Academic journal article International Journal of Child Health and Human Development

Multi-Level Determinants of Regional Variations in Infant Mortality in India: A State Level Analysis

Academic journal article International Journal of Child Health and Human Development

Multi-Level Determinants of Regional Variations in Infant Mortality in India: A State Level Analysis

Article excerpt


Health status of new-born children has been regarded as one of the premier ingredient of the Human development achievements in a developing country like India. Clearly, children have not benefitted to the same extent as adults from the improvements in food supply, and from the preventive and curative measures implemented so far. Identification of effective strategies to reduce infant mortality requires a better understanding of the determinants of infant mortality, and of factors responsible for the observed regional variations in infant mortality levels in India.

The present study attempts to identify the key factors determining the interregional variations of infant mortality in India at different levels of operations and examines some of the relevant relationships between those factors based on a crosssection analysis of state level data. An attempt has been made to build an analytical framework, which shows infant mortality as a function of multi-level factors operating at different stages of child birth, namely pre-natal, peri-natal and post natal periods.

The present study mainly attempts to enquire the effect of multi-level (individual, household and community level) factors over infant death during different periods of child birth as the independent effect of all the factors are not equal at different periods of child birth.

Another major objective to observe the independent effect of all the different level factors differently over neo-natal (the probability of dying at the first month of life) and post neo-natal mortality (the probability of dying after the first month of life but before the first birthday) that will trace out the fact that the determinant of these two types of mortality are different which is often shaded by infant mortality. However, the study attempts to develop an analytical framework on the basis of segmenting the wide range of factors affecting infant mortality and by measuring their partial and independent effects.

The proposition of the present study primarily based on the objective statements mentioned above. The central question would be how the interplay between multi-level factors may influence infant mortality at different stages and what would be the relative importance of these factors?


In the analytical framework used in the present analysis factors are distinguished at three different levels: Community, Household and Individual (Figure 1). They are arranged in ascending order according to their proximity to the dependent variable of interestin the present case, the death of an infant. The individual-level factors are closest to the dependent variable. Next come the household-level factors, and the community level factors are the most distant.

Individual level factors

Excluding endogenous genetic factors at the individual level, it is assumed that the chances of infant survival depend upon the degree of care with which the infant is brought up. Broadly visualized, care, starting from conception to the first birthday, i.e. during 21 months of life, is important for an understanding of the determinants of infant mortality. Pre-natal care, for example vaccination of the pregnant mother against tetanus, can virtually eliminate deaths from neo-natal tetanus.

Proper medical care at delivery can reduce the risk of death from birthday injury and tetanus. Post natal care in the form of breastfeeding, immunization, and timely and appropriate medical treatment in case of illness can reduce the risk of death during infancy. Hence, two important dimensions of individual level factors affecting infant mortality are:

* Timing

* Type of Care

Timing can be divided into three categories:

* Pre-natal

* Peri-natal

* Post-natal

Type of care can be divided into two main groups:

* Medical

* Non-medical

Medical care includes immunization, treatment of illness and medical attention at birth. …

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