The author describes the development of demography in Hungary from 1928 to the present with a focus on the contribution of Hungarian demographers to the activities of the International Union for the Scientific Study of Population (IUSSP). This paper is part of an IUSSP project that deals with the history of the Union and involves the preparation of papers on such activities in several countries. (summary in ENG RUS) (ANNOTATION)

Contribution of Hungarian demographic science and Hungarian demographers to the work of the International Union for the Scientific Study of Population

World Population Prospects, the 2010 Revision: Estimation and projection methodology

By pooling the results from five previously published prospective studies the relative risks of mortality were estimated among young children 6-24 months after they had been identified as having mild-to-moderate or severe malnutrition. These risk estimates along with global malnutrition prevalence data were then used to calculate the total number of young childhood deaths attributable to malnutrition in developing countries. Children (6-60 months of age) with mild-to-moderate malnutrition (60-80% of the median weight-for-age of the reference population) had 2.2 times the risk of dying during the follow-up period than their better nourished counterparts ( > 80% of the median reference weight-for-age). The relative risk of mild-to-moderate malnutrition was 1.2-3.5 compared with the reference categories of better nourished children whose expected weight-for-age was greater than either 75% or 80% of the median value. Severely malnourished children ( < 60% of the reference median weight-for-age) had 6.8 times the risk of dying during the follow-up period than better nourished children. Each year in developing countries an estimated 1251280 excess deaths occur in mild-to-moderately malnourished children aged 6-60 months while 1067268 excess deaths occur in severely malnourished children: in total 2318548 deaths. These excess deaths represent 41% of all deaths in this age group or 21% of all deaths among under-5-year-olds. The relative risk of severe malnutrition ranged from 3.1 to 19.2 compared with the reference categories. A test for heterogeneity indicated that there were significant differences between the study relative risks (P <0.005). The pooled relative risk was 6.8; the overall association was highly significant (P <0.001). Child survival programs should assign greater priority to the control of childhood malnutrition.

[Nutritional status as a predictor of child survival: summarizing the association and quantifying its global impact]

This paper presents a productivity argument for investing in disadvantaged young children. For such investment, there is no equity-efficiency tradeoff.

The Productivity Argument for Investing in Young Children

The impact of climate change on migration has gained both academic and public interest in recent years. Here we employ a meta-analysis approach to synthesize the evidence from 30 country-level studies that estimate the effect of slow- and rapid-onset events on migration worldwide. Most studies find that environmental hazards affect migration, although with contextual variation. Migration is primarily internal or to low- and middle-income countries. The strongest relationship is found in studies with a large share of countries outside the Organisation for Economic Co-operation and Development, particularly from Latin America and the Caribbean and sub-Saharan Africa, and in studies of middle-income and agriculturally dependent countries. Income and conflict moderate and partly explain the relationship between environmental change and migration. Combining our estimates for differential migration responses with the observed environmental change in these countries in recent decades illustrates how the meta-analytic results can provide useful insights for the identification of potential hotspots of environmental migration. Using a meta-analysis approach, the authors find robust evidence that environmental factors play a role in explaining migration patterns across countries and over time, but the size of the effects depend on the economic and sociopolitical context, and the environmental factors considered.

/pdf/a-meta-analysis-of-country-level-studies-on-environmental-v2yoo43zbo.pdf

A meta-analysis of country-level studies on environmental change and migration

Background and objective

India contributes the highest global share of deaths among the under-fives. Continuous monitoring of the reduction in the under-five mortality rate (U5MR) at local level is thus essential to set priorities for policy-makers and health professionals. In this study, we aimed to provide an update on district-level disparities in the neonatal mortality rate (NMR) and the U5MR with special reference to Sustainable Development Goal 3 (SDG3) on preventable deaths among new-borns and children under five.
Data and methods

We used recently released population-based cross-sectional data from the National Family Health Survey (NFHS) conducted in 2015-2016. We used the synthetic cohort probability approach to analyze the full birth history information of women aged 15-49 to estimate the NMR and U5MR for the ten years preceding the survey.
Results

