1887
Volume 2025, Issue 1
  • EISSN: 2220-2749

Abstract

In 2022, 4.9 million children died worldwide before the age of five years. The UN General Assembly has set the target to reduce under-five child mortality rate (U5MR) to 25 deaths per 1,000 live births by 2030. However, the UN Inter-Agency Group for Child Mortality Estimation highlights that, without rapid action, many low and lower middle-income countries may fall short of this target, resulting in the loss of 35 million children under five years of age before 2030. In such a scenario, it is crucial to understand the determinants that contribute to the reduction of preventable child deaths.

Anonymized and publicly accessible data from the Indian National Family Health Survey (NFHS-5) were used. The sample consisted of 724,115 women aged 15–49 years, categorized into urban and rural groups. Data on the number of community daycare centers, or Anganwadi centers, per state were obtained from the Ministry of Women and Child Development. For better analysis of data, the country was divided into regions, with union territories classified according to their geographical locations. Various statistical methods such as descriptive statistical analysis, correlation coefficient, and linear regression analysis were used.

Descriptive analysis showed that Central India had the highest U5MR (49.8%), despite having the second highest number of community daycare centers (74,510) in the country. The Spearman rank correlation analysis showed a significantly large positive relationship between community daycare centers (%) and U5MR ( = 0.521, < 0. 001). Conversely, there was a significantly large negative relationship between women with internet access (%) and U5MR ( = -0.6908, < 0. 001). The results from multiple linear regression showed 0 = 53.6807, 1 = -0.58788, and 2 = 0.77266, with an 2 value of 0.5616 ( = 0). Additionally, simple linear regression analysis for the percentage of community daycare centers along with U5MR in children showed a beta coefficient () of 2.5767 ( < 0. 001), with an 2 value of 0.2938. For the data on internet access to women (%) and U5MR, the beta coefficient () was -0.6759, the value was 0, and the 2 value was 0.5444.

In comparison to the data from NFHS-4 (2015–16), there was a notable decrease in the U5MR in almost all states in the country. The study showed that urban women had greater access to the Internet than rural women. Furthermore, child mortality rates were higher in rural areas than in urban areas in every state. The enhanced access to health information through the Internet for urban women may have contributed to the lower child mortality rates observed in urban settings. Internet access for women at the individual level is significantly more effective in reducing the U5MR than the community-level approach of daycare centers.

Loading

Article metrics loading...

/content/journals/10.5339/avi.2025.2
2025-03-11
2025-03-26
Loading full text...

Full text loading...

/deliver/fulltext/avi/2025/1/avi.2025.2.html?itemId=/content/journals/10.5339/avi.2025.2&mimeType=html&fmt=ahah

