study

Childhood stunting is often conceptualised as a singular concept (i.e., stunted
or not), and such an approach implies similarity in the experiences of children
who are stunted. Furthermore, risk factors for stunting are often treated in
isolation, and limited research has examined how multiple risk factors interact
together. Our aim was to examine whether there are subgroups among
stunted children, and if parental characteristics influence the likelihood of
these subgroups among children. Children who were stunted were identified
from the 2005-2006 Indian National Family Health Survey (n = 12,417).
Latent class analysis was used to explore the existence of subgroups among
stunted children by their social, demographic, and health characteristics.
We examined whether parental characteristics predicted the likelihood of
a child belonging to each latent class using a multinomial logit regression
model. We found there to be 5 distinct groups of stunted children; “poor,
older, and poor health-related outcomes,” “poor, young, and poorest healthrelated
outcomes,” “poor with mixed health-related outcomes,” “wealthy
and good health-related outcomes,” and “typical traits.” Both mother and
father’s educational attainment, body mass index, and height were important
predictors of class membership. Our findings demonstrate evidence that
there is heterogeneity of the risk factors and behaviours among children who
are stunted. It suggests that stunting is not a singular concept; rather, there
are multiple experiences represented by our “types” of stunting. Adopting a
multidimensional approach to conceptualising stunting may be important for
improving the design and targeting of interventions for managing stunting.