INTER-STATE VARIATION IN NEONATAL MORTALITY RATE AMONG INDIAN STATES (original) (raw)
Related papers
Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine, 2021
Background: The Government of India initiated different programs to reduce neonatal mortality. However, the variability of neonatal deaths occurs among states of India. Objective: This study aimed to identify the differential determinants associated with neonatal deaths in northern and southern regions of India. Materials and Methods: Bivariate analysis and Cox regression analysis have been performed to evaluate the predictors of neonatal mortality from National Family Health Survey (NFHS-4) data. Results: For neonatal mortality, mother and child factors became more consistent in the southern region than northern regions of the country, while household factor was almost the same in both regions of India. Conclusions: Primary intervention is also required to reduce public health problem as neonatal mortality. It should be focused on education of mother, birth interval, age at birth, antenatal care, poverty reduction programs, and proper heath facility to pregnant mothers.
Journal of Ecophysiology and Occupational Health
Infant mortality is an important indicator of nation's socioeconomic welfare. There are many socioeconomic , demographic and environmental determinants of infant mortality. As infant has an innate relationship with the mother, therefore the maternal health programmes have also very important repercussion on infant health. The above two dimensions of infant mortality have seldom been examined together in infants-based studies. Thus, the survival analysis for infants regarding its several determinants along with maternal health programmes and their impact is seen in the study. The paper applies Kaplan-Meier and Cox proportional hazard model using National Family Health Survey data 2005-06, in India, to demonstrate the risk of infant death with the above said factors. Poor households are more likely to experience infant deaths than rich and middle households. Maternal health programmes have a significant effect on infant mortality, but the inclusion of breastfeeding, mother education and wealth index make these results insignificant. This study indicates that there is a need to increase birth spacing, improve mother's education level, encourage breastfeeding and discourage teenage pregnancy in order to achieve the desired outcome of reducing infant mortality. Many interesting facets of the successful implementation of government and non-government policies on the improvement of infant survival are also discussed.
The neonatal (NNMR) and post neonatal mortality (PNNMR) together constitutes the infant mortality rate (IMR) which is regarded as an important indicator of health status of a community and judge the effectiveness of intervention programmes. India has the highest number of neonatal deaths in the world and it accounts for 56 percent of under-five child mortality. Over the last 42 years, IMR, NNMR and PNNMR have declined and share of NNMR and PNNMR to IMR has changed. Therefore, the present exercise has been done to find out the trends of IMR and its components and trend of share of these components in India and its selected states. The study found that the pace of decline in infant mortality has quickened in recent years. The post-neonatal deaths have declined faster resulting in faster decline in IMR and the neonatal deaths recorded only a modest reduction.
Predictors of Neonatal and Infant Deaths in India
https://www.ijhsr.org/IJHSR\_Vol.9\_Issue.6\_June2019/IJHSR\_Abstract.02.html, 2019
Background: Child mortality is one of the important indicators that reflect level of socio-economic development and existence and utilization of medical services of any nation. Decline of child mortality, especially during neonate and infancy period is highly desirable. Many programmes launched by the country; still child mortality is of major concern. Further, effective implementation of modified programs is the need to reduce IMR for which modifiable determinants of mortality during neonatal period and infancy are needed. Aim: Assessing the status and determinants of neonatal and infant mortality Method: Present analysis was carried on data of NFHS-3 conducted in 2005-06. Bivariate analysis was used to identify the associated characteristics and Logistic Regression analysis to eliminate the effect of confounding was followed to identify the determinants of IMR. Statistical significance was judged at 5% level of significance. Result: A wide regional gap was found for both neonatal and IMR; lowest in western and southern regions (3.2%) and highest in central region (6.6%) but the proportion of neonatal to infant deaths was almost similar and was around 70% in all the regions except north-east. Education, income, age and parity had much role to play to neonatal and infant mortalities. The risk of death during infancy was higher by 1.28, 1.23, 1.76 and 1.32 times higher in north, north-east, central and east compared to southern region. Higher was the education of mother, lower was the neonatal and infant deaths irrespective of region. Conclusion: Women should be advised to avoid pregnancy before age 20 years, maintain adequate spacing, and not to move to higher order births for which needed contraceptive methods should be suggested to practice. Also, regional variation in services to reduce low birth weight babies should be on priority for maximum IMR reduction.
Determinants of neonatal mortality in rural India, 2007-08
2013
Background. Despite the growing share of neonatal mortality in under-5 mortality in the recent decades in India, most studies have focused on infant and child mortality putting neonatal mortality on the back seat. The development of focused and evidence-based health interventions to reduce neonatal mortality warrants an examination of factors affecting it. Therefore, this study attempt to examine individual, household, and community level factors affecting neonatal mortality in rural India. Data and methods. We analysed information on 171,529 singleton live births using the data from the most recent round of the District Level Household Survey conducted in 2007-08. Principal component analysis was used to create an asset index. Two-level logistic regression was performed to analyse the factors associated with neonatal deaths in rural India. Results. The odds of neonatal death were lower for neonates born to mothers with secondary level education (OR = 0.60, p = 0.01) compared to those born to illiterate mothers. A progressive reduction in the odds occurred as the level of fathers' education increased. The odds of neonatal death were lower for infants born to unemployed mothers (OR = 0.89, p = 0.00) compared to those who worked as agricultural worker/farmer/laborer. The odds decreased if neonates belonged to Scheduled Tribes (OR = 0.72, p = 0.00) or 'Others' caste group (OR = 0.87, p = 0.04) and to the households with access to improved sanitation (OR = 0.87, p = 0.02), pucca house (OR = 0.87, p = 0.03) and electricity (OR = 0.84, p = 0.00). The odds were higher for male infants (OR = 1.21, p = 0.00) and whose mother experienced delivery complications (OR = 1.20, p = 0.00). Infants whose mothers received two tetanus toxoid injections (OR = 0.65, p = 0.00) were less likely to die in the neonatal period. Children of higher birth order were less likely to die compared to first birth order. Conclusion. Ensuring the consumption of an adequate quantity of Tetanus Toxoid (TT) injections by pregnant mothers, targeting vulnerable groups like young, first time and Scheduled Caste mothers, and improving overall household environment by increasing access to improved toilets, electricity, and pucca houses could also contribute to further reductions in neonatal mortality in rural India. Any public health interventions aimed at reducing neonatal death in rural India should consider these factors.
