Socioeconomic and Regional Disparities in Under-Five Mortality in India Yadav Jeetendra1, Yadav Ashish Kr2,*, Reddy Umenthala Srikanth3, Singh KH Jitenkumar4 1Technical Assistant (Research), National Institute of Medical Statistics (NIMS), ICMR, N. Delhi 2Assistant, Professor, Biostatistics, ESIC Medical College, Kolkata 3Research Officer, N.I.M.S (ICMR, Delhi)) 4Scientist ‘D’, NIMS (ICMR, N. Delhi) *Corresponding Author: Dr. Ashish Kumar Yadav Assistant Professor, ESIC-Post Graduate Institute of Medical Sciences & Research, Joka, Kolkata-700104, Phone: 9804596878
Online published on 3 April, 2018. Abstract Background India has the world's highest total number of under-five deaths. Although in last one and half decades, under-five mortality has declined substantially from 115 deaths per 1000 live births in 1990 to 60 deaths per 1000 live births in 2010, still India continues to be the top contributor of under-five deaths. Under-five mortality varies substantially across regions and socioeconomic groups. The present study attempts to assess the socioeconomic and regional disparities and trace the trends and pattern of Under-Five Mortality in India, over last one and half decade, using National Family Health Survey Data. Methods Data from three rounds of the National Family Health Survey (NFHS-I, II & III) were analyzed to identify the disparities and nature of the association between under-five mortality and selected socioeconomic characteristics, bivariate and multivariate Cox proportional hazard model (both separate and pooled) analysis were performed. Key Findings In India, there has been a decline in overall under-five mortality but still disparities in underfive mortality by mother's age at birth, the composite variable of birth order and birth interval, economic status, sanitation facility and region of residence were evident from analysis. Controlling for a set of socioeconomic and regional factors, the hazard of under-five mortality was less (CHR=0.69 CI=0.68–0.70) (AOR=0.83 CI=0.82–0.85) and (CHR=0.87 CI=0.86–0.88) (AOR=0.89 CI=0.88–0.91) during the period 2005–06 and 1998–1999 respectively as compared to period 1992–1993. Conclusion Socioeconomic and regional disparities were clearly indicated in under-five mortality in India during last one and half decade, (1990–2006). Initiatives to addresses social determinants of health which have impact on under-five mortality, such as mother's age at the time of birth, economic status, level education, birth order and interval along with safe sanitation facility need to be stepped up especially for EAG states. The government of India needs to proceed with integrated approaches for child health, especially in rural India. Top Keywords NFHS, Pooled data, Under-five mortality. Top |