Intensifying Infant Mortality Inequality in India and a Reversal by Policy Intervention

Abstract

The adverse sex ratio, a feature of India, is an outcome of two forms of inequality; natal inequality through sex-selective abortion, and mortality inequality. The analysis of trends in mortality inequality at the infant stage, which is the subject of this paper, in the rural and urban areas of 15 major Indian states reveals that overall mortality inequality has intensified. This is particularly the case in the developed states, accounting for a large proportion of the foregone reduction in the infant mortality rate. However, the trend in Tamil Nadu state points to a reversal in mortality inequality in recent years on account of multi-pronged policy interventions by the state government, which are aimed at protecting the girl child. The political-will of the party in power during 1991-1996 and 2001-2006 in Tamil Nadu points the way for the rest of the nation, and is possibly the way for India to achieve the Millennium Development Goal with respect to the infant mortality rate.Infant mortality rate, Natal inequality, Mortality inequality, Sex ratio, Girl child protection, Cradle baby scheme,

Determinants of neonatal mortality in rural India, 2007–2008

“…A review of past studies on this issues reveals that although there are many studies examining the factors affecting neonatal mortality available elsewhere in the world (Bhutta et al, 2005; Titaley et al, 2008; Shakya & McMurray, 2001; Samms-Vaughan, McCaw-Binns & Foster-Williams, 1990; Machado & Hill, 2003; Mahmood, 2004; Rahman & Abidin, 2010; Diallo et al, 2010), the issue seems to be understudied in India. Although there is a large body of literature available describing levels, trends and differentials in infant and child mortality at national and sub-national level (Jain, 1985; Gupta, 1990; Simmons et al, 1982; Narayana, 2008; Subramanian et al, 2006; Pradhan & Arokiasamy, 2010; Joe, Mishra & Navaneetham, 2010; Behl, 2012; Bhattacharya & Chikwama, 2011; Pandey et al, 1998), existing studies on neonatal mortality are generally limited to small geographical areas (Arokiasamy & Gautam, 2008; Kumar et al, 2013; Bapat et al, 2012; Singh, Yadav & Singh, 2012). This study, therefore, aims to examine the effect of various determinants – socio-demographic, economic, healthcare, and community – on neonatal mortality in rural India.…”

Ensuring Daughter Survival in Tamil Nadu, India

“…In the context of an examination of country-wide patterns in gender differences in infant mortality, Narayana (2008) analyses the case of Tamil Nadu and suggests that policy interventions such as the Cradle Baby Scheme and social awareness campaigns have played an important role in reducing gender differences in infant mortality. Our article extends Narayana's exploratory analysis in several ways and has two aims.…”

“…Theni (43 points accompanied by an increase in deficit in other districts, the overall message is one of declining post-birth daughter deficit (see also Narayana, 2008).…”

“…7 Narayana (2008) relies only on the 1998 round of the Vital Events Survey (VES) and focuses on gender differences in infant mortality. In contrast, we use five editions of the VES data covering the birth years 1996 to 2003 to examine gender differences in both infant mortality and sex ratios at birth.…”

Understanding Policy and Programming on Sex-Selection in Tamil Nadu: Ethnographic and Sociological Reflections

“…Such intensive public health intervention accompanied by some punitive action had earlier led the Tamil Nadu government (as well as some demographers) to claim that female infanticide had been controlled, as evidenced by a sharp decrease in female infant mortality rates as well as an improvement of child sex ratios in some regions of Tamil Nadu (see Narayana 2008). Srinivasan and Bedi (2012) have offered a similar argument wherein they suggest that state and NGO interventions seem to have played an important role in improving the child sex ratio (0-6 years) in Tamil Nadu.…”