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 anapproach implies similarity in the experiences of children who are stunted. Furthermore, risk fac-tors for stunting are often treated in isolation, and limited research has examined how multiplerisk factors interact together. Our aim was to examine whether there are subgroups amongstunted children, and if parental characteristics influence the likelihood of these subgroups amongchildren. Children who were stunted were identified from the 2005–2006 Indian National FamilyHealth Survey (n= 12,417). Latent class analysis was used to explore the existence of subgroupsamong stunted children by their social, demographic, and health characteristics. We examinedwhether parental characteristics predicted the likelihood of a child belonging to each latent classusing a multinomial logit regression model. We found there to be 5 distinct groups of stunted chil-dren;“poor, older, and poor health‐related outcomes,”“poor, young, and poorest health‐relatedoutcomes,”“poor with mixed health‐related outcomes,”“wealthy and good health‐relatedoutcomes,”and“typical traits.”Both mother and father's educational attainment, body massindex, and height were important predictors of class membership. Our findings demonstrateevidence that there is heterogeneity of the risk factors and behaviours among children whoare stunted. It suggests that stunting is not a singular concept; rather, there are multiple expe-riences represented by our“types”of stunting. Adopting a multidimensional approach toconceptualising stunting may be important for improving the design and targeting of interven-tions for managing stunting