age, which reflects children‘s development relative to a reference population of wellnourished children (WHO 2006).<sup>5</sup> Because children‘s weight at birth influences their health and prospects for survival (Rosenzweig and Shultz 1982), a key variable for this study is the data on children‘s weight at birth in the survey. The NFHS collects information on weight at birth in addition to weight at the time of the survey and asks mothers to categorize the weight of their children at birth as large, average, or small.<sup>6</sup> The sample of children with weight measured at birth is much smaller than the sample of children whose weight was assessed by their mother (table A1 in the appendix). The study relies mainly on these subjective assessments as a proxy for health endowments at birth. The weight of about 20–25 percent of children was lower than average according to their mothers‘ assessments (see table A1), a figure not out of keeping with the rate of low birth weight children in India.

The data show that average height-for-age has risen over time for both boys and girls, with z-scores rising from –1.91 in 1992 to –1.55 in 2005 for boys and from –1.86 to –1.53 for girls. Correspondingly, stunting declined from 72 percent of boys and 70 percent of girls in 1995 to 65 percent for both sexes by 2005. Despite these improvements, malnutrition remains prevalent in India.

Deaths around the time of birth (neonatal) are high in all rounds of the NFHS (table 1). Boys accounted for about 56 percent of all deaths in the immediate postnatal period. However, beyond age 6 months, the share of deaths is higher for girls than for boys. A plot of the cumulative mortality hazard by gender for the three rounds of the NFHS again shows that more than half the deaths in children under age 36 months occur in the first month after birth, with little change over the years. It also shows a higher mortality risk for boys than for girls in the early months of life (figure 1), followed by a reversal in later months. This switch in mortality patterns results in almost identical total mortality rates for boys and girls ages 0–36 months.

> 5 A report by Nutrition Foundation of India concluded that the World Health Organization (WHO) standard was generally applicable to Indian children (IIPS 2000). The nutritional status of children calculated in this way is compared with the nutritional status of an international reference population recommended by the WHO (Dibley and others 1987). The use of this reference group is based on the empirical finding that wellnourished children in all population groups for which data exist follow similar growth patterns (Martorell and Habicht 1986). Across rounds of the NFHS, about 10 percent of eligible children were not measured, either because the children were not at home or because their mothers refused to allow the measurements (Lokshin, Das Gupta, and Ivaschenko 2005).

> 6 There is a good correspondence between the measured weight and the weight at birth assessed by the mothers. For example, in 1992, only about 3 percent of children who were assessed as large at birth had measured weight in the lowest quintile of the weight distribution. Seidman and others (1987) show that about 75 percent of self-reported birth weights were accurate within 100 grams. A study by Adegboyea and Heitmannb (2008) that uses a weight categorization similar to NFHS concludes that maternal assessment of a child‘s weight at birth ―seems to be sufficiently accurate for clinical and epidemiological use.‖

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