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Pauses and Reversals of Infant Mortality Decline in 2017 and 2018
This note examines recent trends in infant mortality in India, based on summary reports from the Sample Registration System. We find evidence of slowdown, pauses, and reversals in infant mortality decline in large parts of India in 2017 and 2018. In urban areas, the infant mortality rate stagnated at 23 deaths per 1,000 births between 2016 and 2018. Worse, overall infant mortality increased in the poorer states of Chhattisgarh, Jharkhand, Madhya Pradesh, and Uttar Pradesh. One possible interpretation of these findings is that the demonetisation experiment in late 2016 and the subsequent economic slowdown had an adverse effect on child health.
The authors are grateful to Jere Behrman, Pritha Chatterjee, Diane Coffey, Patrick Gerland, Michel Guillot, Payal Hathi, Avinash Kishore, Nikhil Srivastav, Nikkil Sudharsanan, Sangita Vyas, and Anumeha Yadav for helpful comments and suggestions. Aashish Gupta was supported by the IUSSP CRVS fellowship.
In a historical perspective, the last few decades have been a time of rapid health improvements in developing countries (Deaton 2013; Hill 1991; Rosling et al 2019). In India, for instance, 129 out of every 1,000 infants died before reaching their first birthday in 1971, when the Sample Registration System (SRS) started monitoring mortality (ORGI 2016a). Four decades later, in 2011, infant mortality had declined to about 44 deaths per 1,000 live births. However, these improvements are not continuous or automatic. Pauses and even reversals in mortality decline have been observed.1 In this article, we present evidence of slowdown, pauses, and reversals of infant mortality decline in large parts of India in 2017 and 2018, the last two years for which SRS data is available.
The SRS is a country-wide survey which tracks vital events in a panel of villages and urban blocks (Mahapatra 2017). Annual estimates of infant mortality from the SRS are representative at the national level and for the larger states. Since individual-level data from the SRS is not available to researchers, we follow the previous literature (Canudas-Romo et al 2016; Drèze and Sen 2015; Saikia et al 2010) and use reported infant mortality rates from annual reports, bulletins, and compendiums published by the SRS (ORGI 2016a, 2020). The most recent estimates in the public domain are for 2018.
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