Does Context Matter? Factors influencing Neonatal Deaths in Rural North Indian (EAG) States: Hierarchical Linear Modeling Approach

Abstract

United Nations Millennium Development Goal (MDG) for 2015 aims at reducing child mortality level from its level in 1990 by two-thirds. India has disproportionate burden of infant and child deaths. In India approximately two thirds of all the infant deaths are neonatal deaths. India achieves the MDG target of reduction in child mortality levels or not hinges largely on the progress made in the demographically poor performing states of undivided Bihar, Madhya Pradesh, Uttar Pradesh, Rajasthan and Odisha. Finding shows that neonatal deaths in pregnant mothers receiving Tetanus Toxid injections during the antenatal care visits is way less compared those who did not receive the TT injections. High levels of intra-class correlation indicate clustering of deaths. Fifty percent of the variations in neonatal deaths are due to between community differences. These community level differences are not captured well in the available dataset. The community distance to primary health facility used to study the variations at the community level do not have significant impact in explaining the differences in neo natal deaths at community level in the selected States.