Sex-specific Trends in Under-five Mortality in Rural Ballabgarh

Objectives: To assess sex-specific differentials in child survival from 1992-2011. Methods: We analyzed data from the electronic database of Health and Demographic Surveillance System (HDSS) site in Ballabgarh in North India. Results: Sex ratio at birth was adverse for girls throughout the study period (821 to 866 girls per 1,000 boys) and was lowest in the period 2004-2006 at 821 girls per 1,000 boys. Overall, under-five mortality rates during the period 1992-2011 remained stagnant due to increasing neonatal mortality rate (9.2 to 27.7 P<0.001). Mortality rates among girls were consistently and significantly higher than boys during the post-neonatal period (160% to 200% higher) as well as in childhood (160% to 230% higher). Conclusions: Strategies to address the neonatal mortality and gender differences are required for further reductions in child mortality in India.