Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-19T16:21:10.163Z Has data issue: false hasContentIssue false

INFLUENCE OF FAMILY STRUCTURE ON CHILD HEALTH: EVIDENCE FROM INDIA

Published online by Cambridge University Press:  10 December 2012

ABHISHEK KUMAR
Affiliation:
International Institute for Population Sciences, Mumbai, India
FAUJDAR RAM
Affiliation:
International Institute for Population Sciences, Mumbai, India

Summary

This paper examines the association between family structure and child health in India using the third round of the National Family Health Survey, conducted during 2005–06. Two important child health indicators – underweight and full immunization – are used as dependent variables. Descriptive and multivariate statistics are deployed to establish the relationship between family structure and child health. The results of the descriptive statistics show that children who belong to a non-nuclear family have better nutritional status and higher immunization coverage than those in nuclear families. Children living with siblings have worse health status than those living without siblings for both the outcomes. Multivariate analysis shows that family structure has a small effect on the two child health outcomes, which is no longer significant after adjusting for socioeconomic measures and region. However, number of siblings is significantly and negatively associated with the nutritional status of children and full immunization coverage, even after other socio-demographic and geographic factors are controlled for. Along with family structure, parent's educational attainment, age of the mother and household economic status are significant determinants of underweight and full immunization.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albrecht, S. L., Miller, M. K. & Clarke, L. L. (1994) Assessing the importance of family structure in understanding birth outcomes: Journal of Marriage and Family 56(4), 9871003.CrossRefGoogle Scholar
Amato, P. (1987) Family processes in one-parent, stepparent and intact families: the child's point of view. Journal of Marriage and Family 69, 327337.CrossRefGoogle Scholar
Anh, T. S., Knodel, J., Lam, D. & Friedman, J. (1998) Family size and children education in Vietnam. Demography 35, 5770.CrossRefGoogle ScholarPubMed
Arnold, F., Choe, M. K. & Roy, T. K. (1998) Son preference, the family-building process, and child mortality in India. Population Studies 52(3), 301315.CrossRefGoogle Scholar
Arokiasamy, P. (2004) Regional patterns of sex bias and excess female child mortality in India. Population 59(6), 833863.CrossRefGoogle Scholar
Basu, A. M. & Basu, K. (1991) Women's economic roles and child survival: the case of India. Health Transition Review 1(1), 83103.Google ScholarPubMed
Basu, A. M. (1992) Culture, the Status of Women and Demographic Behaviour: Illustrated with the Case of India. Clarendon Press, Oxford.Google Scholar
Basu, R. N. (1985) India's immunization program. World Health Forum 6, 3538.Google Scholar
Beenstock, M. & Sturdy, P. (1990) The determinants of infant mortality in regional India. World Development 18(3), 443453.CrossRefGoogle Scholar
Behrman, J. R. (1998) Intra-household allocation of resources: is there a gender bias? In United Nations (ed.) Too Young to Die: Genes or Gender? United Nations, New York, pp. 223242.Google Scholar
Behrman, J. R. (1995) Household behavior, preschool child health and nutrition, and the role of information. In Pinstrup-Andersen, P., Pelletier, D. & Alderman, H. (eds) Child Growth and Nutrition in Developing Countries: Priorities for Action. Cornell University Press, New York.Google Scholar
Berman, P., Kendall, C. & Bhattacharya, K. (1994) The household production of health: integrating social science perspectives on micro-level health determinants. Social Science & Medicine 38(2), 205215.CrossRefGoogle ScholarPubMed
Blake, J. (1981) Family size and the quality of children. Demography 18, 621662.CrossRefGoogle ScholarPubMed
Blake, J. (1989) Family Size and Achievement. University of California Press, Los Angeles, CA.CrossRefGoogle Scholar
Bronte-Tinkew, J. & DeJong, G. F. (2004) Children's nutrition in Jamaica: do households structure and household economic resource matter? Social Science & Medicine 58, 499514.CrossRefGoogle ScholarPubMed
Bronte-Tinkew, J. & DeJong, G. F. (2005) Do household structure and household economic resources predict childhood immunization? Evidence from Jamaica and Trinidad and Tobago. Population Research and Policy Review 24(1), 2757.CrossRefGoogle Scholar
Caldwell, J. C., Reddy, P. H. & Caldwell, P. (1996) The family in South India: past, present and future. Social Change 26(2), 116129.Google Scholar
