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Ujjwal Das Research Scholar, International Institute for Population Sciences, Mumbai, India
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Abstract: Prior study suggested that Socio-economic factors impact on child health and survival through the proximate determinants. The present study makes an attempt to examine the trends, patterns and the determinants of socio-economic factor affect Under-five mortality in the state of Odisha. The long term change of under-five mortality in Odisha was assessed by the annual publication of Sample Registration System (SRS) data. The Cox proportional hazard model was used for determine the socio-economic factor affecting of mortality on the fourth round the National Family Health Survey (NFHS) data. and finally Fairlie‘s decomposition technique was applied for identify factors affecting change in under-five mortality in two periods. The results suggest that low birth weight and female education play the dominant role for increasing the under-five mortality in Odisha. The disadvantage of health care facility is major cause of high under-five mortality in disadvantage districts (western, southern) of the Odisha. Considerably higher rate mortality in the area indicates that an unequal wealth quintile and different distribution use of resources by type of residence.
Keywords: proximate determinants; Cox proportional hazard; Fairlie‘s decomposition; low birth; wealth
I. INTRODUCTION
Childhood is a significant stage of life and deprivation during this period can have a long-term adverse impact on the wellbeing of children. Reduction of under-five morality was one of millennium development goals, as children are the most important assets of a nation. The decline of under-five mortality is therefore not only desirable but also indicative of an improvement in general living standards. This improvement in child survival was associated with positive changes in socioeconomic status of people. The under-five mortality rate (U5MR) is defined as the—probability of children death under age of age five expressed per 1000 live-births. In India, 2.1 million children die before reaching their fifth birthday. Half of these children die even before they are 28 days old, accounting for one-fourth global infant deaths. Of the 9.7 million child deaths worldwide annually, one-third occur in India. Even so, Indian children are still experiencing very high mortality risk compared with children in many other developing countries. The mortality rate for children less than five years of age is currently noted 50 per 1000 live births (National Family Health Survey, 2015–16).According to WHO (2015), the major causes of under-five death are prematurity, congenital sepsis, pneumonia, malaria, and birth complications. These conditions are related to socioeconomic factors, such as poverty, absence of education in mothers, and children born in rural areas. The level of under-five mortality is one of the most revealing actions of how well as society meet the needs of its people, and that child mortality shows how well Governments distribute assailable resource for health education, food distribution, sanitation enhancement of the status of woman and other priorities in public spending. The International Conference on Primary Health Care held in Alma Ata in 1978 was the first global conference to mentioned that how child mortality can be reduced by the systematic development of a primary health care system. And ICPD held in Cairo in 1994 incorporates the reduction of maternal and child mortality. U5MR varies largely across the states of India. The demographically less advanced states of Bihar, Madhya Pradesh, Uttar Pradesh, Rajasthan and Odisha have the highest levels of under-five mortality. Under-five mortality needs a closer look when it comes to Odisha because Odisha is among the EAG states that whose health condition very worse, due to bad socio-economic particularly in poverty. Odisha is also the most poverty-stricken state of India, with 47% of household living below the poverty line as against 43% in Bihar, 31% in Uttar Pradesh, 37% in Madhya Pradesh, 15% in Rajasthan and 26% for India as a whole (Arokiasamy, 2006). Similarly mortality situation in this state is relatively higher than the any other states. In Odisha, the infant mortality rate is 42 per 1000 live birth while under-five mortality rates are 50 per 1000 live births and in 2016 (SRS). The prior’s studies found that underfive mortality is determined by the demographic and socio-economic factors. The socio-economic factors like that poverty, level of parental education, place of residence, occupations, income, and sanitation (source of drinking water and toilet used by a household) and demographic factors, such as women's age at birth of the children, birth order and birth interval, are the leading causes of children’s under-five age of death.
