The persistent caste divide in India’s infant mortality: A study of Dalits (ex-untouchables), Adivasis (indigenous peoples), Other Backward Classes, and forward castes

Ram, Bali; Singh, Abhishek; Yadav, Awdhesh

doi:10.25336/p62c8f

Cited by 14 publications

(15 citation statements)

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“…Thus, our study reconfirms that children belonging to deprived castes are still in a disadvantaged position in terms of mortality outcomes. These findings are consistent with those of previous national and sub-national studies [16,17,21,42]. Our results also indicate that the U5MR of the SC/ST population at district level is higher than that of the non-SC/ST population.…”

Section: Discussionsupporting

confidence: 93%

“…In general, previous studies showed that children belonging to disadvantaged castes such as SCs/STs experience a higher likelihood of death compared to children belonging to non-deprived castes. It has also been found that caste differences in infant and child mortality are substantially reduced when parental socioeconomic characteristics are held constant [21]. In a recent study by Ranjan et al (2016) [25], the authors concluded that the gap in infant mortality between tribal and non-tribal populations was substantial in the early months after birth, narrowed between the fourth and eighth months, and grew after that.…”

Section: Introductionmentioning

confidence: 99%

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The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states

2019

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Objective Although under-five mortality rate (U5MR) is declining in India, it is still high in a few selected states and among the scheduled caste (SC) and scheduled tribe (ST) population of the country. This study re-examines the association between caste and under-five deaths in high focus Indian states following the implementation of the country’s National Rural Health Mission (NRHM) program. In addition, we aim to quantify the contribution of socioeconomic determinants in explaining the gap in under-five death risk between the SC/ST population and non-SC/ST population in high focus states in India. Data and method Using data from the National Family Health Survey (NFHS), we calculated the U5MR by applying a synthetic cohort probability approach. We applied a binary logistic regression model to examine the association of under-five deaths with the selected covariates. Further, we used Fairlie's decomposition technique to understand the relative contribution of socioeconomic variables on under-five death risk between the caste groups. Findings In high focus Indian states, the under-five mortality risk between well-off and deprived caste children has declined in the post-NRHM period, indicating a positive impact in terms of reducing caste-based inequalities in the high focus states. Despite the reduction in under-five death risk, children belonging to the SC population experience higher mortality rates than children belonging to the non-SC/ST population from 1992 to 2016. Both macro level (district level mortality rates) and individual (regression analysis) analyses showed that children belonging to SCs experience the highest likelihood of dying before their fifth birthday. A decomposition analysis revealed that 83% of the caste-based gap in the under-five deaths is due to the distribution of women’s level of educational attainment and household wealth between the SC/ST and non-SC/ST population. Program indicators such as place of birth and number of antenatal care (ANC) visit also contributed significantly to widening caste-based gaps in U5MR. Conclusion The study indicates that there is still room to improve access to health facilities for mothers and children belonging to deprived caste groups in India. Continuous efforts to raise the level of maternal education and the economic status of people belonging to deprived caste groups should be pursued simultaneously.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states

2019

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“…In India, both caste and religion are strongly associated with infant mortality. In spite of numerous social welfare measures, children from lower castes and who are indigenous remain highly susceptible to mortality risks (Ram et al, 2016). This could be due to either their lower socioeconomic status or discriminatory practices on the part of medical professionals.…”

Section: Methodsmentioning

confidence: 99%

Birth Order, Stage of Infancy and Infant Mortality in India

Mishra¹,

Ram

Singh

et al. 2017

J. Biosoc. Sci.

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SummaryUsing data from India's National Family Health Survey, 2005-06 (NFHS-3), this article examines the patterns of relationship between birth order and infant mortality. The analysis controls for a number of variables, including mother's characteristics such as age at the time of survey, current place of residence (urban/rural), years of schooling, religion, caste, and child's sex and birth weight. A modest J-shaped relationship between birth order of children and their risk of dying in the neonatal period is found, suggesting that although both first- and last-born children are at a significantly greater risk of dying compared with those in the middle, last-borns (i.e. fourth and higher order births) are at the worst risk. However, in the post-neonatal period first-borns are not as vulnerable, but the risk increases steadily with the addition of successive births and last-borns are at much greater risk, even worse than those in the neonatal period. Although the strength of relationship between birth order and mortality is attenuated after the potential confounders are taken into account, the relationship between the two variables remains curvilinear in the neonatal period and direct in the post-neonatal period. There are marked differences in these patterns by the child's sex. While female children are less prone to the risk of dying in the neonatal period in comparison with male children, the converse is true in the post-neonatal period. Female children not only run higher risks of dying in the post-neonatal period, but also become progressively more vulnerable with an increase in birth order.

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“…The association between caste and child mortality is well documented (Das et al, 2010;Dommaraju et al, 2008;Mohindra et al, 2006;Nguyen et al, 2013;Po and Subramanian, 2011;Ram et al, 2017;Sahu et al, 2015;Singh-Manoux et al, 2008;Subramanian et al, 2006aSubramanian et al, , 2006b. In general, these studies find that caste differences in infant and child mortality are substantially reduced after parental socio-economic characteristics are held constant (Ram et al, 2017).…”

Section: Introductionmentioning

confidence: 95%

Contribution of Education to Infant and Under-Five Mortality Disparities among Caste Groups in India

Bora¹,

Raushan²,

Lutz³

2021

VID

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The level of infant and under-five mortality is high among scheduled castes (SCs) and scheduled tribes (STs) in India. This study intends to quantify the contribution of education in explaining the gap in infant and under-five mortality between SCs/STs and non-SC/ST population in India with a special focus on the effect of maternal education. We used data from three rounds of National Family Health Survey (NFHS) : 1992-93, 1998-99 and 2005-06. The synthetic cohort probability approach using full birth histories was used to estimate childhood mortality. We performed binary logistic regression analysis to examine the association of infant mortality (IM) and under-five mortality (U5M) with maternal education and selected other covariates. Further, we applied Fairlie's decomposition technique to understand the relative contribution of maternal education and other covariates on IM and U5M risk between the caste groups. The IM rate (IMR) among children born to illiterate mothers is about 3 times higher than those born to mothers with higher education across all caste groups. Similarly, the U5M rate (U5MR) is 5 times higher among ST population and 3 times higher among SC population during the 14-year observation period (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). The proportions of secondary and higher educated SC and ST mothers are relatively lower than among non-SC/ST mothers. The regression analysis shows that mother's education has a statistically significant effect on reducing IM and U5M. A number of socio-economic covariates are found associated with IM and U5M; such as father's education, mother's age at first birth, mother's work status, household wealth, exposure to media and socio-economic empowerment of the mother. A decomposition analysis shows that more than 90 percent of the gap in IM and U5M between social groups is explained by the differences in the distribution of maternal education and household wealth. The findings of this study emphasise the need to provide education to disadvantaged girls and health counselling to women, particularly among SC/STs with more focus on backward regions or states, to further reduce IM and U5M in India.

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The persistent caste divide in India’s infant mortality: A study of Dalits (ex-untouchables), Adivasis (indigenous peoples), Other Backward Classes, and forward castes

Cited by 14 publications

References 38 publications

The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states

The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states

Birth Order, Stage of Infancy and Infant Mortality in India

Contribution of Education to Infant and Under-Five Mortality Disparities among Caste Groups in India

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