Abstract
We document a novel fact about neonatal death, or death in the first month of life. Globally, neonatal mortality is disproportionately concentrated in India. We identify a large effect of birth order on neonatal mortality that is unique to India: later-born siblings have a steep survival advantage relative to the birth-order gradient in other developing countries. We show that India's high prevalence of maternal undernutrition and its correlation with age and childbearing can explain this pattern. We find that Indian mothers exit the underweight body mass range at an internationally comparatively high rate as they progress through childbearing careers.
Highlights
The rapid human development of the past decades is reflected in a steep fall in infant mortality
We propose that our neonatal mortality (NNM) results can be explained by India’s exceptionally poor maternal nutrition combined with weight gain and improvements in social status over her childbearing career
We find a unique later-born neonatal mortality advantage in India that is much steeper than in the rest of the developing world
Summary
The rapid human development of the past decades is reflected in a steep fall in infant mortality. The gradient that we estimate is quantitatively large and is specific to NNM in India: there is no large later-born advantage for NNM in the rest of the developing world, nor is there an internationally unusual later-born advantage for postneonatal mortality (death between months 2-11) in India. This poses a puzzle: why is NNM in India higher for early-born siblings than for later-born siblings? This poses a puzzle: why is NNM in India higher for early-born siblings than for later-born siblings? This result, as we show, is not explained by differences in medical care at birth
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