Low intake of vitamin A–rich foods among children, aged 12–35 months, in India: association with malnutrition, anemia, and missed child survival interventions

ObjectiveTo determine whether children in India who have a low intake of vitamin A–rich foods are at higher risk of malnutrition, anemia, and not receiving child health interventions.MethodsWe analyzed data from the India National Family Health Survey, 2005–2006.ResultsOf 17 847 children (41.9%), aged 12–35 months, 7020 did not receive vitamin A–rich foods, based on 24-h recall. The prevalence of stunting, severe stunting, underweight, and severe underweight among children who did and did not receive vitamin A–rich foods was, respectively, 52.5% versus 59.0%, 26.7% versus 32.9%, 43.8% versus 48.5%, and 17.9% versus 21.6% (all P < 0.0001). Children who did not receive vitamin A–rich foods were more likely to be anemic, not have completed childhood immunizations, and not to have received vitamin A supplementation in the previous 6 mo (all P < 0.0001). Maternal education of ≥10, 7–9, and 1–6 y, respectively, compared with no formal education was associated with the child receiving vitamin A–rich foods (odds ratio 1.41, 95% confidence interval 1.20–1,67, P < 0.0001; odds ratio 1.20, 95% confidence interval 1.04–1.37, P = 0.01; odds ratio 1.16, 95% confidence interval 1.02–1.32, P = 0.02) in a multivariate logistic regression model adjusting for maternal age, household size, socioeconomic status, and location.ConclusionChildren who did not receive vitamin A–rich foods were more likely to be malnourished and to have missed basic child health interventions, including vitamin A supplementation. Children were more likely to receive vitamin A–rich foods if their mothers had previously achieved higher primary or secondary education levels.