https://orcid.org/0000-0001-7809-0278
Population-level nutrition evaluation
Analysis of nationally representative health surveys using multivariate and quasi-experimental methods to assess intervention pathways and maternal and child outcomes.
Research portfolio
Maternal & Child Health, Nutrition and Health Behaviour
Population-level research on maternal nutrition, infant feeding, child malnutrition and stunting, low birth weight, supplementation, infection control and healthcare-seeking behaviour. This research programme combines development economics, public health and quantitative policy evaluation to examine how nutrition interventions work in real-world settings and how their coverage, uptake, equity and effectiveness can be improved.
Population-level nutrition evaluation
Behaviour and programme design
Research in Maternal and Child Nutrition and Health
Nisha Malhotra is an economist whose research in maternal and child health examines child malnutrition and stunting, infant and young child feeding, maternal nutrition, low birth weight, iron–folic acid supplementation, deworming during pregnancy and healthcare-seeking behaviour. Using nationally representative survey data, particularly India’s National Family Health Survey (NFHS), her research evaluates how nutrition information, maternal diet, health interventions and caregiver behaviour shape maternal and child health outcomes.
Across studies of infant feeding, maternal diet, supplementation, infection and childhood illness, Nisha Malhotra’s research identifies the pathways through which public health and nutrition interventions influence behaviour, birth outcomes and child nutrition.
Maternal and child nutrition pathways
Research connecting maternal diet, supplementation, infection, birth weight, infant feeding, treatment seeking, malnutrition and childhood stunting.
Evidence for policy and programme design
Translation of empirical findings into questions of programme coverage, counselling, adherence, behaviour change, implementation quality, equity and real-world effectiveness.
Research evidence and policy pathways
Illuminating Pathways to Child Malnutrition & Stunting
What the linked evidence shows
Our research demonstrates how rigorous population-level evaluation can identify the pathways linking nutrition and health interventions to maternal and child nutritional outcomes. Using nationally representative data from India’s National Family Health Survey, we have examined how maternal diet, supplementation, infection, childhood illness, Infant feeding practices and caregiver behaviour influence birth weight & child malnutrition.
In collaboration with Ravi Prakash Upadhyay, Meenakshi Bhilwar, Nicholas Choy and nutrition scientist Timothy Green , we found that maternal consumption of milk and curd, fruits, pulses and beans was associated with higher odds of a healthy birth weight. Each additional month of iron–folic acid supplementation during pregnancy was associated with an increase of approximately 6.46 grams in infant birth weight.
In related work with Devesh Roy , we used matching methods to evaluate deworming during pregnancy. The study found that receiving deworming medication was associated with an average increase of approximately 66 grams in infant birth weight and a 2.2 percentage-point reduction in the probability of low birth weight.
Improving nutrition, however, is not simply a matter of increasing food intake. Outcomes also depend on nutrient absorption, infection control, maternal nutritional reserves, healthcare access and caregiver knowledge. Intestinal parasites can contribute to anaemia and reduce the benefit of supplementation, while recurrent childhood diarrhoea and delays in treatment can compound nutritional disadvantage.
Our research further shows that poverty alone does not explain inadequate infant feeding. Even among relatively affluent households, complementary foods may be introduced late when caregivers lack appropriate nutrition information.
These findings demonstrate why nutrition programmes should be evaluated not only by what they distribute, but also by coverage, adherence, behavioural response and real-world health outcomes.
Evidence for programme design, funding and evaluation
Indian Nutrition Policy and Our Research
India’s nutrition policies increasingly recognise that malnutrition, anaemia, low birth weight and childhood illness arise through connected biological, behavioural and institutional pathways. Our research uses nationally representative population data to evaluate how nutrition information, maternal diet, supplementation, infection control and healthcare access influence maternal and child outcomes.
Nutrition knowledge
Information improves feeding behaviour independently of wealth.
Diet and supplementation
Dietary quality and sustained IFA use influence birth outcomes.
Infection control
Deworming can strengthen nutrition interventions.
Population evaluation
Coverage, adherence, equity and health effects must be measured.