Both the NMR and U5MR vary enormously across Indian districts. With respect to the SDG3 target for 2030 for the NMR and the U5MR, the estimated NMR for India for the period studied is about 2.4 times higher, while the estimated U5MR is about double. At district level, while 9% of the districts have already reached the NMR targeted in SDG3, nearly half (315 districts) are not likely to achieve the 2030 target even if they realize the NMR reductions achieved by their own states between the last two rounds of National Family Health Survey of India. Similarly, less than one-third of the districts (177) of India are unlikely to achieve the SDG3 target on the U5MR by 2030. While the majority of high-risk districts for the NMR and U5MR are located in the poorer states of north-central and eastern India, a few high-risk districts for NMR also fall in the rich and advanced states. About 97% of districts from Chhattisgarh and Uttar Pradesh, for example, are unlikely to meet the SDG3 target for preventable deaths among new-borns and children under age five, irrespective of gender.
Conclusions

To achieve the SDG3 target on preventable deaths by 2030, the majority of Indian districts clearly need to make a giant leap to reduce their NMR and U5MR.

/pdf/neonatal-and-under-five-mortality-rate-in-indian-districts-4sp5fk95kf.pdf

Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3: An analysis of the National Family Health Survey of India (NFHS), 2015-2016

Objective
Although under-five mortality rate (U5MR) is declining in India, it is still high in a few selected states and among the scheduled caste (SC) and scheduled tribe (ST) population of the country. This study re-examines the association between caste and under-five deaths in high focus Indian states following the implementation of the country’s National Rural Health Mission (NRHM) program. In addition, we aim to quantify the contribution of socioeconomic determinants in explaining the gap in under-five death risk between the SC/ST population and non-SC/ST population in high focus states in India.

Data and method
Using data from the National Family Health Survey (NFHS), we calculated the U5MR by applying a synthetic cohort probability approach. We applied a binary logistic regression model to examine the association of under-five deaths with the selected covariates. Further, we used Fairlie's decomposition technique to understand the relative contribution of socioeconomic variables on under-five death risk between the caste groups.

Findings
In high focus Indian states, the under-five mortality risk between well-off and deprived caste children has declined in the post-NRHM period, indicating a positive impact in terms of reducing caste-based inequalities in the high focus states. Despite the reduction in under-five death risk, children belonging to the SC population experience higher mortality rates than children belonging to the non-SC/ST population from 1992 to 2016. Both macro level (district level mortality rates) and individual (regression analysis) analyses showed that children belonging to SCs experience the highest likelihood of dying before their fifth birthday. A decomposition analysis revealed that 83% of the caste-based gap in the under-five deaths is due to the distribution of women’s level of educational attainment and household wealth between the SC/ST and non-SC/ST population. Program indicators such as place of birth and number of antenatal care (ANC) visit also contributed significantly to widening caste-based gaps in U5MR.

Conclusion
The study indicates that there is still room to improve access to health facilities for mothers and children belonging to deprived caste groups in India. Continuous efforts to raise the level of maternal education and the economic status of people belonging to deprived caste groups should be pursued simultaneously.

/pdf/the-persistent-influence-of-caste-on-under-five-mortality-549exrjpib.pdf

The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states.

Background 
India is expected to experience an increase in the frequency and intensity of extreme weather events in the coming decades, which poses serious risks to human health and wellbeing in the country.


Objective 
This paper aims to shed light on the possible detrimental effects of monsoon weather shocks on childhood undernutrition in India using the Demographic and Health Survey 2015–16, in combination with geo-referenced climate data.


Methods 
Undernutrition is captured through measures of height-for-age, weight-for-height, stunting and wasting among children aged 0–59 months. The standardised precipitation and evapotranspiration index (SPEI) is used to measure climatic conditions during critical periods of child development.


Results 
The results of a multivariate logistic regression model show that climate anomalies experienced in utero and during infancy are associated with an increased risk of child undernutrition; exposure to excessive monsoon precipitation during these early periods of life elevates the risk of stunting, particularly for children in the tropical wet and humid sub-tropical regions. In contrast, the risk of stunting is reduced for children residing in the mountainous areas who have experienced excessive monsoon precipitation during infancy. The evidence on the short-term effects of climate shocks on wasting is inconclusive. We additionally show that excessive precipitation, particularly during the monsoon season, is associated with an increased risk of contracting diarrhoea among children under five. Diseases transmitted through water, such as diarrhoea, could be one important channel through which excessive rainfall increases the risk of stunting.


