Population Research and Policy Review

, Volume 30, Issue 6, pp 861–883

Inequality of Opportunity in Indian Children: The Case of Immunization and Nutrition



Basic services which are essential for the overall development of a child should not depend on circumstances such as caste, religion, gender, place of birth, or other parental characteristics, which are beyond his/her control. This paper uses two rounds of Indian National Family Health Surveys and concepts of Inequality of Opportunity and Human Opportunity Indices to measure inequality arising out of unequal coverage of full immunization and minimum nutrition for Indian children. The results suggest overall high level of inequality of opportunity with substantial geographical variations. Changes in inequality of opportunity in the two services during 1992–1993 to 2005–2006 were mixed with some geographical regions outperforming others. The findings also call for substantial policy revisions if the goal of universal full immunization and minimum nutrition has to be achieved.


Inequality of opportunity Immunization Nutrition Inequality of Opportunity Index Human Opportunity Index Indian children 


  1. Ahluwalia, M. S. (2002). State level performance under economic reforms in India. In A. Krueger (Ed.), Economic policy reforms and the Indian economy (pp. 91–128). Chicago: University of Chicago Press.Google Scholar
  2. Bairagi, R. (1986). Food crisis, nutrition, and female children in rural Bangladesh. Population and Development Review, 12(2), 307–315.CrossRefGoogle Scholar
  3. Barros, R. P., Francisco, H. G., Vega, J. R. M., & Chanduvi, J. S. (2009). Measuring inequality of opportunities in Latin America and the Caribbean. Washington, DC: The World Bank.Google Scholar
  4. Barros, R. P., Vega, J. R. M., & Chanduvi, J. S. (2008). Measuring inequality of opportunities for children. http://siteresources.worldbank.org/INTLACREGTOPPOVANA/Resources/IneqchildrenPaesdeBarrosMolinasSaavedra.pdf. Cited 5 Jan 2010.
  5. Basu, A. M. (1989). Is discrimination in food really necessary for explaining sex differentials in childhood mortality? Population Studies, 43(2), 193–210.CrossRefGoogle Scholar
  6. Bhat, P. N. M. (2002). On the trail of ‘Missing’ Indian females. Economic and Political Weekly, 37(51), 5105–5118.Google Scholar
  7. Bhat, P. N. M., & Zavier, F. (1999). Findings of National Family Health Survey: Regional analysis. Economic and Political Weekly, 34, 3008–3032.Google Scholar
  8. Borooah, V. (2004). Gender bias among children in India in their diet and immunization against disease. Social Science and Medicine, 58, 1719–1731.CrossRefGoogle Scholar
  9. Bose, A. (1991). Demographic diversity of India—1991 Census, State and District level data. Delhi: B.R. Publishing Corporation.Google Scholar
  10. Coalation For Sustainable Nutrition Security For India (CSNSI). (2008). Overcoming the curse of malnutrition in India: A leadership agenda for action. New Delhi: Secretariat, Safdarjung Enclave.Google Scholar
  11. Das Gupta, M. (1987). Selective discrimination against female children in rural Punjab, India. Population and Development Review, 13(1), 77–100.CrossRefGoogle Scholar
  12. Davis-Kean, P. E. (2005). The influence of parent education and family income on child achievement: The indirect role of parental expectations and the home environment. Journal of Family Psychology, 19(2), 294–304.CrossRefGoogle Scholar
  13. Deaton, A., & Dreze, J. (2008). Nutrition in India: Facts and interpretation. Economic and Political Weekly, 44(7), 42–65.Google Scholar
  14. Desai, S., & Kulkarni, V. (2008). Changing educational inequalities in India in the context of affirmative action. Demography, 45(2), 245–270.CrossRefGoogle Scholar
  15. Despande, A. (2001). Caste at birth? Redefining disparity in India. Review of Development Economics, 5(1), 130–144.CrossRefGoogle Scholar
  16. Dibley, M. J., Goldsby, J. B., Staehling, N. W., & Trowbridge, F. L. (1987a). Development of normalized curves for the international growth reference: Historical and technical considerations. American Journal of Clinical Nutrition, 46(5), 736–748.Google Scholar
  17. Dibley, M. J., Goldsby, J. B., Staehling, N. W., & Trowbridge, F. L. (1987b). Interpretation of Z-score anthropometric indicators derived from the international growth reference. American Journal of Clinical Nutrition, 46(5), 749–762.Google Scholar
  18. Dyson, M., & Moore, M. (1983). On kinship structure, female autonomy, and demographic behaviour in India. Population and Development Review, 9(1), 35–60.CrossRefGoogle Scholar
  19. Eccles, J. S., & Davis-Kean, P. E. (2005). Influence of parent’s education on their’s children’s educational attainments: The role of parent and child perceptions. London Review of Education, 3(3), 191–204.CrossRefGoogle Scholar
  20. Filmer, D., & Pritchett, L. H. (2001). Estimating wealth effects without expenditure data- or tears: An application to educational enrollments in states of India. Demography, 38(1), 115–132.Google Scholar
  21. Government of India. (2006). Social Economic and Educational Status of Muslim Community in India. New Delhi: Government of India.Google Scholar
  22. Gragnolati, M., Shekar, M., Dasgupta, M., Bredenkamp, C., & Lee Y. (2005). India’s undernourished children: A call for reform and action. Health Nutrition and Population (HNP) Discussion paper, Aug 2005, Washington, DC: World Bank.Google Scholar
  23. Griffiths, P., Mathews, Z., & Hinde, A. (2002). Gender, family and the nutritional status of children in three culturally contrasting states of India. Social Science and Medicine, 55(5), 775–790.CrossRefGoogle Scholar
