Accounting for Regional Differences in Mother and Child Health : Bangladesh, West Bengal, Bihar, and Jharkhand

Using recent Demographic Health Survey data for Bangladesh and the neighboring Indian states of Bihar, Jharkhand, and West Bengal, this paper reexamines the determinants of child wasting and maternal anemia. The findings bear out the importance of commonly cited factors, such as mother?s education and age, household wealth, and child birth order. However, the findings also highlight significant and large regional differences between Indian states and Bangladeshi provinces. For example, the results for Jharkhand state in India and Barisal province in Bangladesh indicate that controlling for those commonly cited determinants, the poorest, least-educated mothers and their children in Barisal have better health outcomes than the wealthiest, best-educated counterparts in Jharkhand. Mapping analysis of the spatial variations in child wasting and maternal anemia shows clear patterns of clustering over large areas that frequently overlap state/province and national boundaries. Possible sources of these striking differences include spatially differentiated prices and availability of critical nutrients; dietary preferences related to religion and ethnicity; nutrition education; and administration of public health and nutrition policy.