Disparities in child mortality trends in two new states of India

BMC Public Health

Andrew Hodge¹  Kim-Huong Nguyen¹  Sonja Firth¹  Eliana Jimenez-Soto¹  Mark Minnery¹ 

[1] School of Population Health, Public Health Building, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia

关键词: Jharkhand;    Chhattisgarh;    India;    Health disparities;    Child mortality;    Health;   

Others  :  1161891
DOI  :  10.1186/1471-2458-13-779

 received in 2013-01-11, accepted in 2013-08-21,  发布年份 2013

【 摘 要 】

Background

India has the world’s highest total number of under-five deaths of any nation. While progress towards Millennium Development Goal 4 has been documented at the state level, little information is available for greater disaggregation of child health markers within states. In 2000, new states were created within the country as a partial response to political pressures. State-level information on child health trends in the new states of Chhattisgarh and Jharkhand is scarce. To fill this gap, this article examines under-five and neonatal mortality across various equity markers within these two new states, pre-and post-split.

Methods

Both direct and indirect estimation using pooled data from five available sources were undertaken. Inter-population disparities were evaluated by mortality data stratification of rural–urban location, ethnicity, wealth and districts.

Results

Both states experienced an overall reduction in under-five and neonatal mortality, however, this has stagnated post-2001 and various disparities persist. In cases where disparities have declined, such as between urban–rural populations and low- and high-income groups, this has been driven by modest declines within the disadvantaged groups (i.e. low-income rural households) and stagnation or worsening of outcomes within the advantaged groups. Indeed, rising trends in mortality are most prevalent in urban middle-income households.

Conclusions

The results suggest that rural health improvements may have come at the expense of urban areas, where poor performance may be attributed to factors such as lack of access to quality private health facilities. In addition, the disparities may in part be associated with geographical access, traditional practices and district-level health resource allocation.

【 授权许可】

   
2013 Minnery et al.; licensee BioMed Central Ltd.

【 图 表 】

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