Archives of Current Research International

Child undernutrition is an important public health challenge in Bihar and may have intergenerational consequences if left unaddressed. It adversely affects child survival, physical and cognitive development, and future productivity. Despite efforts to eliminate undernutrition among children under five years of age, Bihar continues to record a very high prevalence of stunting, wasting, and underweight. This study examines the socioeconomic determinants of child undernutrition in Bihar using unit-level data from the National Family Health Survey (NFHS)-5, conducted during 2019–2020. Anthropometric measures of stunting (height-for-age), wasting (weight-for-height), and underweight (weight-for-age) were used as outcome variables to assess children's nutritional status in accordance with the WHO Child Growth Standards. The independent variables included socioeconomic characteristics, maternal education and health, child characteristics, and water, sanitation, and hygiene-related factors. The study used descriptive statistics, cross-tabulation, and bivariate analysis to examine the prevalence of child undernutrition across the independent variables. Multivariate analysis using logistic regression was also conducted to identify the socioeconomic, maternal and child health, and water, sanitation, and hygiene-related factors associated with child undernutrition in Bihar. Scheduled Caste children had the highest odds of stunting and underweight among the social groups compared with 'Others' (OR = 1.348 and 1.520, respectively; p < 0.001). Children from the poorest households had higher odds of stunting (OR = 1.723, p < 0.001) and underweight (OR = 1.609, p < 0.001) than those from the richest households. Maternal education was an important determinant: children of mothers with no formal education had higher odds of stunting (OR = 2.087, p < 0.001) and underweight (OR = 1.508, p < 0.001). The findings suggest that socioeconomic inequalities play a critical role in determining children's nutritional outcomes. Higher odds of undernutrition were observed among socioeconomically disadvantaged children, children from poorer households, children whose mothers had no formal education, and children living in households without toilet facilities or clean cooking fuel. Policies aimed at reducing inequalities in access to child nutrition and health-related services, increasing maternal educational attainment, providing appropriate maternal health support during and after pregnancy, and improving access to toilets and safe drinking water could contribute to achieving the Global Nutrition Targets and the Sustainable Development Goals by 2030.