Chatterjee, M. (1989) Competence and care for women: health policy perspectives in the household context. In Krishnaraj, M. & Karuna, C. (eds) Gender and the Household Domain: Social and Cultural Dimensions, Women and the Household in Asia. Sage Publications, New Delhi, pp. 165190.Google Scholar
Chekki, D. A. (1974) Modernization and social change: the family and kin network in urban India. In Kurian, G. (ed.) The Family in India: A Regional View. Studies in the Social Sciences, Vol. 12, Mouton, Paris, pp. 205231.CrossRefGoogle Scholar
Cleland, J., Bernstein, S., Ezeh, A., Faundes, A., Glasier, A. & Innis, J. (2006) Family planning: the unfinalized agenda. The Lancet 368, 18101827.CrossRefGoogle ScholarPubMed
Das Gupta, M. (1987) Selective discrimination against female children in rural Punjab, India. Population and Development Review 13(1), 77100.CrossRefGoogle Scholar
Dawson, D. A. (1991) Households structure and children's health and well-being: data from the 1988 national health interview survey on child health. Journal of Marriage and the Family 53, 573586.CrossRefGoogle Scholar
Deaton, A. & Dreze, J. (2009) Nutrition in India: facts and interpretation. Economic & Political Weekly XLIV(7), 42e65.Google Scholar
Desai, S. (1992) Children at risk: the role of family structure in Latin America and West Africa. Population and Development Review 18(4), 689717.CrossRefGoogle Scholar
Doan, R. M. & Bisharat, L. (1990) Female autonomy and child nutritional status: the extended-family residential unit in Amman, Jordan. Social Science & Medicine 31(7), 783789.CrossRefGoogle ScholarPubMed
Dwyer, D. & Bruce, J. (1988) A Home Divided: Women and Income in the Third Worlds. Stanford University Press, Stanford.Google Scholar
Dyson, T. & Moore, M. (1983) On kinship structure, female autonomy, and demographic behaviour in India. Population and Development Review 9(1), 3554.CrossRefGoogle Scholar
Eloundou-Enyegue, P. M. & Williams, L. B. (2006) Family size and schooling in sub-Saharan settings: a re-examination. Demography 43, 2552.CrossRefGoogle Scholar
Ferrer, R. L. & Burge, S. (2005) The family contribution to health status: a population-level estimate. Annals of Family Medicine 3(2), 102108.CrossRefGoogle ScholarPubMed
Gage, A. J. (1997a) Familial and socioeconomic influences on children's well being: an examination of pre-school children in Kenya. Social Science & Medicine 65(12), 18111828.CrossRefGoogle Scholar
Gage, A. J., Sommerfelt, A. E. & Piani, A. L. (1997b) Households structure and childhood immunization in Niger and Nigeria. Demography 36(2), 295309.CrossRefGoogle Scholar
Gittelsohn, J. (1991) Opening the box: intra-household food allocation in rural Nepal. Social Science & Medicine 33(10), 11411154.CrossRefGoogle Scholar
Griffiths, P., Matthews, Z. & Hinde, A. (2002) Gender, family, and the nutritional status of children in three culturally contrasting states of India. Social Science & Medicine 55, 775790.CrossRefGoogle ScholarPubMed
Heer, D. (1985) Effects of sibling number on child outcomes. Annual Review of Sociology 11(85), 2767.CrossRefGoogle Scholar
Hogan, D. P. & Lichter, D. (1995) Children and youth: living arrangement and welfare. In Farley, R. (ed.) State of the Union: America in the 1990s. Russell Sage Foundation, New York, Vol. 2, pp. 193239.Google Scholar
Horton, S. (1988) Birth order and child nutritional status: Evidence from the Philippines. Economic Development and Cultural Change 36, 341353.CrossRefGoogle Scholar
Horton, S. & Miller, B. D. (1989) The Effects of Gender of Household Head on Food Expenditure: Evidence From Low Income Households in Jamaica. Department of Economics, University of Toronto, Toronto.Google Scholar
International Institute for Population Sciences (IIPS) & Macro International (2007) National Family Health Survey (NFH-3), 2005–06. Vol. I, IIPS, Mumbai, India.Google Scholar
Jejeebhoy, S. J. (1995) Women's Education, Autonomy and Reproductive Behavior: Experience from Developing Countries. Clarendon Press, Oxford.CrossRefGoogle Scholar
Khan, M. E., Anker, R., Dastidar, S. K., Gosh, S. & Bairathi, S. (1989) Inequalities between men and women in nutrition and family welfare services: an in-depth enquiry in an Indian village. In Caldwell, J. C. & Santow, G. (eds) Selected Proceedings in the Cultural, Social and Behavioural Determinants of Health, Health Transition Series, No. 1. Highland Press, Canberra, pp. 175199.Google Scholar
Kumar, A. & Mohanty, S. K. (2011a) Socio-economic differentials in childhood immunization in India, 1992–2006. Journal of Population Research 28(4), 301324.CrossRefGoogle Scholar
Kumar, A. & Mohanty, S. K. (2011b) State of child health among poor and non-poor in urban India. GENUS LXVII(1), 119.Google Scholar
Lalou, R. & Mbacke, C. (1992) The micro consequences of high fertility on child malnutrition in Mali. In Lloyd, C. (ed.) Fertility, Family Size and Structure. Population Council, New York.Google Scholar
