Decades of caste discrimination have contributed to India’s higher rates of child disadvantage than sub-Saharan Africa, new research shows.
The two regions together are home to 44% of the world’s population under the age of five, but are responsible for around 70% of the world’s stunted children – a key indicator of malnutrition.
But while both have made significant progress in recent years, India’s rate is 35.7%, while the average in the 49 sub-Saharan countries is 33.6%.
A child is considered stunted if he is not the expected height for his age – a clear sign of critical nutritional deficiencies.
However, research by Ashwini Deshpande (Ashoka University) and Rajesh Ramachandran (Monash University, Malaysia) shows that focusing only on the height difference – or why Indian children are shorter than children in Sub-Saharan Africa – misses an important factor: the crucial role of social identity, especially caste, in child malnutrition in India.
The first thousand days of a child’s life, also called the ‘golden period’, are crucial: by the age of two, 80% of the brain is developing, laying the foundation for lifelong potential. In these early years, access to health care, good nutrition, early learning, and a safe environment profoundly shape a child’s future.
India and sub-Saharan Africa, both with fast-growing middle classes, young populations and significant labor pools, share long-standing comparisons. In 2021, the World Bank reported: “Sub-Saharan Africa and South Asia [including India] make up more than 85% of the world’s poor,” underscoring similar poverty and development challenges.
Some of the highest stunting rates in the world are in war-torn countries in Sub-Saharan Africa, such as DR Congo [Getty Images]
Using official data, the authors looked at the latest estimates of the growth gap between India and a sample of 19 countries in Sub-Saharan Africa.
Official data shows that more than 35% of India’s 137 million children under the age of five are stunted, while more than a third are also underweight. Globally, 22% of children under the age of five have stunted growth.
They then examined six broad socially disadvantaged groups in India. They include adivasis (tribes living in remote areas) and Dalits (formerly known as untouchables), who alone make up more than a third of the population under the age of five.
The economists found that the percentage of children from higher-ranking, non-stigmatized caste groups in India was 27% – significantly lower than the percentage south of the Sahara.
They also found that children from higher caste groups in India are about 20% less likely to be stunted compared to children from marginalized groups, who occupy the lowest levels of the caste hierarchy.
This conclusion remains significant even after taking into account factors such as birth order, sanitation, maternal height, number of siblings, education, anemia, and the socioeconomic status of the household.
This difference is the result of seventy years of affirmative action, but India’s caste system – a fourfold hierarchy of the Hindu religion – remains deeply entrenched.
“This should come as no surprise, as children from affluent groups in India have access to more calories and face a better disease environment,” the authors say.
Women queue outside a food ration shop in India. Maternal health is critical to reducing child stunting [Getty Images]
The reasons behind the high stunting rate among Indian children have sparked a complex debate over the years.
Some economists have argued that the differences are genetic: that Indian children are genetically predisposed to lower heights.
Others believe that improved nutrition over generations has historically closed height gaps that were thought to be genetic.
Some studies have found that girls do worse than boys, while others do the opposite, using different global benchmarks.
It is fair to say that stunting has decreased in all social groups; a separate 2022 study found that improvements in health and nutrition interventions, household living conditions and maternal factors led to a reduction in stunting in four Indian states. (According to a 1992-1993 federal survey of family health, more than half of Indian children under the age of five were stunted.)
Children from marginalized groups such as adivasis are more likely to be malnourished.
In Africa, the stunting rate has also fallen since 2010, although the absolute number has increased.
Children from marginalized groups such as adivasis (above) are more likely to be malnourished [Getty Images]
But what is clear is that children from poor families, with less educated mothers, or from marginalized groups, are particularly vulnerable to stunting in India.
“The debate over the height difference between Indian and Sub-Saharan African children has led to the role of social identity, and especially caste status, being overlooked,” the authors say.
“This is a crucial dimension for understanding the burden of child nutrition in India.”
The analysis uses data from demographic and health surveys. For India it contains the most recent data from 2019-2021, and for Sub-Saharan Africa it contains data from 19 countries with surveys from 2015 onwards. The dataset includes anthropometric – measurements related to the physical dimensions and composition of the human body – outcomes for 195,024 children under five in India and 202,557 children under five in Sub-Saharan Africa.
