Trends, patterns and predictive factors of infant and child mortality in well-performing and underperforming states of India: a secondary analysis using National Family Health Surveys

Abstract

ObjectivesThis paper analyses the patterns and trends in the mortality rates of infants and children under the age of 5 in India (1992–2016) and quantifies the variation in performance between different geographical states through three rounds of nationally representative household surveys.DesignThree rounds of cross-sectional survey data.SettingThe study is conducted at the national level: India and its selected good-performing states, namely Haryana, Kerala, Maharashtra, Punjab and Tamil Nadu, and selected poor-performing states, namely Bihar, Chhattisgarh, Madhya Pradesh and Uttar Pradesh.ParticipantsAdopting a multistage, stratified random sampling, 601 509 households with 699 686 women aged 15–49 years in 2015–2016, 109 041 households with 124 385 women aged 15–49 years in 2005–2006, and 88 562 households with 89 777 ever married women in the age group 13–49 years in 1992–1993 were selected.ResultsThrough the use of maps, this paper clearly shows that the overall trend in infant and child mortality is on a decline in India. Computation of relative change shows that majority of the states have witnessed over 50% reduction in both infant and under-5 mortality rates from National Family Health Survey (NFHS)-I to NFHS-4. However, the improvements are not evenly distributed, and there is huge variation in performance between states over time. Funnel plots show that the most populous states like Uttar Pradesh Bihar and Madhya Pradesh have underperformed consistently across the survey period from 1992 to 2016. Regression analysis comparing high-performing and low-performing states revealed that female infants and women with shorter birth intervals had greater risk of infant deaths in poor-performing states.ConclusionAttempts to reduce infant and child mortality rates in India are heading in the right direction. Even so, there is huge variation in performance between states. This paper recommends a mix of strategies that reduce child and infant mortality among the high-impact states where the biggest improvements can be expected, including the need to address neonatal mortality.

Preceding child survival status and its effect on infant and child mortality in India: An evidence from National Family Health Survey 2015–16

“…Similar to earlier studies, it was found that central India exhibits the highest IMR and child mortality, whereas southern and western regions perform better in the respective scenario [ 5 ]. It was further commented that IMR was higher in north India in comparison to south India.…”

“…Over the previous two decades, India has made significant advances in child survival; nonetheless, it failed to meet the MDG 2015 targets. In India, the U5MR has decreased by 3% each year since 1990, from 114 per 1000 live births in 1990 to 39 in 2016 [ 5 ]. Similarly, IMR decreased from 81 to 34 per 1000 live births between 1990 and 2016 [ 5 ].…”

“…In India, the U5MR has decreased by 3% each year since 1990, from 114 per 1000 live births in 1990 to 39 in 2016 [ 5 ]. Similarly, IMR decreased from 81 to 34 per 1000 live births between 1990 and 2016 [ 5 ]. Children born to mothers who had completed eight years of schooling had a better probability of surviving, but children born to adolescent mothers had a greater risk of dying [ 6 ].…”

Formative research on infant mortality rate in Manipur

“…determine its success or failure in reducing infant and child mortality in the future. 7 The success of Kerala state in reducing IMR has been attributed to its overall development characterised by (a) high female literacy, (b) higher status of women in the society, (c) good accessibility of health services even in rural areas, (d) equitable distribution of wealth resulting from land reforms. This is despite the lack of any industrial or agricultural development in the state.…”

Voting-Boosting: A novel machine learning ensemble for the prediction of Infants' Data

“…Infant Mortality Rate (IMR) is a standard measure for measuring infants' death per 1,000 live births less than one year of age (1) . IMR of India declined from 81/1000 live births in 1990 to 34/1000 in 2016 and there was a total of 1.08 million deaths of under-5 children in 2016 (2) . India contributed 500,000 i.e.…”