Li, J. & Taylor, B. (1993) Childhood immunisation and family size. Health Trends 25(1), 1619.Google ScholarPubMed
Lloyd, C. B. & Gage-Brandon, A. (1993) Women's role in maintaining households: family welfare and sexual inequality in Ghana. Population Studies 67, 115131.CrossRefGoogle Scholar
Lloyd, C. B. (1995) Household Structure and Poverty: What are the Connections? Working Paper No. 74, Population Council Research Division.Google Scholar
Lloyd, C. B. & Blanc, A. K. (1996) Children's schooling in sub-Saharan Africa: the role of fathers, mothers, and others. Population and Development Review 22(2), 265291.CrossRefGoogle Scholar
Louat, F., Grosh, M. E. & van der Gagg, J. (1993) Welfare Implications of Female Headship in Jamaican Households. Living Standards Measurement Study Working Paper No. 96. World Bank, Washington, DC.Google Scholar
Mayer, S. E. (1997) What money can't buy: family income and children's life chances. Master's thesis, Harvard University Press, Cambridge, MA.Google Scholar
Mazumdar, S. (2010) Determinants of inequality in child malnutrition in India. Asian Population Studies 6(3), 307333.CrossRefGoogle Scholar
McLanahan, S. & Booth, K. (1989) Mother-only families: problems, reproductions and politics. Journal of Marriage and the Family 51, 557580.CrossRefGoogle Scholar
McLanahan, S. & Sandefur, G. (1994) Growing up with a single parent: what hurts, what helps. Master's thesis, Harvard University Press, Cambridge, MA.Google Scholar
Mishra, V., Roy, T. K. & Retherford, R. D. (2004) Sex differentials in childhood feeding, health care, and nutritional status in India. Population and Development Review 30(2), 269295.CrossRefGoogle Scholar
Mosley, W. H. & Chen, L. C. (1984) Child survival: strategies for research. Population and Development Review 10 (Supplement), 2545.CrossRefGoogle Scholar
Moss, N. & Carver, K. (1992) Explaining racial and ethnic differences in birth outcomes: the effect of household structure and resources. Paper presented at The Meeting of the Population Association of America, Denver, CO.Google Scholar
Murthy, P. S. N., Ramnath, T., Vijayaraghavan, K. & Rao, N. P. (1985) Nutritional profile of joint and nuclear families in rural Andhra Pradesh. Journal of Family Welfare 32(2), 8087.Google Scholar
Pande, P. R. & Yazbeck, S. A. (2003) What's in a country average? Wealth, gender, and regional inequalities in immunization in India. Social Science & Medicine 57, 20752088.CrossRefGoogle Scholar
Pande, P. R. (2003) Selective gender differences in childhood nutrition and immunization in rural India: the role of siblings. Demography 40(3), 395418.CrossRefGoogle ScholarPubMed
Pathak, P. K. & Singh, A. (2011) Trends in malnutrition among children in India: growing inequalities across different economic groups. Social Science & Medicine 73(4), 576585.CrossRefGoogle ScholarPubMed
Saikia, N. & Singh, A. (2009) Does type of household affect maternal health? Evidence from India. Journal of Biosocial Science 41, 329353.CrossRefGoogle ScholarPubMed
Schiller, B. R. (1996) The Economics of Poverty and Discrimination. Prentice-Hall, Englewood Cliffs, NJ.Google Scholar
Sereebutra, P., Solomon, N., Aliyu, M. H. & Jolly, P. E. (2006) Socio-economic and environmental predictors of childhood stunting in rural Guatemala. Nutrition Research 26(2), 6570.CrossRefGoogle Scholar
Steptoe, A. L. K. & Cropley, M. (2000) Gender, family structure and cardiovascular activity during the working day and evening. Social Science & Medicine 50(4), 531539.CrossRefGoogle ScholarPubMed
Subramanyam, M. A., Kawachi, I., Berkman, L. F. & Subramanian, S. V. (2010) Socioeconomic inequalities in childhood undernutrition in India: analyzing trends between 1992 and 2005. PLoS ONE 5(6), e11392. doi:10.1371/journal.pone.0011392.CrossRefGoogle ScholarPubMed
Thomson, E., Hanson, T. L. & McLanahan, S. S. (1994) Family structure and child well-being: economic resources versus parental behaviour. Social Forces 73(1), 221262.CrossRefGoogle Scholar
Torun, S. D. & Bakırci, N. (2006) Vaccination coverage and reasons for non-vaccination in a district of Istanbul BMC Public Health 6, 125: doi:10.1186/1471-2458-6-125.CrossRefGoogle Scholar
Wu, L. L. (1996) Effects of family instability, income and income instability on the risk of a premarital birth. American Sociological Review 61, 386406.CrossRefGoogle Scholar
World Bank (2004) Attaining the Millennium Development Goals in India: How Likely and What Will it Take to Reduce Infant Mortality, Child Malnutrition, Gender Disparities and Hunger–Poverty and to Increase School Enrolment and Completion? Report No. 30266-IN, Human Development Unit, South Asia Region, World Bank, Washington, DC.Google Scholar
World Health Organization Multicenter Growth Reference Study Group (2006) Who Child Growth Standards. World Health Organization, Geneva.Google Scholar