The Adivasi Children Mortality Rate

Please, find the worldbank’s research paper on Adivasi Children Mortality Rate.


Introduction –


Almost every monsoon the Indian media is rife with stories of child deaths in tribal areas, with furious debates in Parliament and state legislative assemblies and outrage among civil society activists. This is the starkest manifestation of Adivasi deprivation in India ? an average Indian child has a 25 percent lower likelihood of dying under the age of five compared to an Adivasi child. In rural areas, where the majority of Adivasi children live, they made up about 11 percent of all births but 23 percent of all deaths in the five years preceding the National Family Heath Survey 2005. While there has been progress in child survival over the years and greater awareness of the hazards, which often leads to these stories surfacing in the media at all, the fact remains that children in tribal areas are at much greater risk of dying than those in other areas.


The rich and longstanding demographic and medical literature on child mortality can broadly be classified into three groups ? the first focuses on "routes to low mortality" and aggregate declines in mortality through cross-country studies (for instance, Caldwell 1986; Claeson et al, 2000); the second on the determinants of child mortality (for instance see Mosley and Chen 1984); and the third on inequalities in child mortality across countries, within countries and across households (for instance see Hill and Pebly 1989; Cesar et al, 2003). Differential fertility and mortality patterns within India by caste and tribal status have received greater attention over the last few decades (see Murthi et al, 1996; Dyson and Moore, 1993; Dreze and Gazdar, 1997; Maharatna, 1998; 2000). The preoccupation of such studies on child mortality has however been on correlates of mortality and the slow decline in child mortality in recent years. There is a good reason for this as India looks likely to falter on achieving this important Millennium Development Goal ? a fear expressed in 2000 by Claeson et al.


The anthropological literature has also focused on access to health for India's Adivasis. Excess mortality of tribal children during monsoons in particular has been analyzed by activists more recently through a food security lens. The Right to Food movement and the recent Supreme Court judgments exhort governments to take more aggressive action to address malnutrition nationally but more so in tribal areas. The evidence from the grassroots highlights the peculiar problems in tribal areas because of which poverty is higher, and health and education outcomes are lower. There is for instance, wide acknowledgment that excess mortality in childhood for tribals is partly due to poverty and partly to poor access to services. Our own previous analysis of mortality using data from India's Reproductive and Child Health Surveys, 2005 (see World Bank, 2006) and a recent study on Orissa also shows that once poverty levels are controlled for, the effect of tribal (or indeed Dalit or Scheduled Caste (SC)) status goes away. By and large, therefore, much of the analytical work on Scheduled Tribes (STs) in India has confirmed what we already know about child mortality and its correlates. This paper is an attempt to drill deeper into that knowledge to come up with some disaggregated patterns that more fully describe and explain the high levels of mortality of tribal children.


The analysis undertaken for this paper is part of an ongoing program 3 that looks at social exclusion and the differential outcomes for excluded groups like Dalit and Adivasis along a range of development parameters. The characteristics of Scheduled Tribes and Scheduled Castes and manner in which exclusion manifests itself is discussed in greater detail in the reports from that program. In this paper we disaggregate tribal child mortality patterns to build on the robust understanding that tribals do worse than others.


Tribal groups have historically had more equal gender relations and women's status in tribal societies has been higher. This has manifested itself in later than average age at marriage, higher participation of women in the labor force and lower restrictions on the mobility of women (see Das and Desai, 2003). Until the late 20th century, child mortality and fertility rates for tribals were lower than those for non-tribals (Maharatna, 1998). Dreze and Gazdar (1997) and Maharatna (1998; 2000) however point to a disturbing trend in tribal societies ? that gender equality and their lower fertility and mortality patterns seem to be gradually eroding, as they get more integrated into non-tribal society and as their traditionally sustainable livelihoods are encroached upon. Migration of tribals is also seen to be associated with wearing down their sustainable lifestyles (see for instance Maharatna on Santhal fertility, 2005). This is consistent with findings from other countries on the experience of indigenous populations. In their examination of health of Mexican immigrants in the USA, James (1993) and Vega and Amaro (1994) find a similar pattern of `acculturation' resulting in behaviors or lifestyles that adversely impact health (e.g. decreased fiber consumption, decreased breast feeding, increased use of

cigarettes and alcohol especially by young women).


Tribal groups however are very heterogeneous and there are large differences by state and even by districts within states, and certainly across tribes. The Government of India identifies 533 tribes with 62 of them located in the state of Orissa. 4 The national data do not allow for disaggregation by tribe, so some of these patterns may not hold true for individual tribes. There is an additional issue of heterogeneity. The most disadvantaged tribal groups are those where the Fifth Schedule of the Constitution applies. States in North-Eastern India, particularly those covered by the Sixth Schedule 5 have a large proportion of Scheduled Tribes but many also have much better human development indicators. Often the better indicators in these states raise average human development outcomes, so a state-wise disaggregation becomes really important.


The contribution of this paper lies in the fact that it disaggregates childhood mortality into neonatal, post-neonatal, infant and child mortality and analyzes the correlates of each. Most analyses have lumped child mortality6 into "under-five" mortality or have analyzed only infant


Get complete paper on or at


Authors: Maitreyi Bordia Das, Soumya Kapoor and Denis Nikitin

Sudesh Kumar

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