Epidemiol Health.  2016;38:e2016006. 10.4178/epih.e2016006.

Ecological context of infant mortality in high-focus states of India

  • 1Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, India.
  • 2Population Council, New Delhi, India. ashishatbhu@gmail.com
  • 3Public Health Foundation of India, Gurgaon, Haryana, India.


This goal of this study was to shed light on the ecological context as a potential determinant of the infant mortality rate in nine high-focus states in India.
Data from the Annual Health Survey (2010-2011), the Census of India (2011), and the District Level Household and Facility Survey 3 (2007-08) were used in this study. In multiple regression analysis explanatory variable such as underdevelopment is measured by the non-working population, and income inequality, quantified as the proportion of households in the bottom wealth quintile. While, the trickle-down effect of education is measured by female literacy, and investment in health, as reflected by neonatal care facilities in primary health centres.
A high spatial autocorrelation of district infant mortality rates was observed, and ecological factors were found to have a significant impact on district infant mortality rates. The result also revealed that non-working population and income inequality were found to have a negative effect on the district infant mortality rate. Additionally, female literacy and new-born care facilities were found to have an inverse association with the infant mortality rate.
Interventions at the community level can reduce district infant mortality rates.


Infant mortality; Spatial analysis; Ecological; India
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