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Risk factors for child survival among tribal dominated states in India: a pooled cross sectional analysis

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Abstract

The paper examines risk factors associated with child mortality in the scheduled tribe population in India and explains differences in child mortality outcomes between the scheduled tribe and the non-scheduled tribe population. A weighted total of 7,962 deaths of children aged under 5 years occurred within the 5 years preceding the survey in our pooled sample of NFHS 3 and NFHS 4 where scheduled tribe children contribute approximately 59% of the death. A Cox proportional hazard regression is estimated using several predictors. The findings suggest that there is a significant decline in neonatal, infant and under-five mortality among the tribal population in the last 10 years. Cox regression results indicate that timely implementation of ante-natal care, postnatal care and institutional delivery are important factors behind the reduction in neonatal as well as infant mortality in tribal-dominated areas; whereas proper family planning method, lower birth order of the child and maternal education, media exposure along with autonomy of mother are effective in reducing under-five mortality. Further, early initiation of breastfeeding and exclusive breastfeeding can reduce child mortality more effectively. Therefore, policies and programmes on maternal care and family planning, and the creation of awareness at the community level on reproductive maternal and child health will need to be emphasised to reduce child mortality in the tribal population.

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Fig. 1
Fig. 2

Source: Author’s calculations based on NFHS-3 and NFHS-4

Fig. 3

Source: Author’s calculations based on NFHS-4

Fig. 4

Source: Author’s calculations based on Health Management Information System (HMIS) 2019, Government of India

Fig. 5

Source: Author’s calculations based on Health Management Information System (HMIS) 2019, Government of India

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Notes

  1. Report on the Advisory Committee on the Revision of the list of Scheduled tribes and scheduled caste, 1965 https://ruralindiaonline.org/en/library/resource/the-report-of-the-advisory-committee-on-the-revision-of-the-lists-of-scheduled-castes-and-scheduled-tribes/

  2. National Family and Health Survey in India is similar to Demographic and Health Surveys in other countries. The Multistage sampling framework is used to create a representative sample from all India. It provides information on households’ standard of living, child mortality, health care services, reproductive health and nutrition status of women and child at national and state level.

  3. Due to huge cultural diversity, other North Eastern States except Assam are not included in the study.

  4. The media exposure of women is defined on the basis of three broad indicators, i.e., access and frequency of listening to the radio, watching television and reading newspapers or magazines. Based on frequency of access, to these sources, high media exposure is defined as exposure to any of the three sources every day, while low media exposure is based on rare or no access to media. Those that are not in the category of high or low media exposure are classified as having medium exposure.

  5. The NFHS 4 questionnaire asked about three areas of women's autonomy in decision making. These are, own health care, making household purchases and visits to her family or friends. Each question had six responses: (1) respondent alone; (2) respondent and husband/partner; (3) respondent and other person; (4) husband/partner alone; (5) someone else and (6) others. To create a binary variable for the analysis, we grouped the first two responses under the head having own autonomy. The remaining four responses were categorised as the woman having no say in the decision or low autonomy. Therefore, if a woman can take her own decision in all three domains then she has higher autonomy. In all other cases her autonomy is low.

  6. Timely ANC visit and care helps the mother to connect with formal health system, usage of skill attendant at birth and promote knowledge related to child care like breastfeeding, early post natal care, and optimal family planning.

  7. https://vikaspedia.in/health/health-directory/rural-health-care-system-in-india

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  1. Institute For Human Development, 2nd floor, 256, Okhla Industrial Estate Phase 3 Rd, Okhla Phase III, Okhla Industrial Area, New Delhi, Delhi, 110020, India

    Swati Dutta

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Appendix

Appendix

See Tables

Table 7 Comparison of IMR (per 1000 live birth) between ST and non-ST: 2015–16.
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Table 8 Comparison of U5MR (per 1000 live births) between ST and non-ST: 2015–16.
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Table 9 Adjusted HR (95%CI) for the variables associated with Neonatal Mortality in Tribal Community
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Table 10 Adjusted HR (95% CI) for the variables associated with Infant Mortality in Tribal Community
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Table 11 Adjusted HR (95% CI) for the variables associated with U5MR in Tribal Community
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11.

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Dutta, S. Risk factors for child survival among tribal dominated states in India: a pooled cross sectional analysis. J Pop Research 39, 391–416 (2022). https://doi.org/10.1007/s12546-022-09288-2

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