Journal Article

Under-Five Mortality in High Focus States in India: A District Level Geospatial Analysis

Singh, Prashant Kumar, Rai, Rajesh Kumar, Kumar, Chandan

2012

Overview

This paper examines if, when controlling for biophysical and geographical variables (including rainfall, productivity of agricultural lands, topography/temperature, and market access through road networks), socioeconomic and health care indicators help to explain variations in the under-five mortality rate across districts from nine high focus states in India. The literature on this subject is inconclusive because the survey data, upon which most studies of child mortality rely, rarely include variables that measure these factors. This paper introduces these variables into an analysis of 284 districts from nine high focus states in India. Information on the mortality indicator was accessed from the recently conducted Annual Health Survey of 2011 and other socioeconomic and geographic variables from Census 2011, District Level Household and Facility Survey (2007-08), Department of Economics and Statistics Divisions of the concerned states. Displaying high spatial dependence (spatial autocorrelation) in the mortality indicator (outcome variable) and its possible predictors used in the analysis, the paper uses the Spatial-Error Model in an effort to negate or reduce the spatial dependence in model parameters. The results evince that the coverage gap index (a mixed indicator of district wise coverage of reproductive and child health services), female literacy, urbanization, economic status, the number of newborn care provided in Primary Health Centers in the district transpired as significant correlates of under-five mortality in the nine high focus states in India. The study identifies three clusters with high under-five mortality rate including 30 districts, and advocates urgent attention. Even after controlling the possible biophysical and geographical variables, the study reveals that the health program initiatives have a major role to play in reducing under-five mortality rate in the high focus states in India.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Access roads / Agricultural economics / Agricultural land / Analysis / Anemia / Births / Child health / Child Health Services / Child Mortality / Child, Preschool / Children & youth / Childrens health / Data processing / Economic growth / Economic impact / Economics / Families & family life / Female / Five year plans / Geographic information systems / Geography / Geospatial data / Health aspects / Health care / Health services / Humans / Illnesses / Immunization / India / India - epidemiology / Indicators / Infant / Infant Mortality / Infant, Newborn / Literacy programs / Macroeconomics / Male / Management information systems / Maternal & child health / Mathematical models / Medicine / Mortality / Newborn babies / Population growth / Poverty / Pregnancy / Public health / Rain / Rainfall / Roads / Roads & highways / Sepsis / Sex Factors / Social factors / Social sciences / Socioeconomic Factors / Socioeconomics / Spatial analysis / Spatial dependencies / Spatial distribution / Statistical analysis / Surveys / Urbanization / Womens health