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Impact of National Health Mission on infant mortality in India: An interrupted time series analysis

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Listed:
  • Shankar Prinja
  • Atul Sharma
  • Ruby Nimesh
  • Vineeta Sharma
  • K Madan Gopal
  • Nina Badgaiyan
  • PVM Lakshmi
  • Madhu Gupta

Abstract

Government of India introduced National Rural Health Mission in 2005—now transformed into National Health Mission (NHM), to bring about architectural reforms in health sector. In this study, we evaluate the overall impact of NHM on infant mortality at national and state level. Annual data on infant mortality rate (IMR) from 1990 to 2016 were obtained from Sample Registration System bulletins. With reporting year 2009 considered as cut‐off point, a two‐step segmented time series regression analysis was conducted. Estimates of pre‐slope, post‐slope and change at the point of intervention were computed by applying auto‐regressive integrated moving average (1, 0, 0) while adjusting for trend and auto correlation. We found that while IMR reduced from around 80 to 34 per 1000 live births at the national level from 1990 to 2016, the annual rate of reduction increased from 1.6 per 1000 live births before NHM to 2.2 per 1000 live births after NHM. This is estimated to have averted 248,212 infant deaths in India, between 2005 and 2017. The rate of decline in IMR accelerated in 13 out of 17 larger states, most significantly in Andhra Pradesh, Gujarat, Assam, Haryana, Punjab and Uttar Pradesh. NHM has thus been successful in accelerating the overall rate of reduction in IMR in India. There is still a need to identify the determinants of variations at state level. We recommend strengthening of NHM in terms of funding and implementation.

Suggested Citation

  • Shankar Prinja & Atul Sharma & Ruby Nimesh & Vineeta Sharma & K Madan Gopal & Nina Badgaiyan & PVM Lakshmi & Madhu Gupta, 2021. "Impact of National Health Mission on infant mortality in India: An interrupted time series analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(4), pages 1143-1152, July.
    • Handle: RePEc:bla:ijhplm:v:36:y:2021:i:4:p:1143-1152
    DOI: 10.1002/hpm.3166
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    References listed on IDEAS

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    1. M. Govinda Rao & Choudhury, Mita, 2012. "Health Care Financing Reforms in India," Working Papers 12/100, National Institute of Public Finance and Policy.
    2. Nandita Saikia & Abhishek Singh & Domantas Jasilionis & Faujdar Ram, 2013. "Explaining the rural-urban gap in infant mortality in India," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 29(18), pages 473-506.
    3. Choudhury, Mita & Mohanty, Ranjan Kumar, 2018. "Utilisation, Fund Flows and Public Financial Management under the National Health Mission," Working Papers 18/227, National Institute of Public Finance and Policy.
    4. Seema Jayachandran & Adriana Lleras-Muney, 2009. "Life Expectancy and Human Capital Investments: Evidence from Maternal Mortality Declines," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(1), pages 349-397.
    5. Shankar Prinja & Pankaj Bahuguna & Rakesh Gupta & Atul Sharma & Saroj Kumar Rana & Rajesh Kumar, 2015. "Coverage and Financial Risk Protection for Institutional Delivery: How Universal Is Provision of Maternal Health Care in India?," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-15, September.
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