Policy 01
Integrated Child Development Services
India’s principal platform for supplementary nutrition, early childhood services and nutrition counselling through Anganwadi centres.
What our research finds
Even among households in the upper wealth groups, many parents fail to introduce complementary foods at the recommended age. Dr. Malhotra's research shows that knowledge of infant feeding practices are associated with child malnutrition and wealth alone doesn't explain delayed introduction of complementary solid food.
Population-level evidence
Among higher-income households, 79% of parents who received nutrition advice introduced complementary foods, compared with 60% of parents who did not receive advice from healthcare and Anganwadi workers.
Our contribution to policy
This evidence supports evaluating ICDS not only as a food-distribution programme, but also as a platform for counselling on infant-feeding, nutrition education and behaviour change.
Programme implications and evaluation priorities
Implications for programme design
Strengthening the counselling role of Anganwadi workers can improve the timing of complementary feeding, dietary diversity and adherence to infant and young-child feeding recommendations.
Evaluation priorities
Relevant indicators include contact with Anganwadi workers, receipt of feeding advice, timely introduction of complementary foods, dietary diversity, programme reach across socioeconomic groups and changes in child growth outcomes.
Policy 02
POSHAN Abhiyaan
A national mission combining programme convergence, technology, community participation and social and behaviour-change communication.
What our research finds
Inadequate feeding persists even among relatively affluent families, showing that rising income and food availability alone may not translate into improved infant-feeding practices. Malhotra (2016) provides empirical support for POSHAN Abhiyaan’s emphasis on behavioural change.
Population-level evidence
Contact with health professionals, discussion of nutrition and exposure to reliable information are associated with improved feeding practices across infant age groups.
Our contribution to policy
These findings support investment in frontline counselling, community-based events, media outreach and social and behaviour-change communication alongside food and supplement delivery.
Programme implications and evaluation priorities
Implications for programme design
Behaviour-change initiatives should be integrated with nutrition services rather than treated as peripheral communication activities. Information must be timely, practical and linked to specific feeding decisions.
Evaluation priorities
Evaluation should measure caregiver knowledge, timely complementary feeding, dietary diversity, contact with frontline workers, exposure to campaign activities, service uptake and differences in reach across social and economic groups.
Policy 03
Anemia Mukt Bharat
A life-course strategy addressing anaemia through iron–folic acid supplementation, testing, treatment, counselling and deworming.
What our research finds
Our analysis shows that maternal nutrition is multidimensional. Consumption of milk and curd, fruits, pulses and beans during pregnancy was associated with higher odds of a healthy birth weight, while the duration of iron–folic acid supplementation also mattered.
Population-level evidence
Each additional month of iron–folic acid supplementation during pregnancy was associated with an increase of approximately 6.46 grams in infant birth weight.
Our contribution to policy
Our work shows why programme assessment must move beyond counting tablets distributed and examine adherence, duration, dietary quality, maternal health and birth outcomes.
Programme implications and evaluation priorities
Implications for programme design
Supplementation should be delivered alongside counselling on dietary diversity, management of side effects, adherence support and maternal nutrition before and during pregnancy.
Evaluation priorities
Monitoring should distinguish supplements received from supplements consumed and assess duration, adherence, maternal anaemia, dietary quality, programme discontinuation and infant birth outcomes.
Policy 04
Deworming and Infection Control
Addressing intestinal parasites that contribute to anaemia, malnutrition, impaired nutrient absorption and adverse birth outcomes.
What our research finds
Malhotra and Roy's research positions deworming within a wider nutrition pathway. Parasitic infections can contribute to blood loss and iron-deficiency anaemia, reducing the benefits of dietary improvements and iron supplementation.
Population-level evidence
Deworming during pregnancy was associated with an average increase of approximately 66 grams in infant birth weight and a 2.2 percentage-point reduction in the probability of low birth weight.
Our contribution to policy
These findings demonstrate why infection control should be evaluated as a complementary nutrition intervention rather than as a separate public-health activity.
Programme implications and evaluation priorities
Implications for programme design
Deworming should be coordinated with iron–folic acid supplementation, antenatal care, sanitation and water-quality interventions in settings where helminth infections are endemic.
