IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0211086.html
   My bibliography  Save this article

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

Author

Listed:
  • Jayanta Kumar Bora
  • Rajesh Raushan
  • Wolfgang Lutz

Abstract

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.

Suggested Citation

  • Jayanta Kumar Bora & Rajesh Raushan & Wolfgang Lutz, 2019. "The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    • Handle: RePEc:plo:pone00:0211086
    DOI: 10.1371/journal.pone.0211086
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211086
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0211086&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0211086?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Pradeep Kumar Choudhury, 2015. "Explaining the Role of Parental Education in the Regional Variations in Infant Mortality in India," Asia and the Pacific Policy Studies, Wiley Blackwell, vol. 2(3), pages 544-572, September.
    2. Aparna Mitra & Pooja Singh, 2008. "Trends in literacy rates and schooling among the scheduled tribe women in India," International Journal of Social Economics, Emerald Group Publishing Limited, vol. 35(1/2), pages 99-110, January.
    3. Vikram, Kriti & Vanneman, Reeve & Desai, Sonalde, 2012. "Linkages between maternal education and childhood immunization in India," Social Science & Medicine, Elsevier, vol. 75(2), pages 331-339.
    4. Cleland, John G. & van Ginneken, Jerome K., 1988. "Maternal education and child survival in developing countries: The search for pathways of influence," Social Science & Medicine, Elsevier, vol. 27(12), pages 1357-1368, January.
    5. Shelah Bloom & David Wypij & Monica Gupta, 2001. "Dimensions of women’s autonomy and the influence on maternal health care utilization in a north indian city," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 67-78, February.
    6. S V Subramanian & George Davey Smith & Malavika Subramanyam, 2006. "Indigenous Health and Socioeconomic Status in India," PLOS Medicine, Public Library of Science, vol. 3(10), pages 1-11, October.
    7. Burgard, Sarah, 2004. "Race and pregnancy-related care in Brazil and South Africa," Social Science & Medicine, Elsevier, vol. 59(6), pages 1127-1146, September.
    8. 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.
    9. Subramanian, S.V. & Nandy, S. & Irving, M. & Gordon, D. & Lambert, H. & Smith, G.D., 2006. "The mortality divide in India: The differential contributions of gender, caste, and standard of living across the life course," American Journal of Public Health, American Public Health Association, vol. 96(5), pages 818-825.
    10. Deshpande, Ashwini, 2001. "Caste at Birth? Redefining Disparity in India," Review of Development Economics, Wiley Blackwell, vol. 5(1), pages 130-144, February.
    11. Jayanta Kumar Bora & Rajesh Raushan & Wolfgang Lutz, 2018. "Contribution of Education to Infant and Under-Five Mortality Disparities among Caste Groups in India," VID Working Papers 1803, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna.
    12. Vellakkal, Sukumar & Reddy, Hanimi & Gupta, Adyya & Chandran, Anil & Fledderjohann, Jasmine & Stuckler, David, 2017. "A qualitative study of factors impacting accessing of institutional delivery care in the context of India's cash incentive program," Social Science & Medicine, Elsevier, vol. 178(C), pages 55-65.
    13. Wolfgang Lutz & Endale Kebede, 2018. "Education and Health: Redrawing the Preston Curve," Population and Development Review, The Population Council, Inc., vol. 44(2), pages 343-361, June.
    14. Elsie R. Pamuk & Regina Fuchs & Wolfgang Lutz, 2011. "Comparing Relative Effects of Education and Economic Resources on Infant Mortality in Developing Countries," Population and Development Review, The Population Council, Inc., vol. 37(4), pages 637-664, December.
    15. Chandan Kumar & Prashant Kumar Singh & Rajesh Kumar Rai, 2012. "Under-Five Mortality in High Focus States in India: A District Level Geospatial Analysis," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-15, May.
    16. Premchand Dommaraju & Victor Agadjanian & Scott Yabiku, 2008. "The Pervasive and Persistent Influence of Caste on Child Mortality in India," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 27(4), pages 477-495, August.
    17. Das, Maitreyi Bordia & Kapoor, Soumya & Nikitin, Denis, 2010. "A closer look at child mortality among Adivasis in India," Policy Research Working Paper Series 5231, The World Bank.
    18. Boyle, Michael H. & Racine, Yvonne & Georgiades, Katholiki & Snelling, Dana & Hong, Sungjin & Omariba, Walter & Hurley, Patricia & Rao-Melacini, Purnima, 2006. "The influence of economic development level, household wealth and maternal education on child health in the developing world," Social Science & Medicine, Elsevier, vol. 63(8), pages 2242-2254, October.
    19. Jayanta Kumar Bora & Nandita Saikia, 2018. "Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3: An analysis of the National Family Health Survey of India (NFHS), 2015–2016," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-15, July.
    20. Vani K. Borooah, 2005. "Caste, Inequality, and Poverty in India," Review of Development Economics, Wiley Blackwell, vol. 9(3), pages 399-414, August.
    21. June Y T Po & S V Subramanian, 2011. "Mortality Burden and Socioeconomic Status in India," PLOS ONE, Public Library of Science, vol. 6(2), pages 1-8, February.
    22. Ashwini Deshpande, 2001. "Caste at Birth? Redefining Disparity in India," Review of Development Economics, Wiley Blackwell, vol. 5(1), pages 130-144, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Ghosh, Pritam, 2023. "Determinants and transition of anaemia among under-five children from different social groups in India from 2005–06 to 2015-16," Social Science & Medicine, Elsevier, vol. 320(C).