References

  1. Under-five mortality [cited 2024 Jul 20]. Available from: https://data.unicef.org/topic/child-survival/under-five-mortality/
  2. Sharrow D, Hug L, You D, Alkema L, Black R, Cousens S, et al.. Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. Lancet Glob Health. 2022Feb; 10:(2):e195–206. https://doi.org/10.1016/S2214-109X(21)00515-5
    [Google Scholar]
  3. Sarkar J, Sarkar C. Role of community infrastructure in improving nutrition in under-five children. J Client-Centered Nurs Care. 2025Jan1; 11:(1):21–32. https://doi.org/10.32598/jccnc.11.1.605
    [Google Scholar]
  4. Status of IMR and MMR in India. [cited 2024 Jul 20]. Available from: https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1796436.
  5. Integrated Child Development ServicesWikimedia Foundation; 2024[cited 2024 Jul 20]. Available from: https://en.wikipedia.org/wiki/Integrated_Child_Development_Services
  6. Total 13.96 lakh Anganwadis registered under the Poshan Tracker Application. [cited 2024 Jul 20]. Available from: https://pib.gov.in/PressReleasePage.aspx?PRID=1943759.
  7. The Internet and Mobile Association of India (IAMAI) and KANTAR. Internet in India report 2022; May2023. Available from: https://www.iamai.in/sites/default/files/research/Internet%20in%20India%202022_Print%20version.pdf
    [Google Scholar]
  8. Brownstein JS, Freifeld CC. HealthMap: the development of automated real-time internet surveillance for epidemic intelligence. Euro Surveill. 2007Nov29; 12:(11):E071129.5. https://doi.org/10.2807/esw.12.48.03322-en
    [Google Scholar]
  9. Tu WC, Xiong WY, Ni DX, Wang ZJ. The establishment of an Internet information-assisted public health surveillance system in China. China Public Health. (2010) 08:3.
    [Google Scholar]
  10. Jiang H, Ding F, Zhu Y, Yang J, Chang J, Mao M, et al.. Survey analysis of 1,788 residents’ perceptions, attitudes, and behaviors toward Internet healthcare. China Digit Med. 2019; 07:4. https://doi.org/10.3969/j.issn.1673-7571.2019.07.014
    [Google Scholar]
  11. Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health. 2020Aug1; 20:(1):1193. https://doi.org/10.1186/s12889-020-09301-4
    [Google Scholar]
  12. Jiang S, Basnyat I, Liu PL. Factors influencing Internet health information seeking in India: An application of the comprehensive model of information seeking. Int J Commun. 2021; 15:22.
    [Google Scholar]
  13. Hallyburton A, Evarts LA. Gender and online health information seeking: a five survey meta-analysis. J. Consum. Health Internet. 2014Apr; 18:(2):128–42. https://doi.org/10.1080/15398285.2014.902268
    [Google Scholar]
  14. Early J, Hernandez A. Digital disenfranchisement and COVID-19: broadband Internet Access as a social determinant of health. Health Promot Pract. 2021Sep; 22:(5):605–10. https://doi.org/10.1177/1524839921101
    [Google Scholar]
  15. Bauerly BC, McCord RF, Hulkower R, Pepin D. Broadband access as a public health issue: The role of law in expanding broadband access and connecting underserved communities for better health outcomes. J Law Med Ethics. 2019Jun; 47:(2_suppl):39–42. https://doi.org/10.1177/1073110519857314
    [Google Scholar]
  16. Sarkar J, Sarkar C. Mapping of public approach towards COVID-19 vaccine for preparedness and resilience of emerging threats to facilitate cross-country systematic roll-out of resources. Preprints 2024;2024021366. https://doi.org/10.20944/preprints202402.1366.v1
    [Google Scholar]
  17. Yu D, Li H, Yu J. Can Internet penetration curb the spread of infectious diseases among regions?—Analysis based on spatial spillover perspective. Front Public Health. 2023Jan26; 11:1038198. https://doi.org/10.3389/fpubh.2023.1038198
    [Google Scholar]
  18. Bach RL, Wenz A. Studying health-related internet and mobile device use using web logs and smartphone records. PLoS ONE. 2020Jun12; 15:(6):e0234663. https://doi.org/10.1371/journal.pone.0234663
    [Google Scholar]
  19. Craig L. Does father care mean fathers share?: a comparison of how mothers and fathers in intact families spend time with children. Gender & Society. 2006Apr; 20:(2):259–81. https://doi.org/10.1177/0891243205285212
    [Google Scholar]
  20. Pandey SK, Hart JJ, Tiwary S. Women’s health and the internet: understanding emerging trends and implications. Soc Sci Med. 2003Jan; 56:(1):179–91. https://doi.org/10.1016/s0277-9536(02)00019-9
    [Google Scholar]
  21. Singh A, Pathak PK, Chauhan RK, Pan W. Infant and child mortality in India in the last two decades: A geospatial analysis. PLoS One. 2011; 6:(11):e26856. https://doi.org/10.1371/journal.pone.0026856
