- E-ISSN: 2220-2749
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oa Comparative analysis of individual-level and community-level approaches for achieving sustainable development goals for under-five mortality rate
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المؤلفون:
Jaimini Sarkar1
and Chiradeep Sarkar2
- المصدر: Avicenna, Volume 2025, Issue 1, يونيو ٢٠٢٥, 2
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- ١٤ ديسمبر ٢٠٢٤
- ١٩ يناير ٢٠٢٥
- ١١ مارس ٢٠٢٥
Background: 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.
Design: 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.
Results: 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 (r = 0.521, p < 0. 001). Conversely, there was a significantly large negative relationship between women with internet access (%) and U5MR (r = -0.6908, p < 0. 001). The results from multiple linear regression showed b0 = 53.6807, b1 = -0.58788, and b2 = 0.77266, with an R2 value of 0.5616 (p = 0). Additionally, simple linear regression analysis for the percentage of community daycare centers along with U5MR in children showed a beta coefficient (b) of 2.5767 (p < 0. 001), with an R2 value of 0.2938. For the data on internet access to women (%) and U5MR, the beta coefficient (b) was -0.6759, the p value was 0, and the R2 value was 0.5444.
Conclusion: 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.
