A Bayesian Small Area Estimation Approach for District-Level Fertility and Mortality Estimates in India, 2015-16 to...

Area of Science:

• Demography
• Public Health
• Epidemiology

Background:

• Fertility and child mortality are key public health indicators in India.
• Understanding their district-level trends is crucial for effective health policy and interventions.
• The relationship between declining fertility and decreasing child mortality is a significant area of research.

Purpose of the Study:

• To estimate and compare fertility and child mortality rates at the district level in India.
• To analyze regional trends using National Family Health Survey (NFHS) data (rounds 4 and 5).
• To understand the implications of these trends for targeted health interventions.

Main Methods:

• Investigated Total Fertility Rate (TFR), Neonatal Mortality Rate (NMR), Infant Mortality Rate (IMR), and Under-Five Mortality Rate (U5MR).
• Utilized Bayesian methods and Poisson regression models for district-level estimations.
• Employed data from NFHS rounds 4 (2015-16) and 5 (2019-21).

Main Results:

• Significant increase in districts with TFR below 1.6 (from 21 to 166) and NMR below 10 (from 79 to 140) between 2015-16 and 2019-21.
• Stable number of districts with TFR between 1.6 and 2.1.
• A strong association was observed between declining fertility rates and reduced child mortality.

Conclusions:

• Addressing regional disparities in fertility and child mortality is vital for improving health intervention effectiveness in India.
• Prioritizing access to family planning and maternal-child health services is recommended.
• District-level data enables tailored and more effective public health policies.