Under-five mortality and associated factors in India: an analysis at the district level
DOI:
https://doi.org/10.20947/S0102-3098a0320Palabras clave:
Under-five mortality, Associated factors, India, Bayesian Hierarchical model, Integrated Nested Laplace Approximation (INLA)Resumen
Introducción: La mortalidad en menores de cinco años se refiere al fallecimiento de un niño o niña antes de alcanzar dicha edad. Es un indicador fundamental para comprender la salud infantil y el nivel de desarrollo de un país. En este estudio, utilizamos datos de la Encuesta Nacional de Salud Familiar (NFHS, por sus siglas en inglés) de 2015–2016 para estimar la mortalidad en niños menores de cinco años a nivel distrital en India, considerando una serie de variables socioeconómicas y demográficas.
Métodos: Examinamos la asociación entre estas variables y la mortalidad en niños menores de cinco años utilizando un modelo jerárquico bayesiano para 677 distritos, empleando el enfoque de Integrated Nested Laplace Approximation (INLA).
Resultados: Nuestros resultados indican que el exceso de mortalidad en niños menores de cinco años es más prevalente en los estados del norte y noreste de India. Además, los niños hindúes y aquellos cuyas madres saben leer y escribir tienen menos probabilidades de morir antes de cumplir cinco años. Por otro lado, se observaron mayores riesgos de mortalidad entre niños pertenecientes a grupos socialmente desfavorecidos, que no fueron amamantados o que nacieron fuera de instituciones de salud.
Conclusiones: Los resultados de este estudio destacan la necesidad urgente de implementar estrategias específicas para enfrentar la mortalidad infantil en India. Una variedad de factores —como las condiciones biofísicas, las desigualdades sociodemográficas y el acceso limitado a los servicios de salud— deben ser considerados no solo para fortalecer la infraestructura sanitaria, sino también para promover la educación materna y reducir las desigualdades socioeconómicas. Priorizar la implementación de políticas y programas de salud eficaces es esencial para que India logre la meta de los Objetivos de Desarrollo Sostenible (ODS) relacionada con la reducción de la mortalidad infantil y la protección de la salud de su población más joven en las distintas regiones y grupos demográficos.
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