Spatial clustering and risk factors of infant mortality: district-level assessment of high-focus states in India

Gupta, Ashish Kumar; Ladusingh, Laishram; Borkotoky, Kakoli

doi:10.1186/s41118-016-0008-9

Cited by 29 publications

(29 citation statements)

References 32 publications

(22 reference statements)

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“…The similar spatial clustering in childhood malnutrition was observed in a recent study. 34 Earlier studies [34][35][36][37] showed clustering of infant and child mortality and its contextual correlates. In the present paper, bivariate LISA maps highlight a total of 159 hot spots districts mostly from the central and eastern part of India.…”

Section: Discussionmentioning

confidence: 99%

A spatial analysis of childhood stunting and its contextual correlates in India

Bharti

Dhillon

Narzary

2019

Clinical Epidemiology and Global Health

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Introduction: Despite various programmes aiming to improve the nutritional status of children, nearly 38% of children under age five are still stunted in India, and there is huge spatial variation across the states. Objectives: The present study first examines the spatial clustering of childhood stunting and then investigates the contextual determinants including meteorological factors, poverty and crop production affecting childhood stunting. Methods: The percentage of stunted children under 5 years of age is taken from the district factsheets of National Family Health Survey 2015-16 (NFHS-4). Other data are taken from Census of India (2011) and Ministry of Agriculture and Farmers Welfare. To fulfil the set objectives, the spatial analysis including Moran-I index and spatial regressions models are used.Results: The spatial analysis shows a high degree of clustering (Moran's I: 0.65) in childhood stunting in districts of India. Extreme temperature of districts reveals a positive association with childhood stunting as nearly 40% of children from districts with maximum temperature above 40°C were stunting. After controlling for socioeconomic factors, spatial regression reveals that a 1°C increase in average annual temperature would lead to 0.134 increase in the percentage of stunted children. The study reveals a negative effect of district-level percapita crop production, wealth and education levels on the childhood stunting. Conclusion: The paper manifests the gigantic variations and clustering in the childhood malnutrition across districts of India. The study recommends to target the districts in hot spot areas, districts with extreme temperature and with low levels of crop production to fight against malnutrition under the umbrella of sustainable development goals.Poverty is a main cause of malnourishment because it confines the amount of food available to children causing wasting and a lack of micronutrients value leading to stunting and low weight. 6 Similarly, a study 7 exhibited household wealth, and the condition of women was related to both stunting and wasting. Further, overpopulation is a serious problem linked with the competition for food, shelter and medical facilities, and lead to malnutrition amongst children, particularly in the rural areas where access to food and medical facilities were limited. 6 Also, poverty and malnutrition enhance the risk of infants and children to various kinds of infectious diseases, like diarrhoea and pneumonia, and also increases the possibility of death. 8 International Food Policy Research Institute (IFPRI) reported that poverty, water, sanitation and hygiene, education, food systems, climate change, social protection, and agriculture all have the vital effect on nutrition outcomes. 9 Another study conducted by Pathak and Singh (2009) 10 showed that poverty might not solely be the determinant of child malnutrition. Rather, https://doi.

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Section: Discussionmentioning

confidence: 99%

A spatial analysis of childhood stunting and its contextual correlates in India

Bharti

Dhillon

Narzary

2019

Clinical Epidemiology and Global Health

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“…There has been a great deal of information on socioeconomic and geographical disparity in neonatal, infant, and UFM in recent years [ 2 – 12 ]. Only a few studies, however, have examined that disparity at below the Indian state level [ 4 , 13 – 15 ]. Ram and colleagues [ 13 ] applied the state and district mortality-rate pattern, derived from a few nationally representative surveys, to the 2012 UN sex-specific birth and mortality totals; the researchers indirectly calculated that only 37% of 597 districts were on track to achieve Millennium Development Goal (MDG) number 4 of 38 deaths per 1000 live births among the under-fives by 2015, and only around another 37% after 2020.…”

Section: Introductionmentioning

confidence: 99%

“…They also found that more districts lagged behind the respective goal for NMR than for the U5MR. Gupta et al [ 4 ] examined the spatial clustering and risk factors of infant mortality rate (IMR) across nine high focused states of India. The nine high focused states are Assam, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh.…”

Section: Introductionmentioning

confidence: 99%

Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3: An analysis of the National Family Health Survey of India (NFHS), 2015–2016

