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Infant mortality differentials among the tribal and non-tribal populations of Central and Eastern India

use of health care services such as ante-natal care (Sastry, 1997b; Ramalingaswami, Jonsson, and
Rohde, 1996; Measham, Rao, Jamison et. al. 1999; Gragnolati, Shekar, Das Gupta et al. 2005; Nair,
2007; Virmani, 2007; Sharma, Sarangi, Kanungo et al., 2009; Gaiha, Kulkarni, Pandey et al., 2011;
Sahu, Nair, Singh et al., 2015). Educated women are not only likely to earn more — thus, improving
living conditions for the children at home — but also likely to assert more control over household
resources and spend for their children (Caldwell, 1993). Educated mothers are also more likely to
take their children to health centers when ill and regulate their own reproductive behavior (Cleland
and Van Ginneken, 1988; Das Gupta, 1990; Martin and Juarez, 1995). All these advantages could
make a difference in infant mortality. Due to its very small proportion within tribes, infants born to
women with high school level education or above did not experience a significant protection in sur-
vival compared to those born to illiterate women. However, among non-tribes, education of the
mother did not play a significant role in affecting the survival of infants. This result is unexpected,
and is possibly because of the following reasons. Firstly, the quality of education in the central and
eastern Indian region is very poor, which leads to poor educational outcomes even among educated
women; also, women still remain superstitious and follow home-based child care rather than scien-
tific-based care. Secondly, due to homogeneity in the socio-economic environment, the attitude
and behavior of both educated and uneducated women in child rearing are hardly different. Thirdly,
women who approach healthcare centers for their children are driven mostly by the experience of
older women of the household instead of education.
We found relatively higher infant survival for higher order births among tribes. One possible rea-
son could be that for initial births, tribal women strictly followed their own traditional customs, ri-
tuals, and norms; but later on, for higher order births they utilized their own experience gained in
previous child care and even relaxed some of their traditional beliefs, which led to better child sur-
vival prospects (Das Gupta, 1990). On the other side, for non-tribes there is no significant influence
of higher order births on infant survival. Few earlier studies highlighted that after controlling for
factors such as mother’s age and child’s birth weight, the child’s birth order does not affect its mor-
tality for the first six months of life (DaVanzo, Butz, and Habicht, 1983). This could be because
women’s behavior towards postnatal child care and utilization of modern health care facilities does
not change for higher order births (Miller, Trussell, Pebley et al., 1992; Bhalotra and van Soest,
2008).
The strength of the present paper is the comparison of factors associated with infant
mortality between tribal and non-tribal populations in Central and Eastern India. The theme on
differentials in infant mortality between tribal and non-tribal populations is understudied in the
existing literature. By using a recent survey dataset with a relatively large sample size and inclusion
of major characteristics of the household/community, the mother, and the infant, we examined
factors that contribute to the difference in infant mortality among these tribes and non-tribes.
Because of these unique features, we argue that our results are robust. However, as we did not
perform separate analysis for SCs from other classes of non-tribes, some associations may be mixed.
Research on separation analysis will likely provide new insights on this issue.
Our findings could have important implications. The present study tries to raise a few issues af-
fecting the infant mortality among both tribes and non-tribes. Overall, our study implies that the dif-
ferentials in the situation faced by mothers and infants/children of the tribal and non-tribal popula-
tions need quick actions by both the government and the health industry sector so that the differen-
tials in child mortality risk could be reduced. Our research further emphasizes the need to ensure
accessibility and affordability in health services utilization for all the people. There should be a sep-
arate plan for tribal and non-tribal areas, and all plans or programs should be region-specific,
not based on the overall conditions of the district. Our findings for tribal populations also imply that
the health infrastructure should be strengthened in the areas where there are larger numbers of tribes.
Many of the maternal and newborn health problems can be prevented by increasing the awareness
and utilization of ante-natal care, institutional deliveries, and postnatal visits among tribes. There is

38 International Journal of Population Studies | 2016, Volume 2, Issue 2