Abstract
This study has twofold objectives: (1) to investigate the progress in sex differentials in child mortality in India in terms of within and between group changes and (2) to identify the factors explaining the sex differentials in child mortality and quantify their relative contributions. We have used three rounds of the National Family Health Survey (NFHS) data, 1992 to 2006. Life table approach and Pyatt and Oaxaca decomposition models were used as methods of analyses. The results revealed that though sex differential in child mortality is still high in India, it declined during 1992 to 2006 (Gini index from 0.36 to 0.24). This decline was primarily led by a change in within inequality of female child mortality (Gini index from 0.18 to 0.14). Among the selected predictors, breastfeeding (40%), birth order (24%), antenatal care (9%), and mother’s age (7%) emerged as critical contributors for the excess female child mortality in India. From the findings of this study, we suggest that any efforts to do away with gender differences in child survival should focus more on within female child disparity across different population subgroups alongside male-female disparity. Implications are advanced.
Highlights
In most populations, female mortality rates are lower than male mortality rates and females are more than males, which remain consistent across all the ages [1]
The contribution of within male and female inequalities to total gender inequalities in child mortality was consistently over 50% for all the three rounds of the NFHS
This gives a strong message that rather than male-female inequalities, inequalities within the female and male children by socioeconomic, demographic, and health care characteristics of the households contributed more to the total inequality in the child mortality
Summary
Female mortality rates are lower than male mortality rates and females are more than males, which remain consistent across all the ages [1]. Historically South Asia is known for its male skewed child sex ratio. Researchers have attributed sex differentials in child mortality as one of the primary factors contributing to its skewed sex ratios in 0–6 year population. India’s Sample Registration System (SRS) has been indicating the presence of sex differentials in child mortality since 1970s. The recent SRS report has indicated a large gap (9 per 1000 live births) in terms of under-five mortality rate among males and females which further increases in rural areas [2]. The issue of sex differentials in child mortality has remained a major hurdle for achieving gender equity and Millennium Development Goals-4 (MDG-4) in India
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