Hobcraft, J. N., et al (1985) examined the demographic determinants of infant and early child mortality. Singe, S., et al (1989) studied the determinants of infant and child mortality in rural Haryana. Khan, J.R and Awan, N. A (2017) made a comprehensive analysis of child mortality and its determinants in Bangladesh. Krishan Kumar; et al (2017) examined the socio-demographic determinants of under-five mortality in rural Agra of Uttarpradesh. Chilupula. N. F (2020) has examined demographic and socio-economic determinants of child mortality.Paul, P (2020) studied child marriage and its association with morbidity and mortality of children under 5 years old in India.

Apart from other determinants of child mortality, demographic aspects are also responsible for child mortality rate. Hence, it is important to examine the influence of these factors to reduce child mortality.

The paper aims at exploring the demographic determinants of child mortality India and its bigger States/UTs, 2018.

The paper is based on the descriptive type of research and secondary data collected from sample registration system statistical report of 2018. In this paper, Infant mortality, age at marriage and first birth, total fertility rate, birth order and interval and birth attendant are considered as determinants of child mortality.

In demography, child mortality refers to ‘the death of children under the age of five (U5MR)’, while infant mortality refers to ‘the death of those under the age of one year’. Infant mortality is one of the components of child mortality. Hence, higher the infant mortality, greater will be the under-five mortality rates (U5MR). Singhi, S. et al (1989) found that increased risk of infant and child mortality was associated with previous infant or child death(s) in the family. Table-1 shows that the states like Assam, Chhattisgarh, Madhya Pradesh, Odisha, Rajasthan and Uttar Pradesh with higher infant mortality had registered higher rate of child mortality. On the other hand, lower child mortality recorded in the states like Himachal Pradesh, Karnataka, Maharashtra, Punjab, Tamil Nadu and West Bengal with lower infant mortality rate. Thus, infant mortality is positively related to child mortality. Hence, to reduce child mortality rates, infant mortality has to be minimized.

Mean age at effective marriage of females is ‘the average age of a female when she first gets married’. For a given calendar year, the mean age of a person at first marriage can be calculated using first marriage rates by age. The prevalence of morbidity and mortality were significantly higher among the births of women who married before 18 years of age compared to those births whose mother married at 18 years of age or older (Paul, 2020). Table-1 depicts that states like Himachal Pradesh, Jammu & Kashmir, Kerala, Punjab, and Tamil Nadu with higher mean age at effective marriage of females had registered lower child mortality rate and vice versa in the states with lower mean age at effective marriage of females. Hence, it can be said that the mean age at effective marriage of females is inversely related to child mortality rate.

Mean age of fertility is the average age of women at the time of the first birth of a child. In general, earlier and older reproductive age associated with higher child mortality, because of complicated reproductive health issues in theses ages. Hobcraft, J. N., et al (1985) examined the age of the mother at the time of the birth have significant influence on under-five mortality.Table-1 shows states such Assam, Bihar, Gujarat, Haryana, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand with females with higher mean age of fertility had higher child mortality rate and vice versa in states with females with lower mean age of fertility.

Total Fertility Rate is ‘the number of children who would be born per woman (or per 1,000 women) if she/they were to pass through the childbearing years bearing children according to a current schedule of age-specific fertility rates’. Lower (or higher) mortality might induce lower (or higher) fertility, but it's well established that higher birth rates result in higher infant and child mortality. This higher mortality is said to the effect on infants and kids of earlier weaning and reduced care from mothers. Table-1 reveals that states like Assam, Bihar, Chhattisgarh, Gujarat, Haryana, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand with highest total fertility recorded had higher child mortality, while vice versa in states with lower total rate. Therefore, the total rate is inversely associated with child morbidity.

Birth order is that the chronological order of sibling births during a family. In general, higher the birth order, greater will be the child mortality because of mainly reproductive health issues. Singhi, S. et al (1989) found that increased risk of infant and child mortality was related to maternal age but 20 and over 30 years, birth order 4^th or higher. Table-1 reveals that states like Assam, Bihar, Chhattisgarh, Haryana, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, province and Uttarakhand with a higher percent of current live births by 4 and above birth order had registered higher child mortality rate and vice versa in the states with lower proportion of current live births having 4 and above birth order.

Birth interval is the duration of time between two consecutive live births. The preceding birth interval is the variance between birth date of the child and birth date of the preceding child in months. For children of multiple births, the birth date of the preceding child is the number of months since the end of the preceding pregnancy that ended in a live birth. In general, three years is the suggested birth interval for wellbeing of mother and children. Hobcraft, J. N., et al (1985) examined a number of indicators of spacing of adjacent births among the correlates of chances of survival for children below the age of five years. Table-1 reveals that states like Andhra Pradesh, Bihar, Gujarat, Haryana, Madhya Pradesh, Rajasthan and Uttarakhand with a higher percent of interval between current and previous live birth consisting only 10-12 months had a higher child mortality rate. Thus, lower the birth interval, greater will be the child mortality and vice versa.

A skilled birth attendant manages normal (uncomplicated) pregnancies, childbirth and therefore the immediate postnatal period, and within the identification, management and referral of complications in women and newborns. The share of births attended by skilled health personnel are calculated because the number of births attended by skilled health personnel (Doctors, Nurses or Midwives) expressed as a percentage of the entire number of births within the same period. The studies have known that the incidence of morbidity and mortality is high when a house is chosen to be the place of delivery attended by untrained dais and others (Haq, Ehsanul, 2008). Table-1 depicts those UT/states like Delhi, Kerala, Maharashtra, Punjab and Tamil Nadu registered with the highest percent of medical attention at delivery had a lower child mortality rate. Thus, medical attention at delivery is inversely associated with child morbidity in general.

If child mortality (under 5) is reduced, then eventually fertility reduction follows, with the net effect of lower growth of population. In determine the child mortality rate, apart from other factors, demographic aspects also play crucial role. Results show that infant mortality, age at marriage, mean age of fertility, total fertility rate, birth order, birth interval by current and previous live birth and medical attention at delivery are some of demographic determinants of child mortality in India. Hence, health policy-makers and medical profession dealing with child mortality should focus on demographic aspects along other intervention measures in controlling the child mortality rate in India. Finally, counseling on danger signs of the demographic aspects on child mortality are recommended for both mothers in laws and reproductive age females.