Malaria Risk among Children under Five in India: A Hierarchical Multi-Modelling Approach

Rayhan Rahman, International Institute for Population Sciences (IIPS)

This study investigates the multifaceted risk factors contributing to malaria transmission among children under five in India, focusing on individual, household, community, and environmental factors. Using data from the National Family Health Survey 5 (NFHS-5), a hierarchical multi-model approach was employed, complemented by Pearson’s chi-square test, local Moran's I, LISA, and Erreygers Concentration Index. The findings indicate that 3.3% of children under five are affected by malaria, with higher prevalence observed in eastern and western states like Gujarat, Maharashtra, Odisha, West Bengal, Telangana, and Bihar, reaching up to 4.4%. The analysis reveals significant socio-economic and geographic disparities, identifying male children, extremely young children, and those living in urban areas, households with unimproved toilet facilities, and impoverished regions as particularly vulnerable. Malaria incidence is higher during monsoon seasons and in rural areas with open drainage systems. Approximately 59% of the variance in malaria risk can be attributed to individual, household, and community factors. This study emphasizes the need for geographically tailored interventions to address the diverse factors influencing malaria risk, offering insights for evidence-based policy development to mitigate the disease burden and improve child health outcomes in India.

Keywords: Multi-level modeling , Health and Morbidity, Children, Adolescents, and Youth, Population, Environment, and Climate Change

See extended abstract.