Abstract
The present study is an attempt to examine the distal determinants of Infant Mortality Rate in South Asian Association for Regional Cooperation (SAARC) nations over the period of 2000–2016. Instead of looking at individual nation model, the study tries to develop a regional model to examine the determinants of infant mortality. Infant mortality is modelled as a function of public health expenditure, educational status of women, access to proper sanitation, GDP per capita and urbanisation. To attain this objective, we have applied Pedroni’s cointegration test. Subsequently, to estimate the long run relationship we have utilized the Fully Modified Ordinary Least Square (FMOLS) and Dynamic Ordinary Least Square (DOLS) methods. The results of the Pedroni’s cointegration test have shown the long run relationship among the selected variables. Similarly, FMOLS and DOLS test results have indicated that health expenditure, GDP per capita, educational status of women and sanitation facilities have a significant impact on Infant Mortality Rate of SAARC nations. The results of this study led to the conclusion that Health Expenditure is one of the significant contributors in decreasing the Infant Mortality Rate. Moreover, the results of our study shed light on determinants such as GDP Per Capita, Female Education, Urbanisation and Sanitation which have some clear policy implications for reducing Infant Mortality Rate in SAARC nations.
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The authors would like to acknowledge the Ministry of Human Resource Development (GOI) and National Institute of Technology Durgapur, India for providing fellowship to the first and second authors of this study.
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Appendix: Figures representing the trend of individual determinants used in the study
Appendix: Figures representing the trend of individual determinants used in the study
Fig. 7 has shown the public health expenditure of the SAARC nations over the period of 2000–2016. In this study, Public Health expenditure refers to the public and private expenditures as a ratio of total population of a given place. Among others, it includes provision of health services, nutrition activities, and emergency aid designated for health. Data are in current U.S. dollars. Health Expenditure has a significant impact on the high-quality healthcare system and skills of health service providers which are very important for reducing the mortality rate in any nation. Looking at the trend of health expenditure as evident in the above figure, it can be noted that out of all SAARC countries, Maldives, Nepal and Afghanistan allocates a larger portion of their GDP to the health sector. On the hand, public health expenditure of India, Bangladesh, Pakistan, Sri Lanka and Bhutan are comparatively low.
Public Health Expenditure of SAARC countries, 2000–2016
Fig. 8 has shown the trend of female education in the SAARC countries over the period of 2000–2016. Percentage of female students enrolled at the primary level has been taken as proxy to see the level of female education in the SAARC countries. The level of female education helps in enhancing a woman’s position and well-being by giving them the agency to voice their opinions and asserting their will and decisions. Despite the awareness regarding the benefits of female education, the level of female education still remains low as compared to the male in the SAARC countries. From the above figure, it has been observed that Afghanistan and Pakistan report very low female education enrolment rate in primary level. In comparison to these two nations, India, Bhutan and Maldives have higher enrolment of female students at primary level yet it demands more efforts towards the desired results. Bangladesh and Sri Lanka have shown a very impressive rate of enrolment of female students at primary level over the last few years.
Level of Female Education in SAARC countries, 2000–2016
Fig. 9 has shown the trend of urbanisation in SAARC countries over the period of 2000–2016. Urban population (people inhabiting urban areas) as percentage of the total population has been taken as a proxy for Urbanisation in this study.
Urbanisation in SAARC countries, 2000–2016
From the figure, it can be observed that the rate of urbanisation in Maldives has increased rapidly than the other SAARC nations. Bangladesh has also shown a trend similar to Maldives.
India as well as Pakistan show moderate level of urbanisation while Sri Lanka reveals a low rate of urbanisation. In case of India, the urban population has increased considerably over the years but since the total population of India is very high, the percentage of urban population appears low in comparison to the other SAARC countries. Nepal, Bhutan and Afghanistan reveal a moderate increase of urban population.
Though urbanisation has increased in the SAARC countries yet the conditions that the people living in the urban areas receive determines their well-being. So, there is an intricate relationship between the conditions of urban areas and IMR.
Fig. 10 has shown the sanitation facilities in SAARC countries over the period of 2000 to 2016. Percentage of total population having access to basic drinking water has been taken as a proxy for Sanitation in the study as clean drinking water is one of the important indicators of sanitation facility. Despite considerable progress been achieved over the years, much remains to be done. A large percentage of population has limited accessibility to safe drinking water, which is one of the prime reasons of poor health in general and high IMR. For instance in Afghanistan, as observed in Fig. 4, the percentage of population having access to clean water is very low and at the same time we observe that Afghanistan also experiences high IMR. Bhutan, Maldives and Sri Lanka has experienced a continuous improvement while in case of Pakistan the percentage of population having access to clean water remains stagnant. In case of India, there has been a moderate rise.
Sanitation Facilities in SAARC countries, 2000–2016
Fig. 11 has shown the GDP per capita of SAARC countries over the period of 2000 to 2016. GDP per capita has been taken as a proxy for the income in this study. Income is an important determinant of IMR as having a high income entails having access to better facilities and nutritious food. Therefore, the GDP per capita is an important factor that the study has taken into account to get an idea regarding this.
GDP per capita of SAARC countries, 2000–2016 (in current US$)
It has been observed from the figure that Maldives has shown a significant rise in GDP per capita amongst the SAARC nations. Sri Lanka and Bhutan have also experienced a continuous increase in GDP per capita over the years. Sri Lanka has shown an impressive increase in the per capita GDP specifically in between 2003 to 2016 while Bhutan has also shown an impressive rate of growth in the last few years. For India and Pakistan, there has been a very slow rise in the GDP per capita while for Bangladesh, Afghanistan and Nepal it has remained stagnant.
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Dutta, U.P., Gupta, H., Sarkar, A.K. et al. Some Determinants of Infant Mortality Rate in SAARC Countries: an Empirical Assessment through Panel Data Analysis. Child Ind Res 13, 2093–2116 (2020). https://doi.org/10.1007/s12187-020-09734-8
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DOI: https://doi.org/10.1007/s12187-020-09734-8