The relationship of household assets and amenities with child health outcomes: An exploratory cross-sectional study in India 2015–2016

Healthy development of children in India is far from ensured. Proximate
determinants of poor child health outcomes are infectious diseases and
undernutrition, which are linked to socioeconomic status. In low- and
middle-income countries, researchers rely on wealth indices, constructed
from information on households’ asset ownership and amenities, to study
socioeconomic disparities in child health. Some of these wealth index items
can, however, directly affect the proximate determinants of child health. This
paper explores the independent association of each item used to construct
the Demographic and Health Surveys’ wealth index with diverse child health
outcomes. This cross-sectional study used nationally representative sample
of 245,866 children, age 0-59 months, from the Indian National Family Health
Surveys conducted in 2015-16. The study used conditional Poisson regression
models as well as a range of sensitivity specifications. After controlling for
socioeconomic status, health care use, maternal factors, community-level
factors, and all wealth index items, the following wealth index items were the
most consistently associated with child health; type of toilet facilities, water
source, refrigerator, pressure cooker, type of cooking fuel, land usable for
agriculture, household building material, mobile phone, and motorcycle/
scooter. The association with type of toilet facilities and water source was
particularly strong for mortality, showing a 16-35% and 14-28% lower
mortality, respectively. Most items used to construct the Demographic and
Health Surveys’ wealth index only indicate household socioeconomic status,
while a few items may affect child health directly, and can be useful targets
for policy intervention.