Inadequate Feeding of Infant and Young Children in India: Lack of Nutritional Information or Food Affordability?
N Malhotra, Public health nutrition 16 (10), 1723-1731
Malhotra (2013) finds that nutritional counselling by frontline community health workers predicts WHO-compliant IYCF practices across all wealth quintiles in India, with household wealth not significant for infants aged 6–8 months, positioning child malnutrition as much a health literacy challenge as an affordability problem.
Cite: Malhotra, N. (2013). Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability? Public Health Nutrition, 16(10), 1723–1731. https://doi.org/10.1017/S1368980012004065
This study in Public Health Nutrition (Cambridge, 2013) examines whether inadequate infant and young child feeding (IYCF) practices in India are driven by information constraints or household economic capacity, using the National Family Health Survey (NFHS-3) and logistic regression across 9,241 children aged 6–18 months. Nutritional counselling by frontline community health workers is a strong, consistent predictor of WHO-compliant feeding practices across all wealth quintiles. For infants aged 6–8 months, household wealth is not statistically significant; early feeding behaviour is shaped more by knowledge than income. Yet compliance remains low even among higher-income households, and mass media exposure independently improves outcomes, reinforcing behaviour change communication (BCC) as a scalable intervention. The findings position child malnutrition not only as a resource problem but as a health literacy and behaviour change challenge with direct implications for IYCF program design across LMICs.
Malhotra (2013) finds that nutritional counselling by frontline community health workers predicts WHO-compliant IYCF practices across all wealth quintiles in India, with household wealth not significant for infants aged 6–8 months, positioning child malnutrition as much a health literacy challenge as an affordability problem.
Cite: Malhotra, N. (2013). Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability? Public Health Nutrition, 16(10), 1723–1731. https://doi.org/10.1017/S1368980012004065
The Role of Maternal Diet and Iron-folic Acid Supplements in Influencing Birth Weight: Evidence from India’s National Family Health Survey.
N Malhotra, R.P. Upadhyay, M. Bhilwar, N. Choy and T. Green, Journal of tropical pediatrics 60 (6), 454-460
Aim: To examine the role of maternal diet in determining the low birth weight (LBW) in Indian infants.Methods: Data from the National Family Health Survey (2005–06) were used. Multivariate regression analysis was used to analyze the effect of maternal diet on infant birth weight.
Results: Infants whose mothers consumed milk and curd daily [odds ratio (OR), 1.17; 95% confidence interval (CI), 1.06–1.29]; fruits daily (OR, 1.20; 95% CI, 1.07–1.36) or weekly (OR, 1.13; 95% CI, 1.02–1.24) had higher odds of not having a low birth weight baby. The daily consumption of pulses and beans (OR, 1.18; 95% CI, 1.02–1.36) increased the odds while weekly consumption of fish (OR, 0.79; 95% CI, 0.70–0.89) decreased the odds of not having an LBW infant. Intake of iron-folic acid supplements during pregnancy increased birth weight by 6.46 g per month.
Child Malnutrition, Infant Feeding Practices, and Nutrition Information: Evidence from India.
Book chapter: A Human Right-Based Approach to Development in India, UBC Press (2019) p. 106 - 122
Malhotra (2019) finds that nutritional counselling by frontline community health workers predicts WHO-compliant IYCF practices across all wealth quintiles in India, with household wealth not significant for infants aged 6–8 months, positioning child malnutrition as much a health literacy challenge as an affordability problem.
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Hall, W.A., Malhotra, N., Clark, E., Hodge, K., Griffith, G. and Vedam, Birth, 53: 215-223. (2026)
Hall, Malhotra et al. (2026) find that racialized people (including Indigenous Peoples) experiencing pregnancy loss in Canada are 2.61 times more likely to report that providers did not listen to their concerns raised during pregnancy, and have significantly lower odds of autonomy (AOR 0.31) and respectful care (AOR 0.34). The paper also introduces the CDL psychometric index for measuring compassionate provider communication during pregnancy loss, with miscarriage associated with significantly lower compassionate disclosure scores than late pregnancy loss.
