Nutritional Challenges Among Under-five Children of Migrant Construction Workers in Ahmedabad, Gujarat: A Cross-Sectional Convergent Mixed-Methods Study

Abstract

Introduction:
Migrant construction workers’ children often live in temporary settlements with limited access to nutrition and health services, increasing their vulnerability to undernutrition. Evidence on their nutritional status in rapidly urbanizing Gujarat remains limited.

Objectives:
To assess the nutritional status of under-five migrant children, analyze feeding practices, examine socio-demographic determinants and evaluate access to nutrition and health services.

Methods:
A cross-sectional mixed-methods study was conducted between August to November 2025 among 175 under-five children residing at construction sites across seven zones of an urban district in Gujarat. Data were collected through caregiver interviews, anthropometric assessments and qualitative inquiry. Quantitative analysis included mean, SD, chi-square tests and logistic regression; qualitative data underwent thematic analysis.

Results:
Among 175 under-five children of migrant construction workers, mean age was 29.8±15.4 months. Undernutrition was common, with 39.4% stunted, 36.0% underweight, 20.0% wasted and 4.6% having severe acute malnutrition. Exclusive breastfeeding for six months was reported in 38.3% children, while age-appropriate meal frequency was observed in 41.1%. None of the children received ICDS services and only 42.3% had adequate access to healthcare services. Stunting was independently associated with low household income (AOR 2.31, 95% CI 1.29–4.13), maternal illiteracy (1.87, 1.04–3.36), limited healthcare access (2.42, 1.31–4.25), and residence <1 year (1.74, 1.02–3.12). Qualitative findings revealed knowledge gaps explaining suboptimal young child feeding.

Conclusions:
Undernutrition among migrant children is high and influenced by poverty, maternal illiteracy, inadequate services and mobility. Strengthening outreach, improving scheme portability and targeted support for migrant families are urgently needed.