Contribution of Education to Infant and Under-Five Mortality Disparities among Caste Groups in India

The level of infant and under-five mortality is high among scheduled castes (SCs) and scheduled tribes (STs) in India. This study intends to quantify the contribution of education in explaining the gap in infant and under-five mortality between SCs/STs and non-SC/ST population in India with a special focus on the effect of maternal education. We used data from three rounds of National Family Health Survey (NFHS): 1992–93, 1998–99 and 2005–06. The synthetic cohort probability approach using full birth histories was used to estimate childhood mortality. We performed binary logistic regression analysis to examine the association of infant mortality (IM) and under-five mortality (U5M) with maternal education and selected other covariates. Further, we applied Fairlie's decomposition technique to understand the relative contribution of maternal education and other covariates on IM and U5M risk between the caste groups. The IM rate (IMR) among children born to illiterate mothers is about 3 times higher than those born to mothers with higher education across all caste groups. Similarly, the U5M rate (U5MR) is 5 times higher among ST population and 3 times higher among SC population during the 14-year observation period (1992–2006). The proportions of secondary and higher educated SC and ST mothers are relatively lower than among non-SC/ST mothers. The regression analysis shows that mother’s education has a statistically significant effect on reducing IM and U5M. A number of socio-economic covariates are found associated with IM and U5M; such as father’s education, mother’s age at first birth, mother’s work status, household wealth, exposure to media and socio-economic empowerment of the mother. A decomposition analysis shows that more than 90 percent of the gap in IM and U5M between social groups is explained by the differences in the distribution of maternal education and household wealth. The findings of this study emphasise the need to provide education to disadvantaged girls and health counselling to women, particularly among SC/STs with more focus on backward regions or states, to further reduce IM and U5M in India