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Childhood stunting remains a public health concern in India. In Karnataka, the districts vary substantially in stunting prevalence. Using the NFHS-4 and AidData GEO datasets, we tested the hypothesis that 'wet' and 'dry' districts in Karnataka show different contributions to stunting. We found that for 30 environmental and health factors, Bengaluru appears to be distinct from the other districts. Using a mixed linear model approach, we found that for the entire state, and in both wet and dry districts, preceding birth interval, altitude-adjusted haemoglobin level and child age showed significant correlations with height for age (HFA). The wet districts showed an additional association between maternal age and child HFA. However, interaction effects also differed among the three conditions. Our results suggest that subtle variations should not be ignored when considering factors impacting child health outcomes. [ABSTRACT FROM AUTHOR]

Childhood stunting remains a prominent metric in the health and development of modern India. In Karnataka, India, districts vary substantially in stunting prevalence. Here we take a close look at the nature of childhood stunting in the state: its epidemiology, genetics, biology, nutritional basis, environmental contribution, policy and field-based understanding. We explore how these factors interact with one another, and suggest ways to target modifiable risk factors for stunting (e.g. nutrition, exposure to infectious diseases, sanitation), which may influence the impact of non-modifiable risk factors (e.g. congenital factors, climate). We suggest that programmes designed to reduce stunting prevalence should accommodate these complex interactions, which could translate to more substantial impact on child health outcomes. [ABSTRACT FROM AUTHOR]