Gender and Economic Inequality in under-5 Mortality in India from 2000 to 2022

Under-5 mortality serves as a critical indicator of the population's overall health and effectiveness of the healthcare system. Reduction in under-5 mortality is a key global health goal, access to healthcare, nutrition, and sanitation. Disparities in under-5 mortality according to gender and economic status have not been well explored in India. This study aims at assessing the inequalities of under-5 mortality in India from 2000 to 2020.

The World Health Organization's Health Equity Assessment Toolkit was used to investigate the inequalities. Different summary measures like difference, ratio, population attributable risk, and population attributable fraction (PAF) were used. For each measure, point estimate and confidence interval were estimated. The data source was UN IGME.

In India, there is a declining pattern of under-5 mortality in females, that is, 96.6, 78.2, 61.0, 44.9, 32.6, and 29.2 in 2000, 2005, 2010, 2015, 2020, and 2022, respectively. The difference in gender-related inequality gradually decreased from 9.6 in 2000 to 0.2 in 2022. The difference in wealth-related inequality gradually decreased from 81.9 in 2000 to 28.9 in 2022. There was a significant decrease in PAF in economic status in 2005, that is, -49.4, as compared to -49.9 in 2000, which gradually increased to -48.8 in 2022.

In India, under-5 mortality has decreased between the years 2000 and 2022. Gender-related inequalities of under-5 mortality have decreased significantly between the years 2000 and 2022, but economic status-related inequality still persists, which can be addressed by successful interventions.