Conclusions 
We find a positive association between childhood undernutrition and exposure to excessive monsoon precipitation in India. Pronounced differences across climate zones are found. The findings of the present analysis warn of the urgent need to provide health assistance to children in flood-prone areas.

https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0231479&type=printable

Monsoon weather and early childhood health in India

The level of infant and under-five mortality is high among scheduled castes (SCs) and scheduled tribes (STs) in India. This study intends to quantify the contribution of education in explaining the gap in infant and under-five mortality between SCs/STs and non-SC/ST population in India with a special focus on the effect of maternal education. We used data from three rounds of National Family Health Survey (NFHS): 1992–93, 1998–99 and 2005–06. The synthetic cohort probability approach using full birth histories was used to estimate childhood mortality. We performed binary logistic regression analysis to examine the association of infant mortality (IM) and under-five mortality (U5M) with maternal education and selected other covariates. Further, we applied Fairlie's decomposition technique to understand the relative contribution of maternal education and other covariates on IM and U5M risk between the caste groups. The IM rate (IMR) among children born to illiterate mothers is about 3 times higher than those born to mothers with higher education across all caste groups. Similarly, the U5M rate (U5MR) is 5 times higher among ST population and 3 times higher among SC population during the 14-year observation period (1992–2006). The proportions of secondary and higher educated SC and ST mothers are relatively lower than among non-SC/ST mothers. The regression analysis shows that mother’s education has a statistically significant effect on reducing IM and U5M. A number of socio-economic covariates are found associated with IM and U5M; such as father’s education, mother’s age at first birth, mother’s work status, household wealth, exposure to media and socio-economic empowerment of the mother. A decomposition analysis shows that more than 90 percent of the gap in IM and U5M between social groups is explained by the differences in the distribution of maternal education and household wealth. The findings of this study emphasise the need to provide education to disadvantaged girls and health counselling to women, particularly among SC/STs with more focus on backward regions or states, to further reduce IM and U5M in India.

https://www.econstor.eu/bitstream/10419/184850/1/WP2018_03.pdf

Contribution of education to infant and under-five mortality disparities among caste groups in India

Variation in human growth and the genetic and environmental factors that are influencing it have been described worldwide. The objective of this study is to assess the geographical variance of under-five children nutritional status and its related covariates across Indian districts. We use the most recent fourth round of the Indian National Family Health Survey conducted in 2015-2016, which for the first time offers district level information. We employ principal component analysis (PCA) on the demographic and socio-economic determinants of childhood morbidity and conduct hierarchical clustering analysis to identify geographical patterns in nutritional status among children of age under five at the district level. Our results reveal strong geographical clustering among the districts of India. Throughout most of Southern India, children are provided with relatively better conditions for growth and improved nutritional status, as compared to districts in the central, particularly rural parts of India. Looking at average weight, as well as the proportion of children that suffer from underweight and wasting, northeastern Indian districts seem to be offering living conditions more conducive to healthy child development. The geographical clustering of malnutrition, as well as below-average child height and weight coincides with high poverty, low female education, lower BMI among mothers, higher prevalence of both parity 4+ and teenage pregnancies. The present study highlights the importance of combining PCA and cluster analysis methods in studying variation in under-five child growth and nutrition at the district level. We identify the geographical areas, where children are under severe risk of undernutrition, stunting and wasting and contribute to formulating policies to improve child nutrition in India.

Jayanta Kumar Bora

Papers

Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3: An analysis of the National Family Health Survey of India (NFHS), 2015-2016

The persistent influence of caste on under-five mortality: Factors that explain the caste-based gap in high focus Indian states.

Monsoon weather and early childhood health in India

Contribution of education to infant and under-five mortality disparities among caste groups in India

Under-Five Child Growth and Nutrition Status:Spatial Clustering of Indian Districts. VID Working Paper 03/2019