Journal Article

Gender differentials in feeding practices, health care utilization and nutritional status of children in Northern India

Purpose
The purpose of this paper is to determine the gender differentials in childhood feeding practices, health care utilization and nutritional status of children by birth order and sex composition of previous living children in Northern India.

Design/methodology/approach
In this paper, data were drawn from India’s 2006 National Family Health Survey. A variety of different analytic methods were used to look for gender differentials in childhood feeding practices, health care utilization and nutritional status of children. Bi-variate analysis was applied to examine the raw values of gender differentials in childhood feeding, health care and nutritional status of children. Besides, gender differentials at the different birth order and sex composition of previous living children have been measured through multivariate logistic regression analysis.

Findings
The raw values of gender differentials in childhood feeding, health care and nutritional status of children, regardless of child’s birth order, mother’s number of living sons and other characteristics of the child or mother, shows that the proportion of children who received any liquid, proportion of children receiving solid/semi-solid food and the proportion of fully immunized children vary by their gender significantly. The results of standardized gender differentials by birth order and sex composition of previous living children in the selected indicators of childhood feeding, immunization and health care and nutritional status of children based on multivariate binary logistic regression show that among children of birth order 3+ (3 and higher), male children were less likely to receive solid/semi-solid foods during 24 hours prior to the survey in families with no living son, but two times were more likely to receive any solid/semi-solid food than female children in families with 1+ living sons (p<0.0001). Male children aged 12–23 months born to mothers with no living son were more likely to be fully immunized than female children, while male children born to mothers with 1+ living sons were less likely to be fully immunized than female children (p<0.05) at birth order 3+. However, the analysis showed no significant gender differentials in the nutritional status of children.

Research limitations/implications
The authors observed a strong association between the extents of gender differentials and birth order of the index child and the sex composition of older living siblings. Strong evidence of sex bias against female children was found in families with no living sons and particularly at higher birth orders 2 and 3+ (3 and higher). Overall, the study demonstrates the need to focus on predominance of intra-household differential rather than inter-household differential.

Originality/value
This paper brings out the gender differentials in childhood feeding practices, health care utilization and nutritional status of children by birth order and sex composition of previous living children in Northern India.