Cite: Hall, W. A., Malhotra, N., Clark, E., Hodge, K., Griffith, G., & Vedam, S. (2026). Inequities in care during pregnancy loss: empirical insights from experiences with Canadian perinatal care. Birth, 53, 215–223. https://doi.org/10.1111/birt.70020
This study in Birth (Wiley, 2026) makes two contributions to Canadian perinatal care research: it introduces the Compassionate Disclosure of Loss (CDL) index, a new validated psychometric instrument measuring the quality of provider communication at the time of pregnancy loss, and documents significant racial inequities in care experiences among people who experienced pregnancy loss in Canada.
Using the RESPCCT (Research Examining Stories of Pregnancy and Childbearing in Canada Today) cross-sectional survey (July 2020–February 2022) among 172 individuals who experienced early or late perinatal loss, the study applies the Mothers' Autonomy in Decision Making (MADM) scale, the Mothers on Respect Index (MORi), the CDL index, and a single item measuring whether providers listened to pregnancy concerns, patient-reported experience measures (PREMs) relevant to CIHI's pan-Canadian health system performance reporting.
Racialized people (including Indigenous Peoples in Canada, Black, and People of Colour) were 2.61 times more likely to report that providers did not listen to their pregnancy-related concerns prior to the loss (AOR 2.61**), and had significantly lower odds of autonomy (AOR 0.31***) and respectful care (AOR 0.34**). These findings speak to Health Canada's work to address anti-Indigenous racism and improve equitable access to care, as well as to PHAC's mandate for inclusive, equity-informed perinatal care. Those experiencing early pregnancy loss reported significantly lower CDL scores than those experiencing late loss — pointing to miscarriage as a neglected gap in Canadian perinatal bereavement care.
Cite: Hall, W. A., Malhotra, N., Clark, E., Hodge, K., Griffith, G., & Vedam, S. (2026). Inequities in care during pregnancy loss: empirical insights from experiences with Canadian perinatal care. Birth, 53, 215–223. https://doi.org/10.1111/birt.70020
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Domestic Violence and Women's Autonomy: Evidence from India.
M Eswaran, N Malhotra, Canadian Journal of Economics/Revue canadienne d'économique 44 (4), 1222-1263
This paper sets out a simple non-cooperative model of resource allocation within the household in developing countries that incorporates domestic violence as an instrument for enhancing bargaining power. We demonstrate that the extent of domestic violence faced by women is not necessarily declining in their reservation utilities, nor necessarily increasing in their spouses’. Using the National Family Health Survey data of India for 1998-99, we isolate the e¤ect of domestic violence on female autonomy, taking into account the possible two-way causality through the choice of appropriate instruments. We provide some evidence for the evolutionary theory of domestic violence, which argues that such violence stems from the jealousy caused by paternity uncertainty in our evolutionary past. The findings have strong policy implications, suggesting that it will take more than an improvement in women's employment options to address the problem of spousal violence.[go to paper]
Why Are There Delays in Seeking Treatment for Childhood Diarrhoea in India?
N Malhotra and RP Upadhyay, Acta Paediatrica 102 (9), e413-e418
In this paper we examine the barriers and the facilitating factors for seeking treatment for childhood diarrhoea, and determine the main causes for delay in seeking treatment. Data from Indian Demographic and Health Survey 2005-06 (NFHS-III) were used. Mothers were asked whether i) their children (<5-years) had suffered from diarrhoea during the 2 weeks preceding the survey, ii) if treatment was sought, and iii) the number of days waited to seek treatment after the diarrhoea had started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the 'delay' in seeking advice/treatment.
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Risky Behaviour and HIV Prevalence Among Zambian Men.
N Malhotra, J Yang, Journal of biosocial science 43 (2), 155
The objective of this paper is to identify demographic, social and behavioural risk factors for HIV infection among men in Zambia. In particular, the role of alcohol, condom use, and the number of sex partners is highlighted as being significant in the prevalence of HIV.