Determinants of neonatal mortality in rural India, 2007–2008
Background. Despite the growing share of neonatal mortality in under-5 mortality in the recent decades in India, most studies have focused on infant and child mortality putting neonatal mortality on the back seat. The development of focused and evidence-based health interventions to reduce neonatal mortality warrants an examination of factors affecting it. Therefore, this study attempt to examine individual, household, and community level factors affecting neonatal mortality in rural India. Data and methods. We analysed information on 171,529 singleton live births using the data from the most recent round of the District Level Household Survey conducted in 2007-08. Principal component analysis was used to create an asset index. Two-level logistic regression was performed to analyse the factors associated with neonatal deaths in rural India. Results. The odds of neonatal death were lower for neonates born to mothers with secondary level education (OR = 0.60, p = 0.01) compared to those born to illiterate mothers. A progressive reduction in the odds occurred as the level of fathers' education increased. The odds of neonatal death were lower for infants born to unemployed mothers (OR = 0.89, p = 0.00) compared to those who worked as agricultural worker/farmer/laborer. The odds decreased if neonates belonged to Scheduled Tribes (OR = 0.72, p = 0.00) or 'Others' caste group (OR = 0.87, p = 0.04) and to the households with access to improved sanitation (OR = 0.87, p = 0.02), pucca house (OR = 0.87, p = 0.03) and electricity (OR = 0.84, p = 0.00). The odds were higher for male infants (OR = 1.21, p = 0.00) and whose mother experienced delivery complications (OR = 1.20, p = 0.00). Infants whose mothers received two tetanus toxoid injections (OR = 0.65, p = 0.00) were less likely to die in the neonatal period. Children of higher birth order were less likely to die compared to first birth order. Conclusion. Ensuring the consumption of an adequate quantity of Tetanus Toxoid (TT) injections by pregnant mothers, targeting vulnerable groups like young, first time and Scheduled Caste mothers, and improving overall household environment by increasing access to improved toilets, electricity, and pucca houses could also contribute to further reductions in neonatal mortality in rural India. Any public health interventions aimed at reducing neonatal death in rural India should consider these factors.
Infant Mortality in Northern and Southern Regions of India: Differentials and Determinants
Social Science Spectrum, 2018
Using the National Family Health Survey (NFHS-3) 2005-06 data, this paper examines the differentials and determinants of IMR in northern and southern regions of India –which record two extreme levels (highest and lowest respectively). Inferential statistics,bivariate analysis and multilevel Cox proportional regression were used as the methods of analysis. The result suggests that IMR is more pronounced in the northern than southern region. This was observed across the factors taken into consideration in the study. Nevertheless, mother’s illiteracy, working status, and marrying and delivering first child at a young age were the major mother-related factors for a high IMR. Birth interval of less than two years, being of small-sized at birth, being a female child, and not breastfed at the time of survey were the main child-related factors for a high IMR. Further, poor economic condition, living in a rural area and not having access to basic civic amenities were the key household-relate...
BMJ Open, 2019
ObjectivesThis paper analyses the patterns and trends in the mortality rates of infants and children under the age of 5 in India (1992–2016) and quantifies the variation in performance between different geographical states through three rounds of nationally representative household surveys.DesignThree rounds of cross-sectional survey data.SettingThe study is conducted at the national level: India and its selected good-performing states, namely Haryana, Kerala, Maharashtra, Punjab and Tamil Nadu, and selected poor-performing states, namely Bihar, Chhattisgarh, Madhya Pradesh and Uttar Pradesh.ParticipantsAdopting a multistage, stratified random sampling, 601 509 households with 699 686 women aged 15–49 years in 2015–2016, 109 041 households with 124 385 women aged 15–49 years in 2005–2006, and 88 562 households with 89 777 ever married women in the age group 13–49 years in 1992–1993 were selected.ResultsThrough the use of maps, this paper clearly shows that the overall trend in infan...
State of newborn health in India
Journal of perinatology : official journal of the California Perinatal Association, 2016
About 0.75 million neonates die every year in India, the highest for any country in the world. The neonatal mortality rate (NMR) declined from 52 per 1000 live births in 1990 to 28 per 1000 live births in 2013, but the rate of decline has been slow and lags behind that of infant and under-five child mortality rates. The slower decline has led to increasing contribution of neonatal mortality to infant and under-five mortality. Among neonatal deaths, the rate of decline in early neonatal mortality rate (ENMR) is much lower than that of late NMR. The high level and slow decline in early NMR are also reflected in a high and stagnant perinatal mortality rate. The rate of decline in NMR, and to an extent ENMR, has accelerated with the introduction of National Rural Health Mission in mid-2005. Almost all states have witnessed this phenomenon, but there is still a huge disparity in NMR between and even within the states. The disparity is further compounded by rural-urban, poor-rich and gend...