Regional with urban-rural variation in low birth weight and its determinants of Indian children: findings from National Family Health Survey 5 data

Background Low birth weight is a key indicator for child health, especially a concern in low-middle-income countries. However, health and medically-related reforms are being actively implemented in some middleincome countries like India. Identifying low birth weight (LBW) babies with their determinants across the whole country is essential to formulate regional and area-specific interventions. The objective of this study was to find out the burden and determinants of LBW on the regional and residential (rural-urban) divisions of India. Methods The present study was based on the NFHS-5 dataset (2019-21), a nationally representative survey in India. A total of 209,223 births were included in this study. A newborn weighing less than 2500 g was considered as LBW. According to the objectives, we used frequency distribution, chi-square test and binary logistic regression analysis for analysing the data. Results About 18.24% of the babies were LBW in India, significantly higher in rural areas than in urban areas (18.58% vs 17.36%). Regionally prevalence was more frequent in western (20.63%) and central (20.16%) rural areas. Regarding maternal concerns, in the eastern and southern regions of India, mothers aged 25-34 were less likely to have LBW children than mothers aged 35-49 years. It was found that the risk of LBW was more likely among the children born out of unintended pregnancies in almost all regions except for eastern part. In rural India, women who delivered children at home were more likely to have LBW children in India (AOR = 1.19, CI: 1.12-1.28, p < 0.001) and its central, northern, and southern regions than those who gave birth in institutions. The study indicates that LBW coexists with lower maternal education levels and poor household wealth index across all regions. About 58% and 57% of cumulative effects of independent variables on LBW can be distinguished in urban and rural India, respectively. Conclusions Targeted-specific strategies need to be undertaken as per region and geographical variations. Then only India should be able to decline LBW as proposed by National Health Policy.

Automated summary

The burden and determinants of low birth weight (LBW) were studied in different regions and rural-urban areas of India. The study found that approximately 18.24% of babies in India were born with LBW, with higher prevalence in rural areas compared to urban areas. In the eastern and southern regions, mothers aged 25-34 were less likely to have LBW children than mothers aged 35-49. It was also found that women in rural India who gave birth at home were more likely to have LBW children compared to those who gave birth in institutions. The study emphasizes the need for targeted strategies based on regional and geographical variations to reduce LBW in India, as proposed by the National Health Policy.