  24. Gupta, D. (1991). Social stratification. New Delhi: Oxford University Press.Google Scholar
  25. Hasan, M. (2001). Legacy of a divided nation: India’s Muslims since independence. New Delhi: Oxford University Press.Google Scholar
  26. Howe, L. D., Hargreaves, J. R., Gabrysch, S., & Huttly, S. R. A. (2009). Is the wealth index a proxy for consumption expenditure? A systematic review. Journal of Epidemiology and Community Health, 63, 871–877.CrossRefGoogle Scholar
  27. IIPS & ORCMacro. (1995). National Family Health Survey 1992–93, India. Mumbai: International Institute for Population Sciences and Macro International.Google Scholar
  28. IIPS & ORCMacro. (2007). National Family Health Survey 2005–06, India. Mumbai: International Institute for Population Sciences and Macro International.Google Scholar
  29. Jejeebhoy, S. J. (1993). Family size, outcomes for children, and gender disparity: Case of rural Maharashtra. Economic and Political Weekly, 28(35), 1811–1821.Google Scholar
  30. Johnson, K., & Bradley, S. (2008). Trends in population and health outcomes: Further analysis of the 2006 Nepal Demographic and Health Survey. Calverton, MD: Macro International Inc.Google Scholar
  31. Kishor, S. (1993). May God give sons to all: Gender and child mortality in India. American Sociological Review, 58, 247–265.CrossRefGoogle Scholar
  32. Knodel, J. E., & Wongsith, M. (1991). Family size and children’s education in Thailand: Evidence from a national sample. Demography, 28(1), 119–131.CrossRefGoogle Scholar
  33. Miller, B. D. (1981). The endangered sex: Neglect of female children in rural North India. Ithaca: Cornell University Press.Google Scholar
  34. Mishra, V., Roy, T. K., & Retherford, R. (2004). Sex differentials in childhood feeding, health care and nutritional status in India. Population and Development Review, 30(2), 269–295.CrossRefGoogle Scholar
  35. Montgomery, M. R., Gragnolati, M., Burke, K. A., & Paredes, E. (2000). Measuring living standards with proxy variables. Demography, 37(2), 155–174.CrossRefGoogle Scholar
  36. Muhuri, P. K., & Preston, S. H. (1991). Effects of family composition on mortality differentials by sex among children in Matlab, Bangladesh. Population and Development Review, 17(3), 415–434.CrossRefGoogle Scholar
  37. Mukherjee, D., & Das, S. (2008). Role of parental education in schooling and child labour decision: Urban India in the last decade. Social Indicators Research, 89, 305–322.CrossRefGoogle Scholar
  38. Oster, E. (2006). Does increased access increase equality? Gender and child health investments in India. Chicago: University of Chicago.Google Scholar
  39. Pal, P., & Gosh, J. (2007). Inequality in India-A survey of recent trends. DESA Working paper, no. 45, New York: Department of Economics and Social Affairs.Google Scholar
  40. Pande, R. (2003). Selective gender differences in childhood nutrition and immunization in rural India: The role of siblings. Demography, 40(3), 395–418.CrossRefGoogle Scholar
  41. Pande, R., & Yazbeck, A. S. (2003). What’s in a country average? Wealth, gender and regional inequalities in immunization in India. Social Science and Medicine, 57, 2075–2088.CrossRefGoogle Scholar
  42. Pathak, P. K., & Singh, A. (2009). Geographical variation in poverty and child malnutrition in India. In K. K. Singh, R. C. Yadava, & A. Pandey (Eds.), Population, poverty and health: Analytical approaches (pp. 183–206). New Delhi: Hindustan Publishing Corporation.Google Scholar
  43. Ram, F., & Roy, T. K. (2004). Comparability issues in large sample surveys—some observations. In T. K. Roy, M. Guruswamy, & P. Arokiaswamy (Eds.), Population health and development in India—changing perspectives (pp. 40–56). New Delhi: Rawat Publications.Google Scholar
  44. Roemer, J. E. (1998). Equality of opportunity. Cambridge, MA: Harvard University Press.Google Scholar
  45. Rutstein, S. O., & Johnson, K. (2004). DHS comparative report 6: The DHS wealth Index. Calverton, MD: ORC Macro.Google Scholar
  46. Sen, A. (1988). Family and food: Sex bias in poverty. In T. N. Srinivasan & P. K. Bardhan (Eds.), Rural poverty in South Asia (pp. 346–368). Ithaca: Oxford University Press.Google Scholar
  47. Sen, A., & Himanshu, (2005). Poverty and inequality in India: Getting closer to the truth. In A. Deaton & V. Kozel (Eds.), Data and dogma: The great indian poverty debate (pp. 177–199). New Delhi: Macmillan.Google Scholar
  48. Sharma, K. L. (1999). Social inequality in India: Profiles of caste, class and social mobility. Jaipur: Rawat Publications.Google Scholar
  49. Singh, A., Hazra, A., & Ram, F. (2008). Women’s autonomy and sex differential in child mortality in India. Genus, 63(3–4), 55–75.Google Scholar
  50. Vyas, S., & Kumaranayake, L. (2006). Constructing socio-economic status indices: How to use principal component analysis. Health Policy and Planning, 21(6), 459–468.CrossRefGoogle Scholar
  51. Wagstaff, A., & Watanabe, N. (2000). Socioeconomic inequalities in child malnutrition in developing world. Policy research working paper 2434, Washington DC: World Bank.Google Scholar
  52. World Bank. (2006). World Development Report 2006: Equity and development. Washington, DC: World Bank.Google Scholar
  53. World Health Organization Multicenter Growth Reference Study Group. (2006). WHO child growth standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for age—methods and development. Geneva: World Health Organization.Google Scholar

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© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Indira Gandhi Institute of Development ResearchMumbaiIndia

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