Assessing Child Health in India: Development and Validation of a Comprehensive Child Health Index

While developing a child health index is of interest, it is particularly important in the Indian context, because of a high burden of poor child health, the disparities in child health between different social, economic, and geographical regions and the absence of such a comprehensive index. This paper focuses on the development and validation of a Child Health Index (CHI) for India. Using publicly available data at the district level and principal component analysis, this index is composed of 16 variables representing six domains namely socio-cultural, child health status, determinants of child health (both risk and protective factors), household environment and health system and policy. Several statistical tests were conducted to provide internal and external validation. The application to predict child mortality confirmed its validation. This study thus provides a new tool for characterising child health and detecting child health inequalities at a district level in India. Consequently, it can be used by policymakers, health service providers and other stakeholders involved in child welfare to monitor and improve child health over time and space. center dot The existing Indian health indices need a social determinant framework and inclusion of different stages of life.center dot Proposed Child Health Index (CHI) is based on 16 indicators measuring parameters impacting birth, infancy, and childhood.center dot CHI has a strong theory-base, uses reliable indicators representing various complexity of child health, at small geographical level, it is computed using a robust statistical methodology.center dot CHI provides ranking for all districts of India. Based on the ranking policy makers can prioritize geographical areas for action and focus on indicators that falter in the area.