The survey included socio-economic variables and HIV serostatus for consenting men (N = 4,434). The risk for HIV was positively related to wealth status. Men who considered themselves to be at high risk for HIV-positive were most likely to be HIV-positive. Respondents who, along with their sexual partner, were drunk during the last three times they had sexual intercourse, were more likely to be HIV-positive (Adjusted odds ratio (AOR): 1.60; 95% confidence interval (CI): 1.00-2.56). Men with more than two sexual life partners and inconsistent condom use had a higher risk for being HIV-positive (OR: 1.89; 95% CI: 1.45-2.46 and OR: 1.49; 95% CI: 1.10-2.02, respectively). HIV prevention programs in Zambia should focus even more on these behavioural risk factors. [go to paper]
The Hazards of Starting the Cigarette Smoking Habit.
B Boudarbat, N Malhotra, Journal of Economic & Management Perspectives 3 (2), 93.
In order to develop effective policies and programs that reduce the number of smokers a necessary first step is to understand the determinants of starting to smoke. In this paper, we present a split-sample duration model of the decision to start smoking. We use data from the 2002 Canadian tobacco use monitoring survey. The hazard rate of starting smoking peaks sharply at age 15 and quickly declines thereafter. Our parametric estimates provide evidence that gender, education, marital status, and household size are important determinants of smoking habit. We also find that higher cigarette prices have an impact on picking up the habit, but not on the initiation age. Thus, the results highlight the importance of cigarette taxes in influencing the likelihood of smoking. [go to paper]
Weight-Based Disparities In Perinatal Care: Respect, Autonomy, Mistreatment, And BMI In A National Canadian Survey,
N Malhotra, C M Jevitt, K Stoll, W Phillips-Beck, S Vedam, BMC Pregnancy and Childbirth 24 (1), 737 (2024)
Malhotra, Jevitt, et al. (2024) provide the first pan-Canadian quantitative evidence that BMI, Indigenous identity, and racialized identity independently influence mistreatment and reduced autonomy in perinatal care, even after adjusting for each other and for income and education. Specifically, Indigenous Peoples in Canada face 2.26 times higher odds of mistreatment, non-Indigenous racialized childbearing people 1.33 times higher odds, and those with BMI ≥35 an adjusted odds ratio of 1.95. All effects are mutually adjusted, demonstrating that weight stigma, anti-Indigenous racism, and racial discrimination operate as distinct barriers to respectful perinatal care in Canada.
Cite: Malhotra, N., Jevitt, C. M., Stoll, K., Phillips-Beck, W., Vedam, S., & the RESPCCT Study Team. (2024). Weight-based disparities in perinatal care: quantitative findings of respect, autonomy, mistreatment, and body mass index in a national Canadian survey. BMC Pregnancy and Childbirth, 24, 737. https://doi.org/10.1186/s12884-024-06928-8
The RESPCCT study highlights significant disparities in perinatal care experiences related to body mass index (BMI) among Canadian participants. The cross-sectional survey, which included 3,280 respondents with a BMI of ≥18.5, revealed that individuals with higher BMIs (≥35) experienced notably reduced autonomy and increased mistreatment in healthcare settings. Specifically, the study found an unadjusted odds ratio of 1.62 and an adjusted odds ratio of 1.45 for reduced autonomy among those with a BMI ≥35 compared to normal-weight individuals. Furthermore, the likelihood of falling into the lower tercile of respect scores increased with BMI, with odds ratios of 1.34, 1.51, and 2.04 for BMI categories of 25–25.9, 30–34.9, and ≥35, respectively (p < .01). These findings underscore the pervasive nature of weight stigma in perinatal care, indicating that implicit and explicit biases among healthcare providers contribute to the disrespectful treatment of individuals with higher BMIs. Addressing these biases is essential for improving the quality of care provided to this population. [go to text"]