Examining Intrafamilial Correlation of Early-life Mortality Risk among Siblings in South Asian Countries

Ronak Paul, International Institute for Population Sciences (IIPS)
Abhishek Singh, International Institute for Population Sciences (IIPS)

Infant mortality continues to pose a significant public health challenge in South Asia despite improvements in healthcare. South Asia, home to one-quarter of global births, accounts for the highest proportion of neonatal deaths worldwide. However, infant mortality risk often clusters within families, where some experience multiple infant deaths while others face none. This paper investigates the intrafamilial clustering of infant mortality in six South Asian countries using Demographic and Health Survey (DHS) data. The study explores key socioeconomic, demographic, and health-related factors contributing to this clustering, including the survival status of preceding siblings, birth intervals, and characteristics. It also introduces a novel infant mortality clustering index (IMCI) to compare the extent of mortality clustering across countries. The study employs parametric survival regression models with family-level frailty to assess mortality risks, adjusting for various covariates. Expected findings suggest significant intrafamilial clustering, with higher risks for families facing socioeconomic disadvantage and shorter birth intervals. The results are likely to highlight the need for targeted interventions focusing on high-risk families to break cycles of health disadvantage and reduce infant mortality across generations. This research provides critical insights for policies aimed at mitigating health disparities and improving child survival in South Asia.

Keywords: Mortality and Longevity, Comparative methods , Linked data sets , Mathematical demography

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