    2. Patel, Priyanka & Kumar, Kaushalendra & Singh, Mayank & Kumar Yadav, Ajit, 2020. "Sex differentials in under five mortality in India in last two decades: Evidence from pooled NFHS data," Children and Youth Services Review, Elsevier, vol. 118(C).
    3. Swati Dutta, 2022. "Risk factors for child survival among tribal dominated states in India: a pooled cross sectional analysis," Journal of Population Research, Springer, vol. 39(3), pages 391-416, September.
    4. Aashish Gupta & Nikkil Sudharsanan, 2022. "Large and Persistent Life Expectancy Disparities between India's Social Groups," Population and Development Review, The Population Council, Inc., vol. 48(3), pages 863-882, September.
    5. Raj Panda & Pradeep Guin & Kumar Gaurav, 2020. "Governance in Public Purchasing of Tertiary-Level Health Care: Lessons From Madhya Pradesh, India," SAGE Open, , vol. 10(3), pages 21582440209, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jayanta Kumar Bora & Rajesh Raushan & Wolfgang Lutz, 2018. "Contribution of Education to Infant and Under-Five Mortality Disparities among Caste Groups in India," VID Working Papers 1803, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna.
    2. Swati Dutta, 2022. "Risk factors for child survival among tribal dominated states in India: a pooled cross sectional analysis," Journal of Population Research, Springer, vol. 39(3), pages 391-416, September.
    3. Abhishek Singh & Praveen Kumar Pathak & Rajesh Kumar Chauhan & William Pan, 2011. "Infant and Child Mortality in India in the Last Two Decades: A Geospatial Analysis," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-19, November.
    4. Jayanta Kumar Bora & Nandita Saikia, 2018. "Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3: An analysis of the National Family Health Survey of India (NFHS), 2015–2016," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-15, July.
    5. Neha Agarwal & Anaka Aiyar & Andrew Bergmann & Joseph Cummins & Jingyan Guo & Vaishali Jain, 2024. "Caste Differences in Child Growth: Disentangling Endowment and Investment Effects," Working Papers 202401, University of California at Riverside, Department of Economics.
    6. Premchand Dommaraju & Victor Agadjanian & Scott Yabiku, 2008. "The Pervasive and Persistent Influence of Caste on Child Mortality in India," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 27(4), pages 477-495, August.
    7. Mehtabul Azam, 2012. "A distributional analysis of social group inequality in rural India," Journal of International Development, John Wiley & Sons, Ltd., vol. 24(4), pages 415-432, May.
    8. Ira N. Gang & Kunal Sen & Myeong-Su Yun, 2006. "Poverty in Rural India: Ethnicity and Caste," Departmental Working Papers 200634, Rutgers University, Department of Economics.
    9. Ajmer, Sumela & Rahaman, Margubur & Rana, Md Juel & Sheikh, Illias, 2023. "Contextualising under-five deaths in Bihar, India: Insights from primary and secondary data," Children and Youth Services Review, Elsevier, vol. 144(C).
    10. Chandan Kumar & Prashant Kumar Singh & Rajesh Kumar Rai, 2012. "Under-Five Mortality in High Focus States in India: A District Level Geospatial Analysis," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-15, May.
    11. Hari Bapuji & Snehanjali Chrispal, 2020. "Understanding Economic Inequality Through the Lens of Caste," Journal of Business Ethics, Springer, vol. 162(3), pages 533-551, March.
    12. Chen, Hung-Ju & Sultana, Rezina, 2013. "Job Reservation and Intergenerational Transmission of Preferences," MPRA Paper 45036, University Library of Munich, Germany.
    13. Kshitij Chaudhary, 2015. "The effect of political decentralisation and affirmative action on Multidimensional Poverty Index: evidence from Indian States," Journal of Social and Economic Development, Springer;Institute for Social and Economic Change, vol. 17(1), pages 27-49, April.
    14. Ira N. Gang & Kunal Sen & Myeong-Su Yun, 2017. "Is Caste Destiny? Occupational Diversification among Dalits in Rural India," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 29(2), pages 476-492, April.
    15. Regina Fuchs & Elsie Pamuk & Wolfgang Lutz, 2010. "Education or wealth: which matters more for reducing child mortality in developing countries?," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 8(1), pages 175-199.
    16. Zacharias, Ajit & Vakulabharanam, Vamsi, 2011. "Caste Stratification and Wealth Inequality in India," World Development, Elsevier, vol. 39(10), pages 1820-1833.
    17. Subramanian, S.V. & Subramanyam, Malavika A. & Selvaraj, Sakthivel & Kawachi, Ichiro, 2009. "Are self-reports of health and morbidities in developing countries misleading? Evidence from India," Social Science & Medicine, Elsevier, vol. 68(2), pages 260-265, January.
    18. Susanna M Makela & Rakhi Dandona & T R Dilip & Lalit Dandona, 2013. "Social Sector Expenditure and Child Mortality in India: A State-Level Analysis from 1997 to 2009," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-10, February.
    19. Gracia De Renteria, Pilar & Ferrer Perez, Hugo & Philippidis, George & Sanjuan Lopez, Ana Isabel, 2021. "Capturing the drivers of social SDGs: An econometric analysis of the dimensions of health and education," Conference papers 333271, Purdue University, Center for Global Trade Analysis, Global Trade Analysis Project.
    20. Bharathi, Naveen & Malghan, Deepak & Rahman, Andaleeb, 2018. "Isolated by Caste: Neighbourhood-Scale Residential Segregation in Indian Metros," SocArXiv 9ynpz, Center for Open Science.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0211086. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.