Moradhvaj Dhakad, Austrian Academy of Science
Samir KC, IIASA
India, along with Nigeria, accounted for almost a third of under-five deaths globally. The under-five mortality (U5M) was constantly higher in the rural areas. Previous studies recognized mother education as a primary indicator for reducing U5M; however, no study examined rural-urban trends by mothers' educational attainment. Using the Sample Registration Survey and four rounds of National Family Health Surveys (NFHS-1, II, III, IV), we analyzed the rural-urban differences in U5M rates across the regions and by mother education level during 1991-92 to 2015-16. Multilevel Cox-proportional Hazard model used to understand rural-urban differences in U5M after controlling for mothers' socioeconomic characteristics, reproductive behavior, and community and state-level socioeconomic status, public health facilities. Results suggest that U5M rate remained higher in rural areas across the region during study period. U5M rates are higher among the children born to low educated mothers across the NHFS rounds; however, difference reduced during NHFS-IV. Regression results suggest the rural-urban differences disappear after controlling for significant predictors, and surprisingly, the risk of U5M becomes higher in urban areas. The impact of a mother's educational attainment differs between rural-urban; child born to a mother is more advantageous in the urban setting than in the rural parts of India.