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Socioeconomic and gender inequalities in neonatal, postneonatal and child mortality in India : A repeated cross-sectional study, 2005-2016

Karlsson, Omar LU ; Kim, Rockli ; Joe, William and Subramanian, S. V. (2019) In Journal of Epidemiology and Community Health 73(7). p.660-667
Abstract

Background: In India, excess female under-5 mortality is well documented. Under-5 mortality is also known to be patterned by socioeconomic factors. This study examines sex differentials and sex-specific wealth gradients in neonatal, postneonatal and child mortality in India. Methods: Repeated cross-sectional study of nationally representative samples of 298 955 children 0-60 months old from the National Family Health Surveys conducted in 2005-2006 and 2015-2016. The study used logistic regression models as well as Cox proportional hazards models. Results: Overall, boys had greater neonatal mortality than girls and the difference increased between 2005-2006 and 2015-2016. Girls had greater postneonatal and child mortality, but the... (More)

Background: In India, excess female under-5 mortality is well documented. Under-5 mortality is also known to be patterned by socioeconomic factors. This study examines sex differentials and sex-specific wealth gradients in neonatal, postneonatal and child mortality in India. Methods: Repeated cross-sectional study of nationally representative samples of 298 955 children 0-60 months old from the National Family Health Surveys conducted in 2005-2006 and 2015-2016. The study used logistic regression models as well as Cox proportional hazards models. Results: Overall, boys had greater neonatal mortality than girls and the difference increased between 2005-2006 and 2015-2016. Girls had greater postneonatal and child mortality, but the difference decreased between the surveys and was not statistically significant for child mortality in 2015-2016. A negative wealth gradient was found for all mortality outcomes. Neonatal mortality was persistently greater for boys. Girls had higher child mortality than boys at low levels of wealth and greater postneonatal mortality over much of the wealth distribution. The wealth gradient in neonatal mortality increased between surveys. Females had a stronger wealth gradient than boys for child mortality. Conclusion: Not distinguishing between neonatal, postneonatal and child mortality masks important gender-specific and wealth-specific disparities in under-5 mortality in India. Substantial gains towards the Sustainable Development Goals can be made by combating neonatal mortality, especially at low levels of wealth. Although impressive improvements have been made in reducing the female disadvantage in postneonatal and child mortality, concerted engagements are necessary to eliminate the gender gap - especially in poor households and in north India.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
gender, inequalities, mortality
in
Journal of Epidemiology and Community Health
volume
73
issue
7
pages
660 - 667
publisher
BMJ Publishing Group
external identifiers
  • pmid:30923170
  • scopus:85063573028
ISSN
0143-005X
DOI
10.1136/jech-2018-211569
language
English
LU publication?
yes
id
18ae8461-405b-4a6f-a8f3-ffa155704962
date added to LUP
2019-04-08 14:45:18
date last changed
2022-05-03 19:23:32
@article{18ae8461-405b-4a6f-a8f3-ffa155704962,
  abstract     = {{<p>Background: In India, excess female under-5 mortality is well documented. Under-5 mortality is also known to be patterned by socioeconomic factors. This study examines sex differentials and sex-specific wealth gradients in neonatal, postneonatal and child mortality in India. Methods: Repeated cross-sectional study of nationally representative samples of 298 955 children 0-60 months old from the National Family Health Surveys conducted in 2005-2006 and 2015-2016. The study used logistic regression models as well as Cox proportional hazards models. Results: Overall, boys had greater neonatal mortality than girls and the difference increased between 2005-2006 and 2015-2016. Girls had greater postneonatal and child mortality, but the difference decreased between the surveys and was not statistically significant for child mortality in 2015-2016. A negative wealth gradient was found for all mortality outcomes. Neonatal mortality was persistently greater for boys. Girls had higher child mortality than boys at low levels of wealth and greater postneonatal mortality over much of the wealth distribution. The wealth gradient in neonatal mortality increased between surveys. Females had a stronger wealth gradient than boys for child mortality. Conclusion: Not distinguishing between neonatal, postneonatal and child mortality masks important gender-specific and wealth-specific disparities in under-5 mortality in India. Substantial gains towards the Sustainable Development Goals can be made by combating neonatal mortality, especially at low levels of wealth. Although impressive improvements have been made in reducing the female disadvantage in postneonatal and child mortality, concerted engagements are necessary to eliminate the gender gap - especially in poor households and in north India.</p>}},
  author       = {{Karlsson, Omar and Kim, Rockli and Joe, William and Subramanian, S. V.}},
  issn         = {{0143-005X}},
  keywords     = {{gender; inequalities; mortality}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{7}},
  pages        = {{660--667}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Journal of Epidemiology and Community Health}},
  title        = {{Socioeconomic and gender inequalities in neonatal, postneonatal and child mortality in India : A repeated cross-sectional study, 2005-2016}},
  url          = {{http://dx.doi.org/10.1136/jech-2018-211569}},
  doi          = {{10.1136/jech-2018-211569}},
  volume       = {{73}},
  year         = {{2019}},
}