ABSTRACT:
International Institute for Population Sciences, Mumbai, India. Child malnutrition remains a critical public health challenge in India, with Uttar Pradesh—its most populous state—bearing a disproportionate share of the burden. Despite sustained policy efforts, the prevalence of stunting, wasting, and underweight among children under five continues to reflect deep-seated socio-economic and geographical inequities. Using evidence from the National Family Health Survey (NFHS-5, 2019–2021), this study investigates regional disparities in child malnutrition across five National Sample Survey (NSS) regions of Uttar Pradesh: Northern Upper Ganga Plain (NUGP), Southern Ganga Plain (SGP), Central, Eastern, and Southern. The analysis employs descriptive statistics and logistic regression modelling to assess variations in the three key indicators—stunting, wasting, and underweight—while examining the influence of socio economic and environmental determinants. Results reveal substantial spatial heterogeneity in malnutrition outcomes, indicating that nutritional challenges are unevenly distributed across the state. The Southern region, comprising the drought-prone Bundelkhand plateau, exhibits the highest prevalence of wasting and underweight, underscoring the significance of geographic vulnerability and food insecurity. Conversely, stunting is more pronounced in the SGP and Eastern regions, suggesting that social and structural factors play a role despite fertile agricultural conditions. Wealth status, maternal education, caste affiliation, and rural–urban residence emerge as strong predictors of child nutritional outcomes, highlighting persistent inequities in access to resources and services. Notably, after controlling for socio-economic characteristics, the apparent urban advantage diminishes, reflecting growing inequalities within urban environments. The findings underscore the need for regionally tailored policy frameworks prioritizing localized interventions, improved maternal education, targeted poverty alleviation, and strengthened health and sanitation infrastructure. Addressing the multi-dimensional drivers of malnutrition requires coordinated efforts across health, nutrition, water, sanitation, and livelihood sectors. Recognising regional disparities is essential for designing effective strategies to reduce the enduring burden of child malnutrition and advance equitable development in Uttar Pradesh.