Evaluation priorities
Relevant outcomes include programme coverage, infection burden, maternal anaemia, adherence, birth weight, water and sanitation conditions and the distribution of benefits among high-risk groups.
Publications
Selected publications and research outputs
Maternal and Child Nutrition, Care-Seeking and Health Behaviour
These publications use population-level survey data and applied econometric methods to study maternal nutrition, infant feeding, birthweight, infection control, childhood illness, HIV risk and smoking initiation. The summaries highlight the empirical findings and their relevance for policy, programme design and evaluation.
Research cluster A · Five outputs
Child Malnutrition, Maternal Nutrition and Caregiver Behaviour
Research on nutrition information, infant feeding, maternal diet, iron–folic acid supplementation, deworming, birthweight and treatment-seeking for childhood diarrhoea in India.
Journal article
2013
Key contribution
Inadequate Feeding of Infant and Young Children in India: Lack of Nutritional Information or Food Affordability?
Malhotra, N. (2013). Public Health Nutrition, 16(10), 1723–1731. DOI: 10.1017/S1368980012004065
This study examines why recommended infant and young-child feeding practices remain inadequate even among households that are comparatively well resourced. Using India’s National Family Health Survey, it distinguishes the role of household wealth from the role of nutrition information and contact with health professionals.
Wealth had only a limited relationship with appropriate feeding. For children aged 6–8 months, household wealth was not a significant predictor of recommended feeding practices. Nutritional advice from health professionals, including Anganwadi workers, was strongly associated with better feeding practices across infant age groups.
The results support policies that combine food and income interventions with practical nutrition counselling, caregiver education and reliable public-health information.
Book chapter
2019
Child Malnutrition, Infant Feeding Practices, and Nutrition Information: Evidence from India
Malhotra, N. (2019). In A Human Rights-Based Approach to Development in India. UBC Press, pp. 106–122.
This chapter extends the infant-feeding analysis by locating nutrition information within the broader problem of childhood malnutrition and stunting in India. It reviews the health and developmental consequences of inadequate early-childhood nutrition and examines feeding patterns using NFHS data.
The chapter argues that poverty is an important but incomplete explanation. Delayed complementary feeding and limited dietary diversity are also found among relatively affluent households, indicating that cultural practices and information constraints affect behaviour independently of household resources.
The analysis supports integrating nutrition education into primary healthcare, community-based services and programmes directed at parents and caregivers.
Show chapter and policy summary
The chapter surveys the health consequences of early-childhood malnutrition and analyzes infant-feeding practices using NFHS-3 data.
It emphasizes that delayed complementary feeding occurs across income groups and that nutrition information, social practices and knowledge of recommended feeding guidelines should be treated as central elements of child-nutrition policy.
Journal article
2014
The Role of Maternal Diet and Iron-Folic Acid Supplements in Influencing Birth Weight: Evidence from India’s National Family Health Survey
Malhotra, N., Upadhyay, R. P., Bhilwar, M., Choy, N., & Green, T. (2014). Journal of Tropical Pediatrics, 60(6), 454–460. DOI: 10.1093/tropej/fmu051
This study examines the association between maternal diet, iron–folic acid supplementation and infant birthweight using India’s National Family Health Survey.
Maternal consumption of milk and curd, fruits, pulses and beans was associated with higher odds of a healthy birthweight. Duration of iron–folic acid supplementation also mattered: each additional month of supplementation was associated with an estimated 6.46-gram increase in birthweight.
The findings support antenatal nutrition strategies that combine sustained supplementation with counselling on dietary quality and diversity.
Working paper / preprint
2018
Deworming During Pregnancy and Birth Outcomes
Malhotra, N., & Roy, D. (2018). APDR Working Paper No. 18-12.
This working paper evaluates whether deworming during pregnancy is associated with improved birth outcomes in India. It places deworming within a broader pathway connecting parasitic infection, maternal anaemia, nutrient absorption and infant birthweight.
Using a national sample of mothers and infants and matching methods, deworming during pregnancy was associated with an average increase of approximately 66 grams in infant birthweight and a 2.2 percentage-point reduction in the probability of low birthweight.
