Child Survival In India Research Articles

The Puzzle of Muslim Advantage in Child Survival in India

The Puzzle of Muslim Advantage in Child Survival in India

The Puzzle of Muslim Advantage in Child Survival in India

The socio-economic status of Indian Muslims is, on average, considerably lower than that of upper caste Hindus. Muslims have higher fertility and shorter birth spacing and are a minority group that, it has been argued, have poorer access to public goods. They nevertheless exhibit substantially higher child survival rates, and have done for decades. This paper documents and analyses this seeming puzzle. The religion gap in survival is much larger than the gender gap but, in contrast to the gender gap, it has not received much political or academic attention. A decomposition of the survival differential reveals that some compositional effects favour Muslims but that, overall, differences in characteristics between the communities and especially the Muslim deficit in parental education predict a Hindu advantage. Alternative outcomes and specifications support our finding of a Muslim fixed effect that favours survival. The results of this study contribute to a recent literature that debates the importance of socioeconomic status (SES) in determining health and survival. They augment a growing literature on the role of religion or culture as encapsulating important unobservable behaviours or endowments that influence health, indeed, enough to reverse the SES gradient that is commonly observed.

Child survival in India

About 2.1 million Indian children under 5 years of age die each year. In spite of reductions in child mortality rate over the past two decades, the rate remains high at 87 per 1000 live births. The main causes are diarrhoea, pneumonia, and for deaths among the neonates asphyxia, pre-term delivery, sepsis and tetanus. The major underlying cause of death is undernutrition. Child survival interventions of proven impact, feasible for use at high coverage in India were identified, and their effect on child mortality was calculated if high coverage were to be achieved. Exclusive breastfeeding, oral rehydration therapy, and adequate complementary feeding were among the most effective interventions. If these interventions would be applied universally 57% of mortality among pre-schoolers could be prevented. No cause specific mortality data were available from individual Indian states. Nevertheless, the range of child mortality, as well as the proportion of neo-natal deaths, occurring across the states, suggests that at state level 50-70% of deaths can be prevented. The results show that the targets set in the millennium development goals as well as in the Tenth Five Year plan can be reached.

Economic Development, Gender Inequality, and Demographic Outcomes: Evidence from India

This article examines the determinants of fertility, child mortality, and female disadvantage in child survival in India, using a district-level panel data set linking 1981 and 1991 censuses. The results question the dominant view that variables directly related to women's agency (specifically, the female literacy rate and the female labor force participation rate) have played the crucial roles here. Instead, variables reflecting the general level of development and modernization are shown to have had the greatest effect in reducing fertility and child mortality during the period of the study. Both economic development and women's agency are seen to have had significant effects in reducing the female disadvantage in child survival. The results suggest, however, that with continued economic development, the two women's agency variables lose their significance in influencing this disadvantage. The policy implications of these findings are considered.

Publicly Provided Goods and Intrafamily Resource Allocation: Female Child Survival in India

The paper examines the problem of excess mortality of females in India. The determinants of gender–specific child survival are investigated through the traditional household production model pioneered by Becker, which is extended to include publicly provided goods as fixed inputs in production decisions. The introduction of government–provided goods provides an avenue for investigating the influence of the state on household decisions. Gender–specific child survival equations are estimated using a robust “seemingly unrelated regression” method. Results using 1981 Indian Census data indicate that increases in female literacy and female labor force participation increase female child survival in rural India. Furthermore, higher ratios of female to male medical technicians are associated with higher female child survival relative to males. This paper demonstrates that a large and effective role exists for government to address excess female morality.