Major Determinants of Infant Mortality: District-level Evidence from Annual Health Survey States of India

Abstract

The study aims to understand the major determinants of infant mortality in infant mortality-prone annual health survey states of India. The study has considered district level infant mortality rate as a dependent variable and household size, sex ratio at birth, female literacy, marriage before the legal age, birth spacing, full antenatal care, Mothers who received post-natal care within 48 hours of delivery, Children within 12 to 23 months who are fully immunised, Breastfeeding within 24 hours of birth, Children aged 6 to 35 months are only breastfed for the initial 6 months, women who are aware of HAF/ORS/ORT, and women who are aware of ARI/Pneumonia as independent variables. The study considered district-level data on the mentioned variables over nine annual health survey states over three years. The results reveal that female literacy, birth spacing, immunisation, only breastfeeding till 6 months, and awareness regarding HAF/ORS/ORT all have a statistically significant negative impact on IMR. On the other hand, post-natal care has a statistically significant positive impact on IMR. This surprising result can have two explanations. First, only those children receiving PNC who are already sick and succumbing to their sickness. Second, the patient death rate owing to hospital infection in India is very high, so it may be that infants are succumbing to this particular aspect. Identification of major determinants of infant mortality will eventually lead to actions against them, and that, in due course of time, will tame the onrush of infant mortality in Annual Health Survey States as well as other parts of India and the world. Quantification and determination of the major determinants of infant mortality for the annual health survey states are missing till date, and from that aspect, the article is novel.