title: Disparities in child mortality trends in two new states of India.
abstract: BACKGROUND
  India has the world's highest total number of under-five deaths of any nation. While progress towards Millennium Development Goal 4 has been documented at the state level, little information is available for greater disaggregation of child health markers within states. In 2000, new states were created within the country as a partial response to political pressures. State-level information on child health trends in the new states of Chhattisgarh and Jharkhand is scarce. To fill this gap, this article examines under-five and neonatal mortality across various equity markers within these two new states, pre-and post-split.
  
  
  METHODS
  Both direct and indirect estimation using pooled data from five available sources were undertaken. Inter-population disparities were evaluated by mortality data stratification of rural-urban location, ethnicity, wealth and districts.
  
  
  RESULTS
  Both states experienced an overall reduction in under-five and neonatal mortality, however, this has stagnated post-2001 and various disparities persist. In cases where disparities have declined, such as between urban-rural populations and low- and high-income groups, this has been driven by modest declines within the disadvantaged groups (i.e. low-income rural households) and stagnation or worsening of outcomes within the advantaged groups. Indeed, rising trends in mortality are most prevalent in urban middle-income households.
  
  
  CONCLUSIONS
  The results suggest that rural health improvements may have come at the expense of urban areas, where poor performance may be attributed to factors such as lack of access to quality private health facilities. In addition, the disparities may in part be associated with geographical access, traditional practices and district-level health resource allocation.
authors: School of Population Health, Public Health Building, The University of Queensland, Herston Road, Herston, Brisbane, Queensland 4006, Australia. a.hodge@uq.edu.au.
authors: Mark
authors: M
authors: Minnery
authors: Eliana
authors: E
authors: Jimenez-Soto
authors: Sonja
authors: S
authors: Firth
authors: Kim-Huong
authors: KH
authors: Nguyen
authors: Andrew
authors: A
authors: Hodge
mesh_terms: D002662:Child Health Services; D046688:Child Mortality / Q000639:trends*; D002675:Child, Preschool; D054624:Health Status Disparities; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D012424:Rural Population; D012959:Socioeconomic Factors; D014505:Urban Population
references: Health Serv Res. 2004 Dec;39(6 Pt 2):2013-26
references: 15544642
references: Health Policy Plan. 2011 Sep;26(5):429-40
references: 21112926
references: PLoS Med. 2012;9(6):e1001244
references: 22723748
references: Health Policy. 2010 Dec;98(2-3):114-20
references: 20576309
references: Demography. 2001 Feb;38(1):115-32
references: 11227840
references: Health Policy Plan. 2001 Sep;16(3):256-63
references: 11527866
references: BMJ Open. 2012 Sep 27;2(5):
references: 23019208
references: World J Pediatr. 2012 Feb;8(1):11-8
references: 22282378
references: J Epidemiol Community Health. 2013 Apr;67(4):311-9
references: 23322853
references: Postgrad Med J. 2011 Apr;87(1026):257-63
references: 21296798
references: J Biosoc Sci. 2009 May;41(3):381-98
references: 18845026
references: Am J Public Health. 2006 May;96(5):818-25
references: 16571702
references: Soc Sci Med. 2013 Nov;96:297-304
references: 23484865
references: Health Policy. 2007 Dec;84(2-3):269-76
references: 17540472
references: PLoS Med. 2010 Apr 13;7(4):e1000253
references: 20405055
references: Soc Sci Med. 2004 Sep;59(6):1147-58
references: 15210087
references: Soc Sci Med. 2003 Dec;57(11):2075-88
references: 14512239
references: Lancet. 2011 Sep 24;378(9797):1139-65
references: 21937100
references: Soc Sci Med. 2002 Nov;55(9):1579-87
references: 12297244
references: Lancet. 2011 Feb 5;377(9764):505-15
references: 21227492
references: Bull World Health Organ. 2012 Aug 1;90(8):604-12
references: 22893744
references: Health Policy Plan. 2006 Mar;21(2):110-22
references: 16361350
references: Int J Health Serv. 2007;37(2):205-27
references: 17665720
references: Lancet. 2010 Sep 18;376(9745):991-1023
references: 20833426
references: AIDS Care. 2010;22 Suppl 2:1606-12
references: 21161765
references: Health Policy Plan. 2004 Nov;19(6):402-9
references: 15459165
references: Int J Epidemiol. 2006 Dec;35(6):1430-9
references: 16997849
references: Health Care Women Int. 2012;33(11):1020-34
references: 23066964
references: Stud Fam Plann. 2000 Jun;31(2):111-23
references: 10907277
references: Lancet. 2007 Sep 22;370(9592):1040-54
references: 17889243
references: Lancet. 2008 Apr 12;371(9620):1259-67
references: 18406860
references: J Commun Dis. 2000 Sep;32(3):222-7
references: 11407010
references: Lancet. 2010 Nov 27;376(9755):1853-60
references: 21075444
references: PLoS One. 2012;7(5):e37515
references: 22629412