Bora

Saikia

2018

PLoS ONE

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Background and objectiveIndia contributes the highest global share of deaths among the under-fives. Continuous monitoring of the reduction in the under-five mortality rate (U5MR) at local level is thus essential to set priorities for policy-makers and health professionals. In this study, we aimed to provide an update on district-level disparities in the neonatal mortality rate (NMR) and the U5MR with special reference to Sustainable Development Goal 3 (SDG3) on preventable deaths among new-borns and children under five.Data and methodsWe used recently released population-based cross-sectional data from the National Family Health Survey (NFHS) conducted in 2015–2016. We used the synthetic cohort probability approach to analyze the full birth history information of women aged 15–49 to estimate the NMR and U5MR for the ten years preceding the survey.ResultsBoth the NMR and U5MR vary enormously across Indian districts. With respect to the SDG3 target for 2030 for the NMR and the U5MR, the estimated NMR for India for the period studied is about 2.4 times higher, while the estimated U5MR is about double. At district level, while 9% of the districts have already reached the NMR targeted in SDG3, nearly half (315 districts) are not likely to achieve the 2030 target even if they realize the NMR reductions achieved by their own states between the last two rounds of National Family Health Survey of India. Similarly, less than one-third of the districts (177) of India are unlikely to achieve the SDG3 target on the U5MR by 2030. While the majority of high-risk districts for the NMR and U5MR are located in the poorer states of north-central and eastern India, a few high-risk districts for NMR also fall in the rich and advanced states. About 97% of districts from Chhattisgarh and Uttar Pradesh, for example, are unlikely to meet the SDG3 target for preventable deaths among new-borns and children under age five, irrespective of gender.ConclusionsTo achieve the SDG3 target on preventable deaths by 2030, the majority of Indian districts clearly need to make a giant leap to reduce their NMR and U5MR.

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“…Alcohol trade is also an important source of revenue in India, where non-commercial production of alcohol is the primary livelihood of women from Assam and Sikkim (Chakrabarti et al, 2012). Smoking and drinking alcohol is still a taboo among women in certain parts of the country but chewing tobacco is common among women due to their acceptability in society, ease of availability and inexpensiveness (Gupta et al,2016;Sauvaget et al, 2008). Thankappan & Thresia, (2007) had shown that ban on smoking in the public places of India had resulted in an increment in smokeless tobacco consumption in India.…”

Section: Introductionmentioning

confidence: 99%

Is Mass Media Exposure Associated with Tobacco and Alcohol Consumption Behaviour: Evidence from India

Rashmi¹,

Paul²,

Majumdar³

2020

Preprint

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Tobacco and alcohol consumption are one of the leading lifestyle-related causes of avoidable mortality worldwide. India is the second-largest consumer of tobacco globally after China. The pattern of tobacco smoking, tobacco chewing and alcohol consumption varies across the states and regions of India. Past literature has provided varying evidence regarding the influence of media on the tobacco and alcohol consumption behaviour of Indian people in specific regions and/or specific age brackets. The current study examined the association between media exposure in households and the individual consumption behaviour of tobacco and alcohol in the Indian population while simultaneously accounting for unobserved heterogeneity at the state level. The analysis was performed separately for both rounds of India Human Development Survey (IHDS) cross-sectional datasets. Multivariable standard logit regression models and random-intercept logit regression models were used to fulfil the study objectives. The study showed that exposure to radio and television media in households was associated with a high risk of smoking tobacco and drinking alcohol in both rounds of IHDS. However, exposure to newspaper media in households translated to a lower risk of tobacco and alcohol consumption in both rounds. People aged 20-59 years were highly likely to consume tobacco or alcohol compared to younger individuals in both rounds of data. Additionally, females are more likely to chew tobacco compared to their male counterparts. The study also provides evidence of the presence of a high level of heterogeneity in the risk of smoking tobacco, chewing tobacco and drinking alcohol across the states of India. The findings of the study highlight the need for devising effective policies that curb the role of radio and television mass media as a promotional medium for tobacco and alcohol consumption among the Indian population.

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Spatial clustering and risk factors of infant mortality: district-level assessment of high-focus states in India

Cited by 29 publications

References 32 publications

A spatial analysis of childhood stunting and its contextual correlates in India

A spatial analysis of childhood stunting and its contextual correlates in India

Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3: An analysis of the National Family Health Survey of India (NFHS), 2015–2016

Is Mass Media Exposure Associated with Tobacco and Alcohol Consumption Behaviour: Evidence from India

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