Stunting and Its Determinants among Under-five Children in East Khasi Hills District, Meghalaya.

India tops the list with 46.6 million stunted children, as per the National Global Report 2021. Many studies focus on the correlation of stunting in India but the contextual influences on stunting were less explored, particularly in Northeast India. The current study aimed to determine the prevalence of stunting and the contributing factors of stunting among under-five children in the East Khasi Hills (EKH), District of Meghalaya. An explanatory sequential mixed method design was adopted. A cross-sectional study (n = 1200) covering anthropometric data, rates of feeding practices, delivery status, and previous illness among under-five children. These findings were triangulated through the qualitative focused group discussions (FGDs) (n = 12), which were conducted with mothers from the communities to provide deeper insights into the contributing factors of stunting and understanding the region's knowledge, attitude, and practices toward attaining good nutrition for under-five children. The survey was analyzed descriptively, while the FGDs were analyzed thematically. The prevalence of stunting in the rural areas was 59.17%, while in the urban areas was 28.83%. This study critically identified many gaps like the deficiency in nutrition intake, insufficient illness management, and inadequate implementation of Infant and Young Child Feeding (IYCF) practices programs due to geographical constraints and a lack of motivation to avail of Anganwadi Center (AWC) services. There is a need to incorporate sociocultural relevant strategies for the IYCF program, such as the inclusion of culturally acceptable nutrient-rich food in complementary food and encouraging mothers to support new mothers.