The findings support evaluating deworming as a complementary maternal-nutrition intervention, particularly in settings where helminth infections are endemic.
Show methods and programme implications
Data and methods: The analysis used National Family Health Survey data for 17,117 mothers and infants. Matching methods were used to compare outcomes after accounting for socioeconomic characteristics, water-source quality and household water treatment.
Programme implication: Deworming may complement iron–folic acid supplementation, antenatal care, water, sanitation and infection-control strategies in settings with a high burden of parasitic infection.
Journal article
2013
Why Are There Delays in Seeking Treatment for Childhood Diarrhoea in India?
Malhotra, N., & Upadhyay, R. P. (2013). Acta Paediatrica, 102(9), e413–e418. DOI: 10.1111/apa.12304
This study examines barriers to seeking timely treatment for childhood diarrhoea in India. Delayed care can prolong illness, worsen nutrient loss and contribute to recurrent infection and malnutrition.
Maternal education, household wealth, possession of a health card and physical access to healthcare were associated with treatment-seeking. The analysis also identified a significant gender difference: male children had lower odds of delayed treatment than female children.
The results support stronger public-health infrastructure, caregiver education, oral-rehydration knowledge and measures to reduce gender disparities in care.
Show methods and findings
Sample: Among 41,287 children in NFHS-III, 3,890 were reported to have experienced diarrhoea during the preceding two weeks.
Results: Higher maternal education, greater household wealth and possession of a maternal health card increased the odds of seeking treatment. Distance to a health facility increased the odds of delay, and boys had lower odds of delayed treatment than girls.
Policy relevance: Improved access should be accompanied by caregiver education on timely care and oral rehydration, with explicit attention to gender inequities.
Research cluster B · Two studies
Health-Risk Behaviour
Population-level research on behavioural risk factors and public-health outcomes in Zambia and Canada.
Journal article
2011
Risky Behaviour and HIV Prevalence Among Zambian Men
Malhotra, N., & Yang, J. (2011). Journal of Biosocial Science, 43(2), 155–165. DOI: 10.1017/S0021932010000647
This study identifies demographic, socioeconomic and behavioural factors associated with HIV prevalence among men in Zambia using survey data that include HIV serostatus.
HIV prevalence was associated with alcohol-related sexual risk, multiple lifetime sexual partners and inconsistent condom use. Higher household wealth was also positively associated with HIV prevalence, illustrating that vulnerability did not follow a simple poverty gradient.
The findings support prevention programmes that address alcohol-related risk, consistent condom use and sexual-network behaviour rather than relying only on broad demographic targeting.
Show study findings
The study used socioeconomic, behavioural and HIV-serostatus data for 4,434 consenting men.
Men reporting alcohol intoxication during recent sexual activity, more than two lifetime sexual partners, and inconsistent condom use had higher odds of being HIV-positive.
The results indicate that HIV-prevention programmes should include behavioural interventions addressing alcohol use, condom use and sexual partnerships.
Journal article
2006
The Hazards of Starting the Cigarette Smoking Habit
Boudarbat, B., & Malhotra, N. (2006). Journal of Economic & Management Perspectives, 3(2), 93.
This study uses a split-sample duration model to examine the timing and determinants of cigarette-smoking initiation in Canada.
The hazard of initiating smoking peaked sharply around age 15 and declined thereafter. Gender, education, marital status and household size were associated with initiation. Higher cigarette prices reduced the overall probability of beginning to smoke, although they did not significantly alter the age of initiation.
The findings support cigarette taxation as a population-level deterrent while also pointing to adolescence as the critical period for targeted prevention.
Show methods and policy implications
The analysis used the 2002 Canadian Tobacco Use Monitoring Survey and a split-sample duration model to estimate the timing and determinants of smoking initiation.
The findings identify adolescence as the central prevention window and support cigarette taxes as a deterrent to beginning the habit, alongside targeted youth-prevention strategies.
Research profile and scholarly record
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A complete list of publications can be accessed through the scholarly profiles linked here, including ORCID, Google Scholar, Scopus, Web of Science and OpenAlex.