    [Google Scholar]
  22. Kumar C, Piyasa , Saikia N. An update on explaining the rural-urban gap in under-five mortality in India. BMC Public Health. 2022Nov16; 22:(1):2093. https://doi.org/10.1186/s12889-022-14436-7
    [Google Scholar]
  23. Nakayama LF, Binotti WW, Woite NL, Fernandes CO, Alfonso PG, Celi LA, et al.. The digital divide in Brazil and barriers to telehealth and equal digital health care: Analysis of internet access using publicly available data. J Med Internet Res. 2023Jul21: 25:e42483. https://doi.org/10.2196/42483
    [Google Scholar]
  24. Bowen D. Predictors of women’s Internet access and Internet health seeking. Health Care Women Int. 2003Dec; 24:(10):940–51. https://doi.org/10.1080/07399330390244130
    [Google Scholar]
  25. Sarkar J. Are you staying in an age-ready city? [cited 2024 Jul 16]. Available from: https://nopr.niscpr.res.in/bitstream/123456789/60624/1/SR%2059%2810%29%2020-23.pdf.
    [Google Scholar]
  26. Basuroy T. India: Internet penetration rate 2024. 2024[cited 2024 Jul 20]. Available from: https://www.statista.com/statistics/792074/india-internet-penetration-rate/
    [Google Scholar]
  27. Placiszewski K, Wierzba W, Ostrowski J, Pinkas J, Jankowski M. Use of the internet for health purposes – a national web-based cross-sectional survey among adults in Poland. Int J Environ Res Public Health. 2022Dec6; 19:(23):16315. https://doi.org/10.3390/ijerph192316315
    [Google Scholar]
  28. Al-Surimi K, Khalifa M, Bahkali S, El-Metwally A, Househ M. The potential of social media and internet-based data in preventing and fighting infectious diseases: from internet to Twitter. Adv Exp Med Biol. 2017: 972:131–9. https://doi.org/10.1007/5584_2016_132
    [Google Scholar]
  29. Kanchan S, Gaidhane A. Social media role and its impact on Public Health: a narrative review. Cureus. 2023Jan13; 15:(1):e33737. https://doi.org/10.7759/cureus.33737
    [Google Scholar]
  30. Milinovich GJ, Williams GM, Clements ACA, Hu W. Internet-based surveillance systems for monitoring emerging infectious diseases. Lancet Infect Dis. 2014Feb; 14:(2):160–8. https://doi.org/10.1016/S1473-3099(13)70244-5
    [Google Scholar]
  31. Lin J, Yu Z, Wei YD, Wang M. Internet access, spillover and regional development in China. Sustainability. 2017Jun1; 9:(6):946. https://doi.org/10.3390/su9060946
    [Google Scholar]
  32. World Health Organization. Child mortality (under 5 years). World Health Organization; 2022Jan. [cited 2024 Jul 20]. Available from: https://www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-under-5-mortality-in-2020
    [Google Scholar]
  33. Newborn and child health [cited 2024 Jul 20]. Available from: https://www.unicef.org/india/what-we-do/newborn-and-child-health.
  34. Sengar M, Kunwar R, Mishra CP. The efficiency of Anganwadi centers located in rural field practice area of a medical college in North India: data envelopment analysis. Indian J Community Med. 2022Dec14; 47:(4):562–6. https://doi.org/10.4103/ijcm.ijcm_388_22
    [Google Scholar]
  35. Chudasama R, Kadri A, Rangoonwala M, Sheth A, Vala M, Verma P. Evaluation of nutritional and other activities at Anganwadi Centers under Integrated Child Development Services program in different districts of Gujarat, India. J Med Nutr Nutraceuticals. 2015Jul–Dec; 4:(2):101. https://doi.org/10.4103/2278-019x.141543
    [Google Scholar]
  36. Johari A. A new app is failing India’s fight against child malnutrition [Internet]. Scroll.in; 2021[cited 2024 Jul 20]. Available from: https://scroll.in/article/1007521/a-new-app-is-failing-india-s-fight-against-child-malnutrition
    [Google Scholar]
  37. Krishnatri V, Vellakkal S. Does affordable Internet promote maternal and child healthcare access? Evidence from a post-telecommunication market disruption period in India. Telecom Policy. 2024Nov; 48:(10):102872. https://doi.org/10.1016/j.telpol.2024.102872
    [Google Scholar]
  38. Patil SB, Doibale MK. Study of profile, knowledge and problems of Anganwadi workers in ICDS blocks: a cross-sectional study. Online J Health Allied Scs. 2013Aug; 12:(2):1. Available from: http://www.ojhas.org/issue46/2013-2-1.html
    [Google Scholar]
/content/journals/10.5339/avi.2025.2
Loading
/content/journals/10.5339/avi.2025.2
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): Indiainternet usepopulationsustainable development goals and Under-five mortality
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error