Infant and Child Mortality in Andhra Pradesh: Analysing changes over time and between states

Masset, Edoardo and White, Howard (2003): Infant and Child Mortality in Andhra Pradesh: Analysing changes over time and between states.

Abstract

Most countries of the world are reducing infant and child mortality too slowly to meet the Millennium Development Goal of a two-thirds reduction by 2015. Yet, some countries and regions have achieved impressive reductions, Kerala in India being one example. This paper examines the determinants of infant and child mortality in Andhra Pradesh, where the Young Lives project is taking place, and Kerala and the factors explaining their differential performance. The determinants of mortality are estimated using a Cox proportional hazards model. Infant mortality is found to depend on biological factors, including mother’s age and birth order, and also factors related to health service provision such as tetanus injection and use of antenatal services. Economic well being is not significant once these other factors are taken into account. By contrast, economic well-being is a significant determinant of child mortality, but substantially outweighed in importance by other factors such as maternal education and knowledge of health practices (ORS) and access to safe water. The data also show gender discrimination in Andhra Pradesh, notably toward girls with only female siblings, which is absent from Kerala. We conclude that raising service levels across India toward the levels found in Kerala is a necessary step toward meeting the MDGs, and that the success of these efforts is reinforced by female empowerment.

• Item Type: MPRA Paper
• Language: English
• Keywords: infant mortality; child mortality; health; india; social development; andhra pradesh; kerela; hazards model; health production function
• Subjects: O - Economic Development, Innovation, Technological Change, and Growth > O1 - Economic Development > O10 - General; O - Economic Development, Innovation, Technological Change, and Growth > O1 - Economic Development > O15 - Human Resources ; Human Development ; Income Distribution ; Migration

References

Arnand S. and M. Ravallion (1993), Human Development in Poor Countries: On the Role of Private Incomes and Public Services, Journal of Econoomic Perspectives, Vol. 7, No. 1: 132-150.

Beenstock M. and P. Sturdy (1990), The Determinants of Infant Mortality in Regional India, World Development, Vol. 18, No. 3: 443-453.

Bidani B. and Ravallion M. (1997), Decomposing Social Indicators Using Distributional Data, Journal of Econometrics, 77: 125-139.

Boerma J.T. and G.T. Bicego (1993), Maternal Education and Child Survival: A Comparative Study of Survey Data from 17 Countries, Social Science and Medicine, Vol. 36, No. 9:1207-1227.

Bourne K.L. and Walker G.M. (1991), The Differential Effect of Mothers’ Education on Mortality of Boys and Girls in India, Population Studies, 45: 203-219.

Brockerhoff, M. and L Derose (1996) Child Survival in East Africa: the impact of preventive health care World Development 24(12) 1841-1857.

Caldwell, J.C. (1986), Routes to Low Mortality in Developing Countries, Population and Development Review, 12(2) pp. 171-220.

Christiaensen, L. and H. Alderman (2001) Child malnutrition in Ethiopia: can maternal knowledge augment the role of income, Africa Region Working Paper Series No. 22, October.

Collett, D. (1994) Modelling Survival Time in Medical Research, Chapman and Hall, London.

Cox D.R., and Oakes, D. (1984) Analysis of Survival Data, Chapman and Hall, London.

Croll, Elizabeth (2001) Endangered daughters: discrimination and development in Asia London: Routledge

Das Gupta M. (1987) Selective Discrimination against Female Children in Rural Punjab, India, Population and Development Review, 13, No.1: 77-100.

A N T A N D C H I L D M O RTA L I T Y I N A N D H R A P R A D E S H Das Gupta M. (1990), Death Clustering, Mothers’ Education and the Determinants of Child Mortality in Rural Punjab, India, Population Studies, 44: 489-505.

Das Gupta M. (1997), Socio-economic Status and Clustering of Child Deaths in Rural Punjab, Population Studies, 51: 191-202.

Filmer D., and Pritchett L. (1999) The impact of public spending on health: does money matter?, Social Science and Medicine, 49: 1309-1323.

Fogel R.W. (1997), New Findings on Secular Trends in Nutrition and Mortality: Some Implications for Population Theory, in Rosenzweig M.R. and O. Stark, Handbook of Population and Family Economics, Elsevier, Amsterdam.

Glewwe, Paul (1999), Why Does Mother's Schooling Raise Child Health in Developing Countries? Evidence from Morocco, Journal of Human Resources

Gokhale, MK, SS Rao and VR Garole (2002) "Infant Mortality in India: use of maternal and child health services in relation to literacy status" Journal of Health, Population and Nutrition 20(2) 138-147.

