Association of child survival with birth size and mother’s BMI: a human right approach

Abstract

Purpose Children are the most vulnerable group owing to long lasting impact of the violation of human rights in term of proper nutrition and their right to live. The purpose of this paper is to assess the risk of child mortality associated with size of child at birth and mother’s anemia level in northern India. Design/methodology/approach The data were used from 2015–2016 National Family Health Survey (NFHS). The participants (n = 41,412) were children aged under-five years from north Indian state of Uttar Pradesh. The main outcome measure was child deaths defined by under-five mortality. The univariate, bivariate and multivariate analyses were used in data analysis. Kaplan–Meier analyses, Log-rank tests and Cox’s regression analyses were performed to fulfill the objective of the study. Findings There were a total of 2,835 deaths out of 41,412 births in the past five years preceding the survey period. Children of very small size at birth were significantly two and half times more likely to die than children of average size at birth. The estimated adjusted hazard ratio indicated that the children of severely anemic mothers were significantly 1.5 times more likely to die compared to children of not anemic mothers. Size of child at birth, mother’s anemia level, mother’s age at time of her first birth, wealth index and mother’s education were significantly associated with the under-five mortality in northern India. Research limitations/implications The limitation of this study is recall errors arising from the dates of birth and death given by women interviewed in the survey were minimized by restricting the analyses to births within the five-year period preceding the survey. Practical implications This study advocates the promotion of comprehensive prevention strategies through appropriate institutional mechanism would be the best intervention or adaptive mechanism to reduce the adverse impact of size of child at birth, mother’s anemia level on under-five mortality in Uttar Pradesh, India. Originality/value This research is original. This study enjoys a unique importance by exploring effect of size of child at birth and mother’s anemia on child survival in developing countries like India.