Under-five mortality in high focus states in India: a district level geospatial analysis

Area of Science:

• Public Health
• Demography
• Spatial Analysis

Background:

• Child mortality variations across Indian districts are not fully explained by biophysical and geographical factors alone.
• Existing literature is inconclusive due to limitations in survey data regarding socioeconomic and healthcare indicators.
• This study incorporates these crucial variables for a comprehensive analysis.

Purpose of the Study:

• To determine if socioeconomic and healthcare indicators explain variations in under-five mortality rates in Indian districts.
• To control for biophysical and geographical variables in the analysis.
• To identify high-risk clusters for targeted interventions.

Main Methods:

• Analysis of 284 districts from nine high-focus Indian states using data from Annual Health Survey 2011 and Census 2011.
• Application of the Spatial-Error Model to address spatial autocorrelation in mortality data.
• Inclusion of socioeconomic, healthcare, and geographical variables.

Main Results:

• Coverage gap index, female literacy, urbanization, economic status, and newborn care at primary health centers are significant correlates of under-five mortality.
• High spatial dependence was observed in mortality indicators and predictors.
• Three clusters with high under-five mortality, comprising 30 districts, were identified.

Conclusions:

• Health program initiatives are pivotal in reducing under-five mortality in high-focus Indian states, even after accounting for biophysical and geographical factors.
• Targeted interventions are needed for identified high-mortality clusters.