Patterns and determinants of child mortality in India: a multistate analysis using National Family Health Survey  data

Sanjay Karande; Ramkrishna Lahu Shinde

doi:10.18203/2349-3291.ijcp20262418

Authors

Sanjay Karande Department of Statistics, Sathaye College (Autonomous), Mumbai, Maharashtra, India
Ramkrishna Lahu Shinde Department of Statistics, School of Mathematical Sciences, Kavayitri Bahinabai Chaudhari, North Maharashtra University, Jalgaon, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20262418

Keywords:

Child mortality, Malnutrition, Social determinants of health, Caste, National Family Health Survey, India

Abstract

Background: This paper, utilizing data from several rounds of the National Family Health Survey, investigated long-term differentials in child mortality rates across caste groups and seeked to identify the principal determinants of child survival.

Methods: Trends in child mortality rates were analyzed by using all five rounds of NFHS. Survival analysis and regression analysis were performed by using NFHS-5 (2019-2021). The study included children aged 1-59 months born in the five years preceding the survey, excluding infant deaths. Kaplan-Meier survival analysis, log-rank tests, and binary logistic regression models were used, taking into account the survey design. State-level analysis was performed for Uttar Pradesh, Madhya Pradesh, and Maharashtra.

Results: At the national level, the rate of child mortality was highest among Scheduled Tribes (9.03 per 1,000), followed by Scheduled Castes (8.58 per 1,000), compared with non-SC/ST children (6.04 per 1,000). The survival analysis revealed significant caste differentials in child survival (χ²=28.47, p<0.001), with the gap increasing at older ages of childhood. In unadjusted regression models, Scheduled Castes (OR=1.38; 95% CI: 1.16-1.65) and Scheduled Tribes (OR=1.56; 95% CI: 1.32-1.85) had significantly higher odds of child mortality. These associations were reduced and rendered non-significant after adjusting for proximate determinants, indicating mediation by maternal and health-related variables. Maternal education had a strong protective effect, with higher education being associated with significantly lower odds of child mortality (OR=0.27).

Conclusions: Although there has been a steady decline in child mortality rates across NFHS cycles, caste and geographic inequities in India.

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