WHO South-East Asia Journal of Public Health
  • 259
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
Year : 2015  |  Volume : 4  |  Issue : 1  |  Page : 30-37

Association between household air pollution sand neonatal mortality: an analysis of Annual Health Survey results, India

1 Indian Institute of Public Health, Public Health Foundation of India, Gurgaon, India
2 Department of Pediatrics, All Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, India

Correspondence Address:
Sutapa Bandyopadhyay Neogi
Indian Institute of Public Health-Delhi, Public Health Foundation of India, Plot number 47, sector 44, Gurgaon - 122002
Login to access the Email id

DOI: 10.4103/2224-3151.206618

PMID: 28607272

Rights and Permissions

Background: In India, household air pollution (HAP) is one of the leading risk factors contributing to the national burden of disease. Estimates indicate that 7.6% of all deaths in children aged under 5 years in the country can be attributed to HAP. This analysis attempts to establish the association between HAP and neonatal mortality rate (NMR). Methods: Secondary data from the Annual Health Survey, conducted in 284 districts of nine large states covering 1 404 337 live births, were analysed. The survey was carried out from July 2010 to March 2011 (reference period: January 2007 to December 2009). The primary outcome was NMR. The key exposure was the use of firewood/crop residues/cow dung as fuel. The covariates were: sociodemographic factors (place of residence, literacy status of mothers, proportion of women aged less than 18 years who were married, wealth index); health-system factors (three or more antenatal care visits made during pregnancy; institutional deliveries; proportion of neonates with a stay in the institution for less than 24 h; percentage of neonates who received a check-up within 24 h of birth); and behavioural factors (initiation of breast feeding within 1 h). Descriptive analysis, with district as the unit of analysis, was performed for rural and urban areas. Bivariate and multivariable linear regression analysis was carried out to investigate the association between HAP and NMR. Results: The mean rural NMR was 42.4/1000 live births (standard deviation [SD] = 11.4/1000) and urban NMR was 33.1/1000 live births (SD=12.6/1000). The proportion of households with HAP was 92.2% in rural areas, compared to 40.8% in urban areas, and the difference was statistically significant (P < 0.001). HAP was found to be strongly associated with NMR after adjustment (β = 0.22; 95% confidence interval [CI] = 0.09 to 0.35) for urban and rural areas combined. For rural areas separately, the association was significant (β = 0.30; 95% CI = 0.13 to 0.45) after adjustment. In univariable analysis, the analysis showed a significant association in urban areas (β = 0.23; 95% CI = 0.12 to 2.34) but failed to demonstrate an association in multivariable analysis (β = 0.001; 95% CI = -0.15 to 0.15). Conclusion: Secondary data from district level indicate that HAP is associated with NMR in rural areas, but not in urban areas in India.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded110    
    Comments [Add]    
    Cited by others 3    

Recommend this journal