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Explaining the Rural-Urban Gap in Infant Mortality in India
Authors: Nandita Saikia, Abhishek Singh, Domantas Jasilionis, and Faujdar Ram
Source: Demographic Research, Volume 29, Article 18, Pages 473-506, DOI: 10.4054/DemRes.2013.29.18
Topic(s): Infant mortality
Rural-urban differentials
Country: Asia
Published: SEP 2013
Abstract: Prior studies suggest that infant mortality in the rural areas of India is substantially higher than in urban areas. However, little is known about the determinants explaining such excess of rural mortality. This study systematically assesses the role of socioeconomic and maternal and child health (MCH) care-related programme factors in explaining the rural–urban gap in infant mortality during the past two decades. Long-term changes in rural and urban infant mortality were assessed using Sample Registration System (SRS) data. Population-weighted dispersion measure of infant mortality was applied to estimate the trend in rural–urban difference in infant mortality. Binary logistic regression was used to analyse the association between socioeconomic and MCH care-related programme factors and infant mortality using data from the three rounds of the National Family Health Survey (NFHS). Fairlie’s extension of the Blinder-Oaxaca decomposition technique was applied to understand the relative contribution of different co-variates to the rural–urban gap in infant mortality. The study found that relative inequality with respect to total infant mortality rate has increased although absolute inequality in rural–urban infant mortality rate has decreased. Most of the rural–urban gap in infant mortality can be explained by the distributions of the co-variates in rural and urban area. The biggest part of the rural disadvantage in infant mortality is attributable to the underlying disadvantage in household wealth and maternal education, whereas breastfeeding and knowledge of Oral Rehydration Solution contributed to narrowing the gap. The share of women using modern contraceptive methods and of the percentage of fully vaccinated children in the community also contributed to widening the rural–urban gap in infant mortality. The relative contributions of wealth and maternal education to the rural–urban gap increased from 1992–1993 to 2005–2006.