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New Delhi: Children born to teenage mothers are more likely to be undernourished than those born to adult mothers, according to report published in the journal Lancet Child and Adolescent Health on Friday.

The study titled--Social, biological and programmatic factors link adolescent pregnancy to early childhood under nutrition: a path analysis of India’s 2016 National Family and Health Survey (NHFS-4)--has been done by researchers at the International Food Policy Research Institute (IFPRI).

The researchers analysed data from 60,097 mother-child pairs and examined the extent to which teenage pregnancy is associated with under nourishment in children. Further, they explored potential social, biological, and programmatic factors linking early pregnancy to undernourished children. The study found that stunting and underweight prevalence were 10 percentage points higher in children born to adolescent mothers than in children born to adult mothers.

Compared with adult mothers, teenage mothers were shorter, more likely to be underweight and anaemic, less likely to access health services and had poorer complementary feeding practices. They also had lower education, less bargaining power and lived in poorer households with poorer sanitation, the study found.

India is home to more stunted children than any other country and is one of the ten countries with the largest burden of teenage pregnancy. Although marriage before the age of 18 is illegal in India, the 2016 National Family and Health Survey-4 revealed that 27% of girl children were married before their 18th birthday and further, 31% of married Indian women gave birth by the age of 18.

“Reducing adolescent pregnancy in India can hasten our progress towards achieving the United Nations’ Sustainable Development Goals, particularly those related to poverty, health, nutrition, general wellbeing, equity, and education," said Phuong Hong Nguyen, IFPRI Research Fellow and study co-author.

“The strongest links between adolescent pregnancy and child stunting were through the mother’s education, her socio-economic status, and her weight," said Samuel Scott co author of the study.

This despite the fact that the Indian government has legal instruments in place to prevent early marriage. Central and state governments have also piloted different cash transfers conditional on education, with complementary programming meant to encourage investment in girls’ human capital. In addition, there are several ongoing adolescent health programs under different ministries in India.

Also, the problem of early marriage in India is not geographically uniform. High variability between states and districts suggests that sub national policies and programs that address local reasons for early marriage and early childbearing are still needed. These actions should account for differences in cultural practices and other context-specific conditions affecting early marriage and early childbearing.

The researchers have argued that policies and programs to delay marriage can potentially help break the intergenerational cycle of under-nutrition through many routes. “Unfortunately, in India, early marriage and subsequent pregnancy is often not a deliberate choice, but rather the result of an absence of choices, and of circumstances beyond a girl’s control," said Purnima Menon, IFPRI Senior Research Fellow.

A review of interventions to prevent child marriage in low and middle-income countries shows that interventions including unconditional cash transfers, cash transfers conditional on school enrolment or attendance, school vouchers, life-skills curriculum and livelihood training had a positive impact on raising the age of marriage in girls, the report has highlighted.

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