Influence of Maternal and Child Health Practices on Nutritional Status of Under-Five Children in Urban Slums of Odisha, India

Abstract

Introduction: Maternal and child health (MCH) practices are critical determinants of child growth and nutritional outcomes, particularly in urban slum settings where socioeconomic and environmental vulnerabilities persist. Despite improved service coverage in India, undernutrition among under-five children remains a major public health concern.

Objectives: This study aimed to assess maternal and child health practices and examine their association with the nutritional status of children under five years of age in urban slums of Sambalpur District, Odisha.

Methods: A community-based cross-sectional analytical study was conducted among 550 children aged 6 months to 5 years during 2022–2023. Data on sociodemographic characteristics, maternal and child health practices, breastfeeding, and complementary feeding were collected using a pre-tested structured questionnaire. Anthropometric measurements were taken to assess wasting, stunting, and underweight. Statistical analysis was performed using SPSS version 23. Associations were examined using Chi-square tests, and multivariable logistic regression analysis was applied to identify predictors of malnutrition, with statistical significance set at p < 0.05.

Results: Most children were first or second born, fully immunized, and delivered in health institutions. Colostrum feeding was widely practiced; however, delayed initiation of breastfeeding, early discontinuation, poor feeding hygiene, and inappropriate complementary feeding were common. Multivariable analysis revealed that home delivery (AOR = 5.17) and absence of colostrum feeding (AOR = 2.87) were significantly associated with stunting. Early initiation of breastfeeding (<2 hours) showed a protective effect against wasting, stunting, and underweight. Other maternal and child health practices showed limited associations, indicating the multifactorial nature of childhood malnutrition.

Conclusions: Although coverage of maternal and child health services was high, suboptimal infant and young child feeding practices persist and contribute to undernutrition. Strengthening behavior change communication, promoting early breastfeeding initiation, appropriate complementary feeding, and hygienic practices are essential to improve child nutritional outcomes in urban slum populations.