Social determinants of morbidity during infancy: Results from a cross-sectional study in rural areas of Assam, India

Abstract

Background: Assam, one of the seven North Eastern states of India has achieved the highest decline in maternal and child mortality compared to other states, still neonatal mortality and infant mortality rates are very high. Apart from other causes, certain social factors unique to Indian subcontinent are also responsible for high mortality and morbidity among children here. Objectives: To know the prevailing morbidity conditions among the infants and to assess the social determinants of morbidity of infants in rural areas of Assam. Materials and Methods: It was a cross-sectional study conducted among 250 rural families having an infant in each family. The primary caregiver was interviewed using pre-tested semi-structured interview schedules and investigators also clinically evaluate the index child for any morbidity. Data collected regarding various sociodemographic variables of the family, morbidity status of the infant and also the environmental variables relevant to the study were analyzed tabulated and percentages, and proportions were calculated. Chi-square test was done to see the relationship between the factors. Results: The study observed that prevalence of teenage mothers was high (32.4%). Most of the mothers were primipara (41.2%), and were belonging to nuclear families of lower socioeconomic strata (57%). In our study, acute respiratory infections (33.3%), fever (24.6%), and diarrhea (21.7%) were found to be the most common morbidities among infants. Statistically significant association was also found between morbidity of infants and male gender (p=0.003) and numbers of siblings (p=0.005), use of sanitary water source (p=0.001), and excreta disposal (p=0.001). Conclusion: This study observed that social factors which influence infant morbidity included male gender and numbers of siblings, use of sanitary water source and excreta disposal, less education of mothers, less family income, and lower social class of the family.