Burden of disease among under-five children in urban India

Background: India remains one of the highest contributors of under-five deaths in the work, due to huge population base and higher levels of mortality rates in spite of many programmatic efforts. It has been estimated that... [ view full abstract ]

Background: India remains one of the highest contributors of under-five deaths in the work, due to huge population base and higher levels of mortality rates in spite of many programmatic efforts. It has been estimated that nearly half of under-five mortality is attributed to diarrhoeal diseases and acute respiratory infections. This study examines the burden of diarrhoeal diseases and acute respiratory infections (ARI) among urban samples. Further, socioeconomic and regional variations have also been assessed.
Methods: The study is based on 2,68,545 children aged 0-5 years born to women in the age group 15-49 years who participated in the nationally representative District Level Household and Facility Survey conducted in 2007-2008. DLHS collected information on self-reported prevalence of diarrhoea and ARI during the last two weeks preceding the survey and their treatment seeking behaviour. To examine the determinants of diarrhoea and ARI among urban children number of demographic, socioeconomic, regional and contextual factors adjusted in multilevel analysis.
Results: Finding revealed that nearly 12% of children suffered from diarrhoea and nearly 11% from ARI infections at national level. However, huge regional and socioeconomic disparity was evident. For instance, prevalence of diarrhoea was considerably higher in Maharashtra (20%), Haryana (17%) and Uttar Pradesh (16%). Similarly, ARI was higher in West Bengal (25%), Orissa (17%), Uttar Pradesh (17%) and Bihar (15%). Multilevel analysis suggested that individual level characteristics such as women’s education, social group, and household wealth significantly determine likelihood of ARI and diarrhoea among urban children in India. Moreover, study also found community level factors such as poor locality in terms of proportion of household access to clean water and cooking fuel significantly determine diarrhoea and ARI in urban areas.
Conclusion: Finding shows high burden of diarrhoea and ARI among urban Indian children and suggests targeted interventions at policy level.