Date of Award

January 2025

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Debbie Humphries

Second Advisor

Ruchit Nagar

Abstract

Background: The syndemic of severe acute malnutrition (SAM) and malaria in under-five children in Rajasthan presents a critical public health challenge. Current SAM and malaria programs are implemented as siloed interventions despite the potential benefits of integrated approaches. A better understanding of the interactions between these factors is important to strengthen the delivery of integrated services.

Objective: This study investigates the relationship between under-five SAM and malaria infections at the block level in Rajasthan to inform targeted, integrated interventions. By running regression analysis, we will identify associations between these co-occurring health threats to guide state-level policy integration. To the best of our knowledge, this is the first study to analyze SAM and malaria data for under-five children spanning 4 years (2017-2020) at the block level for the state of Rajasthan using a repeated cross-sectional design. We hypothesize that blocks with higher under-five SAM cases are more likely to experience higher malaria prevalence.

Methods: Data were retrieved from the Health Management Information System (HMIS) government portal and are used to examine block-level associations between under-five block level SAM cases and under-five block-level malaria cases.

Results: Negative binomial regression analysis revealed a positive and statistically significant association between number of under-five severe acute malnutrition (SAM) cases and malaria case counts at the block level in Rajasthan (β = 0.058, p < 0.001). After adjusting for sociodemographic and temporal variables, each additional SAM case was associated with an approximately 5.8% increase in malaria cases in the under-five population at the block level . However, none of the sociodemographic variables were statistically significant predictors of under-five malaria case counts.Conclusion: Under-five SAM and malaria should be addressed in tandem, especially in high burden blocks in Rajasthan. Given the substantial sociodemographic variability across blocks, nutrition and malaria interventions should be tailored to hyperlocal needs to optimize resource allocation.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 12/16/2025

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