Between 1981 and 1990, infant mortality declined 23 percent in India and child mortality declined 34 percent, but mortality rates are still high. Sex differentials in infant and child mortality reflect strong son preference in many states. Among socioeconomic background characteristics, mother's literacy, access to a flush or pit toilet, membership in a scheduled caste or tribe, and household economic level have substantial effects on infant and child mortality. Demographic characteristics, including birth order, mother's age at childbirth, length of previous and subsequent birth intervals, and mortality of an older sibling, all have substantial effects. Mother's tetanus immunization during pregnancy is strongly associated with reduced neonatal mortality. These results suggest that minimizing the number of births to very young mothers, encouraging mothers to space births by at least 24 months, and avoiding high-order births will all substantially enhance the survival chances of children in India. Family health programs should also emphasize tetanus immunization for all pregnant mothers.

The NFHS Subject Reports is a series summarizing secondary analysis of data from the 1992-93 National Family Health Survey (NFHS) in India. The NFHS collected information from nearly 90,000 Indian women on a range of demographic and health topics. Conducted under the auspices of the Indian Ministry of Health and Family Welfare, the survey provides national and state-level estimates of fertility, infant and child mortality, family planning practice, maternal and child health, and the utilization of services available to mothers and children. IIPS conducted the survey in cooperation with consulting organizations and 18 population research centers throughout India. The East-West Center and a U.S.-based consulting firm, Macro International, provided technical assistance, and the United States Agency for International Development (USAID) provided financial support.