Hanmer, L., R. Lensink and H. White (2003) Infant and child mortality: searching the data for robust determinants, Journal of Development Studies Forthcoming.

International Institute for Population Sciences (1995), National Family Health Survey (MHC and Family Planning): India 1992-1993, International Institute for Population Sciences, Bombay.

International Institute for Population Sciences (2000a), National Family Health Survey (NHHS-2) 1998-1999: India, International Institute for Population Sciences, Bombay.

International Institute for Population Sciences (2000b), National Family Health Survey (NHHS-2) India 1998-1999: Andhra Pradesh, International Institute for Population Sciences, Bombay.

International Institute for Population Sciences (2002), National Family Health Survey (NHHS-2)India 1998-1999: Kerala, International Institute for Population Sciences, Bombay. 35 N FA N T A N D C H I L D M O RTA L I T Y I N A N D H R A P R A D E S H 36 Khan, M.E., Anker R., Ghosh Dastidar S.K. and Bairathi (1989), Inequalities between Men and Women in Nutrition and Family Welfare Services: An In-depth Enquiry in an Indin Village, in Caldwell J.C. and S. Santow (eds.), Selected Readings in the Cultural, Social and Behavioural Determinants of Health, Health Transition Series no. 1, Health Transition Centre, Camberra.

Kishor S. (1995) Gender Differentials in Child Mortality: A Review of Evidence, in Das Gupta M., Chen L. and T.N Krishnan (eds.), Women’s Health in India: Risk and Vulnerability, Oxford U. P., Oxford.

Kishor, S. and S. Parasuraman (1998), Mother’s employment and infant and child mortality in India, National Family Health Survey Report No. 8.

Mahadevan K. and M. Sumangala, (1987) Social Development, Cultural Change and Fertility Decline: a Study of Fertility Change in Kerala, Sage, New Delhi.

Merick T. (1985), The Effect of Piped Water on Early Childhood Mortality in Urban Brazil, 1970-1976, Demography, Vol. 22: 1-14.

Mosley W.H and L.C. Chen (1984), An Analytical Framework for the Study of Child Survival in Developing Countries, Population and Development Review, Supplement to Vol. 10.

Murthi M., Guio A.C. and Jean Dreze (1995) Mortality, fertility and gender bias in India: a district level analysis, Population and Development Review, 21: 745-782.

Palloni A. and Tienda M. (1986), The Effects of Breastfeeding and Pace of Childbearing on Mortality at Early Ages, Demography, Vol. 23, No. 1:31-52.

Pebley A.R. and P.W. Strupp (1987), Reproductive Patterns and Child Mortality in Guatemala, Demography, Vol. 24, No. 1: 43-60.

Pressat, R., (1972) Demographic analysis: methods, results, applications, Arnold.

Preston, S.H., Heuveline, P. and Michel Guillot, (2001) Demography, Blackwell Publishers Inc.,Oxford.

Retherford D., Thapa S. and B.B. Gubhaju (1989), To What Extent Does Breastfeeding Explain Birth-Interval Effects on Early Childhood Mortality?, Demography, Vol. 26, No. 3: 439-450.

Robin J., (1992) Women, Politics and Well-being: How Kerala Became a ‘Model’, Macmillan, Basingstoke.

Rutstein S. O. (1984), Infant and Child Mortality: levels, trends and demographic differentials, World Fertility Survey, Comparative Studies: cross national summaries, No.43.

Shiva Kumar A.K. (1995), Women’s Capabilities and Infant Mortality: Lessons from Manipur, in Das Gupta M., Chen L. and T.N Krishnan (eds.), Women’s Health in India: Risk and Vulnerability, Oxford U. P., Oxford.

Sullivan, J.M., Rutstein S.O. and G.T. Bicego (1994) Infant and Child Mortality, Demographic and Health Surveys Comparative Studies No. 15, Macro International inc., Calverton.

UNICEF (1999), Trends in Child Mortality in the Developing World, 1960 to 1996, UNICEF, New York.

White H., (1998) The Determinants of Infant Mortality in Zambia: Analysing Changes Over Time, Institute of Social Studies, The Hague.

White H. (2003) Reducing infant and child mortality, in Richard Black and Howard White, Targeting Development London: Routledge

Wolpin, K.I. (1997) Determinants and Consequences of the Mortality and Health of Infants and Children, in Rosenzweig M.R. and O. Stark, Handbook of Population and Family Economics, Elsevier, Amsterdam.

World Bank (1998), Health, Nutrition and Population Indicators. A Statistical Handbook. The World Bank, Washington D.C.

World Bank (2001), World Development Indicators, 2001. The World Bank, Washington D.C.